高密度脂蛋白胆固醇与心血管风险研究进展

High-density Lipoprotein Cholesterol and Cardiovascular Risk

高密度脂蛋白胆固醇(HDL-C)被冠以"好胆固醇"的称号,公认是抗动脉粥样硬化的保护因子。而基因遗传的差异及升高HDL-C的药物临床试验的失败对这一"好胆固醇"认知提出挑战。此后更是有多项流行病学研究证实HDL-C水平与心血管疾病之间存在U型曲线关系,过高或过低的HDL-C水平均与心血管疾病风险增加有关。因此,为了进一步了解HDL-C与心血管风险之间的关系,研究者从关注HDL-C水平逐渐转为关注HDL-C结构和功能。以HDL-C结构和功能异常作为靶点,可能获得更多的治疗效益。

High-density lipoprotein cholesterol(HDL-C)has been termed as the ‘good cholesterol’ and has been seen as the protective factor of anti-atheroclerosis.However,this cognition was challenged by the differences of genetic mutation and the failure of raising HDL-C pharmacologically in clinical trials.Multiple epidemiological studies have provided strong evidence for U-curve relationship between the concentrations of HDL-C and cardiovascular disease,which both extreme high or extreme low concentrations were associated with increased risk of cardiovascular disease.Thus,researchers have gradually shifted from focusing on HDL-C concentrations to focusing on HDL-C structures and functions in order to learn more about the relationship between the HDL-C and cardiovascular risk.Targeting at the abnormalities of HDL-C structure and function may obtain more therapeutic benefits.