Klop Boudewijn, Proctor Spencer D, Mamo John C, Botham Kathleen M, Castro Cabezas Manuel
Department of Internal Medicine, Center for Diabetes and Vascular Medicine, Sint Franciscus Gasthuis, 3004 BA Rotterdam, The Netherlands.
Int J Vasc Med. 2012;2012:947417. doi: 10.1155/2012/947417. Epub 2011 Sep 25.
Postprandial hyperlipidemia with accumulation of remnant lipoproteins is a common metabolic disturbance associated with atherosclerosis and vascular dysfunction, particularly during chronic disease states such as obesity, the metabolic syndrome and, diabetes. Remnant lipoproteins become attached to the vascular wall, where they can penetrate intact endothelium causing foam cell formation. Postprandial remnant lipoproteins can activate circulating leukocytes, upregulate the expression of endothelial adhesion molecules, facilitate adhesion and migration of inflammatory cells into the subendothelial space, and activate the complement system. Since humans are postprandial most of the day, the continuous generation of remnants after each meal may be one of the triggers for the development of atherosclerosis. Modulation of postprandial lipemia by lifestyle changes and pharmacological interventions could result in a further decrease of cardiovascular mortality and morbidity. This paper will provide an update on current concepts concerning the relationship between postprandial lipemia, inflammation, vascular function, and therapeutic options.
餐后高脂血症伴残留脂蛋白蓄积是一种常见的代谢紊乱，与动脉粥样硬化和血管功能障碍相关，尤其是在肥胖、代谢综合征和糖尿病等慢性疾病状态下。残留脂蛋白附着于血管壁，可穿透完整的内皮细胞，导致泡沫细胞形成。餐后残留脂蛋白可激活循环白细胞，上调内皮黏附分子的表达，促进炎症细胞黏附并迁移至内皮下间隙，并激活补体系统。由于人类一天中大部分时间处于餐后状态，每餐之后持续产生的残留脂蛋白可能是动脉粥样硬化发生发展的触发因素之一。通过生活方式改变和药物干预来调节餐后血脂，可能会进一步降低心血管疾病的死亡率和发病率。本文将对有关餐后血脂、炎症、血管功能及治疗选择之间关系的当前概念进行更新。
