Division of Chemical Pathology and MRC Cape Heart Group, University of Cape Town, 6·33 Falmouth Building, UCT Health Science Faculty, Anzio Rd, Observatory 7925, South Africa.
Proc Nutr Soc. 2013 Aug;72(3):337-41. doi: 10.1017/S0029665113001298. Epub 2013 May 17.
The aim of this review is to place a historical perspective on linking dyslipidaemia with atherosclerosis and emphasises previous knowledge about the impact on the lipoprotein profile and health in persons with mild dyslipidaemia and in those with defined genetic disorders. CVD is becoming the leading cause of death and disability in developed and developing countries and is strongly related to lifestyle factors that influence plasma lipoprotein concentrations. It is established that risk of complications from atherosclerosis increases with increasing LDL and decreasing HDL and that there is potentiation of risk when these and other risk factors co-exist. High-fat diets used for losing body mass may increase risk through dyslipidaemia. Pharmaceutical modulation of the lipoproteins has lowered risk powerfully but residual risk persists, possibly relating to existing disease as well as progression relating in many instances to dietary lipids. The impact of various dietary lipids is reviewed as they relate to the conventional lipoprotein profile in persons who do not have significant metabolic defects, as well as the impact on inherited metabolic disease such as familial hypercholesterolaemia, hypertriglyceridaemia and phytosterolaemia. For most persons with dyslipidaemias a significant benefit will be seen on the lipid profile by adopting a low saturated fat diet with less cholesterol intake.
本综述旨在从历史角度探讨血脂异常与动脉粥样硬化的关系，并强调了人们之前对血脂异常患者（包括血脂轻度异常者和具有明确遗传疾病者）脂蛋白谱和健康影响的认识。心血管疾病在发达国家和发展中国家已成为导致死亡和残疾的主要原因，其与影响血浆脂蛋白浓度的生活方式因素密切相关。大量研究证实，动脉粥样硬化并发症的风险随着 LDL 升高和 HDL 降低而增加，当这些风险因素与其他风险因素并存时，风险会进一步增加。用于减轻体重的高脂肪饮食可能会通过血脂异常增加风险。通过药物调节脂蛋白可以有力地降低风险，但仍存在残余风险，这可能与现有疾病以及在许多情况下与饮食脂质相关的进展有关。本文综述了各种饮食脂质对无明显代谢缺陷者的传统脂蛋白谱的影响，以及对家族性高胆固醇血症、高三酰甘油血症和植物固醇血症等遗传性代谢疾病的影响。对于大多数血脂异常患者，采用低饱和脂肪、低胆固醇饮食可显著改善血脂谱。
