Brownell Nicholas, Rohatgi Anand
Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, Texas, USA.
Curr Opin Lipidol. 2016 Aug;27(4):398-407. doi: 10.1097/MOL.0000000000000317.
Low HDL-cholesterol (HDL-C) levels are predictive of incident atherosclerotic cardiovascular disease events. However, the use of medication to raise HDL-C levels has not consistently shown clinical benefit. As a result, studies have shifted toward HDL function, specifically cholesterol efflux, which has been inversely associated with prevalent subclinical atherosclerosis as well as subsequent atherosclerotic cardiovascular disease events. The purpose of this review is to summarize the effects of current medications and interventions on cholesterol efflux capacity.
Medications for cardiovascular health, including statins, fibrates, niacin, and novel therapeutics, are reviewed for their effect on cholesterol efflux. Differences in population studied and assay used are addressed appropriately. Lifestyle interventions, including diet and exercise, are also included in the review.
The modification of cholesterol efflux capacity (CEC) by current medications and interventions has been investigated in both large randomized control trials and smaller observational cohorts. This review serves to compile the results of these studies and evaluate CEC modulation by commonly used medications. Altering CEC could be a novel therapeutic approach to improving cardiovascular risk profiles.
低高密度脂蛋白胆固醇（HDL-C）水平可预测动脉粥样硬化性心血管疾病事件的发生。然而，使用药物提高HDL-C水平并未始终显示出临床益处。因此，研究已转向HDL功能，特别是胆固醇流出，其与普遍存在的亚临床动脉粥样硬化以及随后的动脉粥样硬化性心血管疾病事件呈负相关。本综述的目的是总结当前药物和干预措施对胆固醇流出能力的影响。
对包括他汀类药物、贝特类药物、烟酸和新型疗法在内的心血管健康药物对胆固醇流出的影响进行了综述。适当讨论了所研究人群和所用检测方法的差异。生活方式干预，包括饮食和运动，也纳入了综述。
目前已在大型随机对照试验和较小的观察性队列中研究了药物和干预措施对胆固醇流出能力（CEC）的影响。本综述旨在汇总这些研究结果，并评估常用药物对CEC的调节作用。改变CEC可能是改善心血管风险状况的一种新的治疗方法。
