Zhao Yixi, Liu Longtao, Yang Shengjie, Liu Guijian, Pan Limin, Gu Chun, Wang Yang, Li Dan, Zhao Ran, Wu Min
Comprehensive Department, Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China.
Cardiovascular Department, Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, China.
Front Cardiovasc Med. 2021 Apr 29;8:636947. doi: 10.3389/fcvm.2021.636947. eCollection 2021.
Postprandial lipemia plays an important role in the formation, occurrence, and development of atherosclerosis, and it is closely related to coronary heart disease and other diseases involving endothelial dysfunction, oxidative stress, inflammation, and other mechanisms. Therefore, it has become a focus area for further research. The studies on postprandial lipemia mainly include TG, TRL, VLDL, CM, and remnant cholesterol. Diurnal triglyceride patterns and postprandial hyperlipidemia are very relevant and are now insufficiently covered. The possible mechanisms between postprandial lipemia and cardiovascular disease have been reviewed in this article by referring to relevant literature in recent years. The research progress on the effects of postprandial lipemia on endothelial function, oxidative stress, and inflammation is highlighted. The intervention of postprandial lipemia is discussed. Non-medicinal intervention such as diet and exercise improves postprandial lipemia. As medicinal intervention, statin, fibrate, ezetimibe, omega-3 fatty acids, and niacin have been found to improve postprandial lipid levels. Novel medications such as pemafibrate, PCSK9, and apoCIII inhibitors have been the focus of research in recent years. Gut microbiota is closely related to lipid metabolism, and some studies have indicated that intestinal microorganisms may affect lipid metabolism as environmental factors. Whether intervention of gut microbiota can reduce postprandial lipemia, and therefore against AS, may be worthy of further study.
餐后血脂异常在动脉粥样硬化的形成、发生和发展中起重要作用,且与冠心病及其他涉及内皮功能障碍、氧化应激、炎症等机制的疾病密切相关。因此,它已成为进一步研究的重点领域。关于餐后血脂异常的研究主要包括甘油三酯(TG)、乳糜微粒(TRL)、极低密度脂蛋白(VLDL)、乳糜微粒(CM)和残余胆固醇。日间甘油三酯模式和餐后高脂血症密切相关,目前对此研究不足。本文通过参考近年来的相关文献,综述了餐后血脂异常与心血管疾病之间可能的机制。重点介绍了餐后血脂异常对内皮功能、氧化应激和炎症影响的研究进展。讨论了餐后血脂异常的干预措施。饮食和运动等非药物干预可改善餐后血脂异常。作为药物干预,已发现他汀类药物、贝特类药物、依折麦布、ω-3脂肪酸和烟酸可改善餐后血脂水平。近年来,新型药物如匹伐他汀、前蛋白转化酶枯草溶菌素9(PCSK9)和载脂蛋白CIII(apoCIII)抑制剂一直是研究的重点。肠道微生物群与脂质代谢密切相关,一些研究表明肠道微生物可能作为环境因素影响脂质代谢。肠道微生物群的干预是否能降低餐后血脂异常,从而预防动脉粥样硬化,可能值得进一步研究。