Howard Barbara V, Ruotolo Giacomo, Robbins David C
MedStar Research Institute, 6495 New Hampshire Avenue, Suite 201, Hyattsville, MD 20783, USA.
Endocrinol Metab Clin North Am. 2003 Dec;32(4):855-67. doi: 10.1016/s0889-8529(03)00073-2.
The primary dyslipidemia related to obesity is characterized by increased triglycerides, decreased HDL levels, and abnormal LDL composition. Much work has been done to elucidate the pathogenesis of the dyslipidemia of obesity, which seems to be closely related to insulin resistance in obese individuals; however, more studies in humans are needed to further understand the metabolic mechanisms underlying the changes, and to distinguish between the roles of insulin resistance and body fat in the lipoprotein changes. The dyslipidemia associated with obesity no doubt plays a major role in the development of atherosclerosis and CVD in obese individuals. All of the components of the dyslipidemia, including higher triglycerides, decreased HDL levels, and increased small, dense LDL particles, have been shown to be atherogenic. Weight loss and exercise, even if they do not result in normalization of body weight, can improve this dyslipidemia and thus reduce CVD risk. In addition, obese individuals should be targeted for intense lipid-lowering therapy, when necessary.
与肥胖相关的原发性血脂异常的特征是甘油三酯升高、高密度脂蛋白水平降低以及低密度脂蛋白组成异常。为阐明肥胖血脂异常的发病机制已开展了大量工作，这似乎与肥胖个体的胰岛素抵抗密切相关；然而，还需要更多针对人类的研究，以进一步了解这些变化背后的代谢机制，并区分胰岛素抵抗和体脂在脂蛋白变化中的作用。与肥胖相关的血脂异常无疑在肥胖个体动脉粥样硬化和心血管疾病的发生发展中起主要作用。血脂异常的所有成分，包括较高的甘油三酯、降低的高密度脂蛋白水平以及增加的小而密低密度脂蛋白颗粒，均已被证明具有致动脉粥样硬化作用。体重减轻和运动，即使不能使体重恢复正常，也可改善这种血脂异常，从而降低心血管疾病风险。此外，必要时，肥胖个体应接受强化降脂治疗。
