Laboratory of Endocrinology and Metabolism, West China Hospital, Sichuan University, Chengdu 610041, Sichuan, People's Republic of China.
Lipids Health Dis. 2010 Oct 17;9:118. doi: 10.1186/1476-511X-9-118.
HDL particles possess multiple antiatherogenic activities and the identification and differentiation of individual HDL subclasses may be useful in documentation and understanding of metabolic changes of different HDL subclasses. The major plasma lipids exist and are transported in the form of lipoprotein complexes. Hence, alterations in plasma lipids levels can interfere with the composition, content, and distribution of plasma lipoprotein subclasses that affect atherosclerosis risk. The research review major discussed the relationship between plasma lipids levels and HDL subclasses distribution. The general shift toward smaller size of HDL particle size in HTG, HCL and MHL subjects, and the changes were more prominent with the elevation of TG and TC levels which imply that HDL maturation might be abnormal and RCT pathway might be weaken, and these changes were more seriously in MHL subjects. Plasma contents of small sized HDL particles significantly higher, whereas those of large sized HDL particles were significantly lower with elevation of TG/HDL-C and TC/HDL-C ratios. Increased in the TC/HDL-C ratio alone did not influence the distributions of HDL subclasses significantly when the TG/HDL-C ratio was low (TG/HDL-C ≤ 2.5). Hence, the TG/HDL-C ratio might be more sensitive to reflect the alteration of HDL subclass distribution than the TC/HDL-C ratio. In LDL-C/HDL-C ≤ 2.3 group, the pattern of distribution in HDL subclass was in agreement with the normolipidemic subjects. Moreover, considering the relative ease of measuring TC/HDL-C, TG/HDL-C and LDL-C/HDL-C ratios, as opposed to measuring HDL subclasses, these 3 ratios together may be a good indicator of HDL subclass distribution. The protective effect of increased apoA-I levels against the reduction of HDL(2b) caused by elevated TG concentration. On one hand, plasma HDL-C and apoA-I appear to play a coordinated role in the assembly of HDL particles and the determination of their contents among the total subjects. On the other hand, the apoA-I level might be a more powerful factor than HDL-C to influence the distribution of HDL subclasses in hyperlipidemic subjects. At the same time, from point of HDL subclasses distribution, the plasma lipids, apos concentrations and apos ratios should be considered while assessing the CHD risk. Abnormality of HDL subclasses distribution may result in accelerated atherosclerosis, therapeutic normalization of attenuated antiatherogenic HDL function in terms of both particle number and distribution of HDL particles is the target of innovative pharmacological approaches to large-sized HDL particles rising, including enhanced apoA-I levels.
高密度脂蛋白(HDL)颗粒具有多种抗动脉粥样硬化作用,鉴定和区分不同的 HDL 亚类可能有助于记录和理解不同 HDL 亚类的代谢变化。主要的血浆脂质以脂蛋白复合物的形式存在和运输。因此,血浆脂质水平的改变可能会干扰不同 HDL 亚类的组成、含量和分布,从而影响动脉粥样硬化的风险。本研究综述主要讨论了血浆脂质水平与 HDL 亚类分布的关系。在 HTG、HCL 和 MHL 患者中,HDL 颗粒大小普遍向较小的方向转变,并且随着 TG 和 TC 水平的升高,变化更加明显,这意味着 HDL 成熟可能异常,RCT 途径可能减弱,而在 MHL 患者中,这些变化更为严重。随着 TG/HDL-C 和 TC/HDL-C 比值的升高,小而密的 HDL 颗粒的血浆含量显著升高,而大而密的 HDL 颗粒的血浆含量显著降低。当 TG/HDL-C 比值较低(TG/HDL-C≤2.5)时,仅增加 TC/HDL-C 比值不会显著影响 HDL 亚类的分布。因此,与 TC/HDL-C 比值相比,TG/HDL-C 比值可能更敏感地反映 HDL 亚类分布的改变。在 LDL-C/HDL-C≤2.3 组中,HDL 亚类的分布模式与正常血脂组一致。此外,考虑到测量 TC/HDL-C、TG/HDL-C 和 LDL-C/HDL-C 比值比测量 HDL 亚类相对容易,这 3 个比值一起可能是 HDL 亚类分布的一个很好的指标。apoA-I 水平的升高对 TG 浓度升高导致的 HDL(2b)减少的保护作用。一方面,血浆 HDL-C 和 apoA-I 似乎在 HDL 颗粒的组装和总人群中 HDL 颗粒含量的确定中发挥协调作用。另一方面,apoA-I 水平可能是比 HDL-C 更有力的因素,影响高脂血症患者 HDL 亚类的分布。同时,从 HDL 亚类分布的角度来看,在评估 CHD 风险时应考虑血浆脂质、载脂蛋白浓度和载脂蛋白比值。HDL 亚类分布异常可能导致动脉粥样硬化加速,从 HDL 颗粒数量和分布两方面治疗减弱的抗动脉粥样硬化 HDL 功能的正常化,是提高大颗粒 HDL 水平的创新药理学方法的目标,包括增强 apoA-I 水平。