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高密度脂蛋白胆固醇是否可以预防心血管疾病?

Alexander C Razavi¹, Vardhmaan Jain¹, Gowtham R Grandhi²

¹Emory Clinical Cardiovascular Research Institute, Emory University School of Medicine, Atlanta, GA 30322, USA.

The Journal of clinical endocrinology and metabolism

|July 12, 2023

概括

高密度脂蛋白胆固醇 (HDL-C) 可能不是对动脉样硬化心血管疾病 (ASCVD) 的普遍保护因素. 矛盾的是,非常高的HDL-C水平与增加的死亡率有关,这表明在ASCVD风险中扮演着复杂的角色.

科学领域:

心血管医学心血管医学
脂质代谢脂质代谢是什么
动脉样硬化研究动脉样硬化研究

背景情况:

高密度脂蛋白 (HDL) 和高密度脂蛋白胆固醇 (HDL-C) 传统上与逆胆固醇运输和降低动脉样硬化心血管疾病 (ASCVD) 风险有关.
旨在增加HDL-C的治疗干预措施未能在接受他类药物治疗的患者中减少ASCVD事件.
门德尔随机化研究质疑HDL-C在ASCVD风险中的直接因果作用.

研究的目的:

重新评估HDL-C对ASCVD风险评估的贡献.
检查HDL-C水平和ASCVD之间的复杂关系.
讨论HDL-C在ASCVD风险评估,治疗和预防中的未来作用.

主要方法:

对HDL-C的生物功能和规范值的审查.
对HDL-C和ASCVD风险的流行病学研究的分析.
检查最近关于非常高的HDL-C水平和死亡率的证据.

主要成果:

传统的HDL-C作为一种保护因素的观点受到最近发现的挑战.
在HDL-C和亚临床动脉样硬化之间存在非线性U形关系.
非常高的HDL-C水平 (男性≥80 mg/dL,女性≥100 mg/dL) 矛盾地与所有原因和ASCVD死亡率的增加有关.

结论:

HDL-C并不是一种普遍的预防动脉样硬化的保护因素.
在ASCVD风险评估中HDL-C的作用需要重新定义.
需要进一步的研究来澄清HDL-C在动脉样硬化和临床ASCVD中的确切作用.

关键词:

在HDL胆固醇.亚脂蛋白 A-I 是一种非脂蛋白.心血管疾病心血管疾病脂质脂质脂质是一种脂蛋白质是一种脂蛋白质.风险评估风险评估风险评估

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