Leança Camila Canteiro, Passarelli Marisa, Nakandakare Edna R, Quintão Eder C R
Laboratório de Lípides, Disciplina de Endocrinologia e Metabologia, Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo, SP, Brasil.
Arq Bras Endocrinol Metabol. 2010 Dec;54(9):777-84. doi: 10.1590/s0004-27302010000900002.
Epidemiological studies demonstrate an inverse correlation between plasma HDL-cholesterol (HDL-C) concentration and incidence of cardiovascular disease (CVD). The antiatherogenic role of HDL has been attributed to its anti-inflammatory, antithrombotic and antioxidant properties, besides its participation in the reverse cholesterol transport (RCT), whereby cholesterol from peripheral tissues (including macrophages of the arterial intima) is delivered to the liver for excretion in bile. Due to these actions, HDL-C has evolved as an attractive target for prevention of CVD. However, the failure of torcetrapib, drug that substantially increases HDL-C levels, in preventing CVD and data from studies with animal models and with carriers of monogenic disorders affecting HDL-C levels in humans provide conflicting data about HDL being antiatherogenic. This review addresses the current state of knowledge regarding HDL based on these recent controversies.
流行病学研究表明，血浆高密度脂蛋白胆固醇（HDL-C）浓度与心血管疾病（CVD）发病率呈负相关。HDL的抗动脉粥样硬化作用不仅归因于其抗炎、抗血栓形成和抗氧化特性，还归因于其参与逆向胆固醇转运（RCT），即外周组织（包括动脉内膜巨噬细胞）中的胆固醇被输送到肝脏以便通过胆汁排泄。由于这些作用，HDL-C已成为预防CVD的一个有吸引力的靶点。然而，托彻普（一种能大幅提高HDL-C水平的药物）在预防CVD方面的失败，以及动物模型研究和影响人类HDL-C水平的单基因疾病携带者的研究数据，提供了关于HDL是否具有抗动脉粥样硬化作用的相互矛盾的数据。本综述基于这些近期的争议探讨了关于HDL的当前知识状态。
