Department of Nutritional Sciences, University of Connecticut, Storrs, CT 06269, USA.
Nutrients. 2012 Aug;4(8):1015-25. doi: 10.3390/nu4081015. Epub 2012 Aug 17.
The associations between dietary cholesterol and heart disease are highly controversial. While epidemiological studies and clinical interventions have shown the lack of correlation between cholesterol intake and cardiovascular disease (CVD) risk, there is still concern among health practitioners and the general population regarding dietary cholesterol. In this review, several clinical studies utilizing cholesterol challenges are analyzed in terms of changes that occur in lipoprotein metabolism resulting from excess consumption of cholesterol. Dietary cholesterol has been shown to increase both LDL and HDL in those individuals who respond to a cholesterol challenge without altering the LDL cholesterol/HDL cholesterol ratio, a key marker of CVD risk. Further, dietary cholesterol has been shown to increase only HDL with no changes in LDL with average cholesterol consumption and during weight loss interventions. Ingestion of cholesterol has also been shown to increase the size of both LDL and HDL particles with the associated implications of a less atherogenic LDL particle as well as more functional HDL in reverse cholesterol transport. Other changes observed in lipoprotein metabolism are a greater number of large LDL and decreases in small LDL subfractions. All this information put together points to specific roles of dietary cholesterol in substantially altering intravascular processing of lipoproteins as well as reverse cholesterol transport.
膳食胆固醇与心脏病之间的关联存在很大争议。尽管流行病学研究和临床干预表明胆固醇摄入与心血管疾病（CVD）风险之间缺乏相关性，但在卫生从业人员和普通人群中，仍对膳食胆固醇存在担忧。在这篇综述中，分析了几项利用胆固醇挑战的临床研究，以评估过量摄入胆固醇对脂蛋白代谢的影响。膳食胆固醇已被证明会增加 LDL 和 HDL，而不会改变 LDL 胆固醇/HDL 胆固醇比值，这是 CVD 风险的关键标志物。此外，膳食胆固醇仅在平均胆固醇摄入量和减肥干预期间增加 HDL，而不会改变 LDL。胆固醇的摄入还会增加 LDL 和 HDL 颗粒的大小，从而使 LDL 颗粒的致动脉粥样硬化性降低，以及逆胆固醇转运中更具功能的 HDL。脂蛋白代谢中观察到的其他变化是 LDL 数量增加和小 LDL 亚组分减少。所有这些信息表明，膳食胆固醇在很大程度上改变了脂蛋白在血管内的处理以及逆胆固醇转运过程中具有特定的作用。
