University of Patras Medical School, Department of Medicine, Pharmacology Unit, Rio, TK, Greece.
Atherosclerosis. 2010 Jan;208(1):3-9. doi: 10.1016/j.atherosclerosis.2009.05.034. Epub 2009 Jun 6.
Coronary heart disease (CHD) is a leading cause of death in western societies. In the last few decades, a number of epidemiological studies have shown that a disproportion between atheroprotective and atherogenic lipoproteins in plasma is one of the most important contributors towards atherosclerosis and CHD. Thus, based on the classical view, reduced HDL cholesterol levels independently predict one's risk factor for developing cardiovascular disease, while elevated HDL levels protect from atherosclerosis. However, more recent studies have suggested that the relationship between HDL and cardiovascular risk is more complex and extends beyond the levels of HDL in plasma. These studies challenge the existing view on HDL and cardiovascular risk and trigger a discussion as to whether low HDL is a causal effect for the development of heart disease. In this article we provide a review of the current literature on the biogenesis of HDL and its proposed functions in atheroprotection. In addition, we discuss the significance of both HDL quality and quantity in assessing cardiovascular risk.
冠心病（CHD）是西方社会的主要死亡原因。在过去的几十年中，许多流行病学研究表明，血浆中具有抗动脉粥样硬化作用和动脉粥样硬化作用的脂蛋白之间的不平衡是动脉粥样硬化和 CHD 的最重要贡献因素之一。因此，根据经典观点，降低 HDL 胆固醇水平可独立预测一个人患心血管疾病的风险因素，而升高的 HDL 水平可预防动脉粥样硬化。然而，最近的研究表明，HDL 与心血管风险之间的关系更加复杂，并且超出了血浆中 HDL 的水平。这些研究挑战了现有关于 HDL 和心血管风险的观点，并引发了关于低 HDL 是否是心脏病发展的因果效应的讨论。在本文中，我们回顾了有关 HDL 的生物发生及其在抗动脉粥样硬化保护中提出的功能的当前文献。此外，我们还讨论了评估心血管风险时 HDL 质量和数量的重要性。
