Department of Nutrition, Harvard T.H. Chan School of Public Health.
Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA.
Curr Opin Lipidol. 2022 Feb 1;33(1):1-15. doi: 10.1097/MOL.0000000000000809.
Dietary fat compared to carbohydrate increases the plasma concentration of high-density lipoprotein (HDL)-cholesterol. However, neither the mechanism nor its connection to cardiovascular disease is known.
Protein-based subspecies of HDL, especially those containing apolipoprotein E (apoE) or apolipoprotein C3 (apoC3), offer a glimpse of a vast metabolic system related to atherogenicity, coronary heart disease (CHD) and other diseases. ApoE stimulates several processes that define reverse cholesterol transport through HDL, specifically secretion of active HDL subspecies, cholesterol efflux to HDL from macrophages involved in atherogenesis, size enlargement of HDL with cholesterol ester, and rapid clearance from the circulation. Dietary unsaturated fat stimulates the flux of HDL that contains apoE through these protective pathways. Effective reverse cholesterol transport may lessen atherogenesis and prevent disease. In contrast, apoC3 abrogates the benefit of apoE on reverse cholesterol transport, which may account for the association of HDL that contains apoC3 with dyslipidemia, obesity and CHD.
Dietary unsaturated fat and carbohydrate affect the metabolism of protein-defined HDL subspecies containing apoE or apoC3 accelerating or retarding reverse cholesterol transport, thus demonstrating new mechanisms that may link diet to HDL and to CHD.
与碳水化合物相比，饮食中的脂肪会增加高密度脂蛋白（HDL）-胆固醇的血浆浓度。然而，其机制及其与心血管疾病的关系尚不清楚。
富含载脂蛋白 E（apoE）或载脂蛋白 C3（apoC3）的 HDL 蛋白亚类为了解致动脉粥样硬化、冠心病（CHD）和其他疾病相关的庞大代谢系统提供了一个视角。ApoE 刺激了几个定义通过 HDL 进行胆固醇逆转运的过程，特别是具有活性的 HDL 亚类的分泌、胆固醇从参与动脉粥样硬化形成的巨噬细胞中流出到 HDL、胆固醇酯的 HDL 大小增大，以及从循环中快速清除。不饱和脂肪会刺激富含 apoE 的 HDL 的通量通过这些保护途径。有效的胆固醇逆转运可能会减轻动脉粥样硬化的发生并预防疾病。相比之下，apoC3 会破坏 apoE 对胆固醇逆转运的益处，这可能解释了含有 apoC3 的 HDL 与血脂异常、肥胖和 CHD 之间的关联。
不饱和脂肪和碳水化合物会影响富含 apoE 或 apoC3 的蛋白质定义的 HDL 亚类的代谢，加速或减缓胆固醇逆转运，从而展示了可能将饮食与 HDL 和 CHD 联系起来的新机制。
