Yanai Hidekatsu, Katsuyama Hisayuki, Hamasaki Hidetaka, Abe Shinichi, Tada Norio, Sako Akahito
Department of Internal Medicine, National Center for Global Health and Medicine, Kohnodai Hospital, Chiba, Japan.
The Jikei University School of Medicine, Tokyo, Japan.
J Clin Med Res. 2015 Mar;7(3):145-9. doi: 10.14740/jocmr2030w. Epub 2014 Dec 29.
High-density lipoprotein (HDL) is a lipoprotein which has anti-atherogenic property by reversing cholesterol transport from the peripheral tissues to liver. Low HDL-cholesterol (HDL-C) as well as high low-density lipoprotein-cholesterol (LDL-C) is associated with the development of coronary heart diseases (CHD). Various epidemiological studies have suggested that the development of CHD increase in individuals with less than 40 mg/dL of HDL-C. In spite of accumulation of evidences suggesting a significant association between low HDL-C and CHD, effects of dietary factors on HDL metabolism remained largely unknown. We reviewed published articles about effects of dietary fat intake on HDL metabolism. The substitution of fatty acids (FA) for carbohydrates is beneficially associated with HDL metabolism. Monounsaturated FA intake may not affect HDL-C. Trans-FA is significantly associated with reduction of HDL-C, and is also adversely related with total cholesterol/HDL-C. Fish oils consumption, especially docosahexaenoic acid consumption, may be favorably associated with HDL metabolism. Although plant sterols and stanols may not affect HDL-C, policosanol intake is associated with a clinically significant decrease in the LDL/HDL ratio.
高密度脂蛋白（HDL）是一种脂蛋白，具有通过将胆固醇从外周组织逆向转运至肝脏来抗动脉粥样硬化的特性。低高密度脂蛋白胆固醇（HDL-C）以及高低密度脂蛋白胆固醇（LDL-C）与冠心病（CHD）的发生相关。各种流行病学研究表明，HDL-C低于40mg/dL的个体患冠心病的风险增加。尽管有大量证据表明低HDL-C与冠心病之间存在显著关联，但饮食因素对HDL代谢的影响在很大程度上仍不清楚。我们回顾了已发表的关于饮食脂肪摄入对HDL代谢影响的文章。用脂肪酸（FA）替代碳水化合物与HDL代谢呈有益关联。摄入单不饱和脂肪酸可能不会影响HDL-C。反式脂肪酸与HDL-C降低显著相关，并且也与总胆固醇/HDL-C呈负相关。食用鱼油，尤其是二十二碳六烯酸，可能与HDL代谢呈有利关联。尽管植物甾醇和甾烷醇可能不会影响HDL-C，但摄入多廿烷醇与LDL/HDL比值临床上的显著降低有关。
