Whyte Martin B
Diabetes and Metabolic Medicine, University of Surrey, Guildford, UK.
JRSM Cardiovasc Dis. 2019 Aug 12;8:2048004019869736. doi: 10.1177/2048004019869736. eCollection 2019 Jan-Dec.
Epidemiological data strongly support the inverse association between high-density lipoprotein cholesterol concentration and cardiovascular risk. Over the last three decades, pharmaceutical strategies have been partially successful in raising high-density lipoprotein cholesterol concentration, but clinical outcomes have been disappointing. A recent therapeutic class is the cholesteryl ester transfer protein inhibitor. These drugs can increase circulating high-density lipoprotein cholesterol levels by inhibiting the exchange of cholesteryl ester from high-density lipoprotein for triacylglycerol in larger lipoproteins, such as very low-density lipoprotein and low-density lipoprotein. Recent trials of these agents have not shown clinical benefit. This article will review the evidence for cardiovascular risk associated with high-density lipoprotein cholesterol and discuss the implications of the trial data for cholesteryl ester transfer protein inhibitors.
流行病学数据有力地支持了高密度脂蛋白胆固醇浓度与心血管风险之间的负相关关系。在过去三十年中，药物策略在提高高密度脂蛋白胆固醇浓度方面取得了部分成功，但临床结果却令人失望。最近一类治疗药物是胆固醇酯转运蛋白抑制剂。这些药物可通过抑制高密度脂蛋白中的胆固醇酯与较大脂蛋白（如极低密度脂蛋白和低密度脂蛋白）中的三酰甘油进行交换，从而提高循环中的高密度脂蛋白胆固醇水平。近期对这些药物的试验尚未显示出临床益处。本文将综述与高密度脂蛋白胆固醇相关的心血管风险证据，并讨论试验数据对胆固醇酯转运蛋白抑制剂的影响。
