Baylor College of Medicine, Baylor Clinic, Houston, TX, 77030, USA.
Curr Atheroscler Rep. 2011 Apr;13(2):107-14. doi: 10.1007/s11883-011-0166-3.
High-density lipoprotein (HDL) is classified as a negative risk factor due to the inverse relationship between elevated levels of HDL cholesterol and atherosclerosis. The mechanism by which HDL can mediate protection from atherosclerosis is complex and multifactorial. The primary role of reverse cholesterol transport in the reduction of risk for coronary artery disease is supported by a considerable amount of experimental data. HDL is able to interact with and remove cholesterol from the lipid-laden foam cells in the peripheral vasculature with subsequent transportation to the liver for excretion. However, HDL has multiple other physiologic effects that may play a significant role in protection from atherosclerosis. HDL has been demonstrated to exhibit multiple beneficial effects on the coagulation system. Platelet function is improved by both direct and indirect mechanisms. HDL has a complex interaction with the protein C and protein S system. Thrombolytic balance is also improved by HDL. HDL has been demonstrated to have a significant natural antioxidant effect that inhibits the oxidative step required for low-density lipoprotein uptake by the macrophage. Additionally, HDL has also been demonstrated to exert multiple beneficial effects on endothelial function, including decreased apoptosis and endothelial repair.
高密度脂蛋白（HDL）被归类为负风险因素，因为 HDL 胆固醇水平升高与动脉粥样硬化之间存在反比关系。HDL 能够介导对动脉粥样硬化的保护作用的机制复杂且多因素。大量的实验数据支持胆固醇逆向转运在降低冠心病风险中的主要作用。HDL 能够与富含脂质的泡沫细胞相互作用并从外周血管中去除胆固醇，随后将其运输到肝脏进行排泄。然而，HDL 还有多种其他生理作用，可能在保护动脉粥样硬化方面发挥重要作用。HDL 已被证明对凝血系统具有多种有益作用。血小板功能通过直接和间接机制得到改善。HDL 与蛋白 C 和蛋白 S 系统有复杂的相互作用。纤溶平衡也得到了 HDL 的改善。HDL 已被证明具有显著的天然抗氧化作用，可抑制巨噬细胞摄取低密度脂蛋白所需的氧化步骤。此外，HDL 还对内皮功能产生多种有益作用，包括减少细胞凋亡和内皮修复。
