Cardioprotective Properties of HDL: Structural and Functional Considerations

doi:10.2174/0929867326666190201142321
摘要

背景: 由于孟德尔随机化(MR)研究显示，改变高密度脂蛋白-胆固醇(HDL-C)水平的变异对心血管疾病(CVD)没有影响，而旨在提高HDL-C的新治疗干预措施导致无效，HDL-C的作用尚不清楚。目的:HDL- C的作用目前尚不明确，因此认为HDL的抗动脉粥样硬化作用可能与HDL颗粒的数量以及其脂质和蛋白质成分等特性有关。科学兴趣集中在高密度脂蛋白的功能和使高密度脂蛋白颗粒功能失调的原因上，然而高密度脂蛋白亚类与心血管疾病的相关性仍然存在争议。方法: 本文讨论了病理条件下高密度脂蛋白质量和数量的变化，以及高密度脂蛋白颗粒浓度与心血管疾病和死亡率之间的联系。重点是关于胆固醇外排能力和决定HDL功能的参数的最新数据，以及关于HDL亚类与心血管死亡率的最新调查。结果: 针对HDL-C的MR研究或药物干预都不支持HDL-C水平假说以及与CVD的关系。寻找与HDL功能相关的生物标记是必要的。同样，高密度脂蛋白颗粒的大小和数量在心血管疾病中表现出有争议的数据，需要进一步的研究。结论: HDL作为良方的旧概念是站不住脚的，因为HDL- C不能被认为是一个强大的标记，并不能反映HDL颗粒大小和数量的重要性。阐明复杂的HDL系统，以及生物标记的发现，将允许任何HDL靶向治疗的发展。
关键词: 高密度脂蛋白，胆固醇外排能力，高密度脂蛋白亚分数，高密度脂蛋白颗粒数，功能障碍高密度脂蛋白，动脉粥样硬化。
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DOI https://dx.doi.org/10.2174/0929867326666190201142321	Print ISSN 0929-8673
Publisher Name Bentham Science Publisher	Online ISSN 1875-533X
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