Nutrition Department, Harvard T.H. Chan School of Public Health, 665 Huntington Ave, Boston 02115, USA.
Nutrition Department, Harvard T.H. Chan School of Public Health, 665 Huntington Ave, Boston, USA.
Biochim Biophys Acta Mol Cell Biol Lipids. 2022 Sep;1867(9):159182. doi: 10.1016/j.bbalip.2022.159182. Epub 2022 May 20.
HDL-cholesterol is associated with reduced risk of cardiovascular disease, and is used in clinical practice for risk stratification. HDL is composed of many protein-defined subspecies that each comprises just a few percent of the total, some associated with lower and some with higher risk of CVD. HDL that contains apoC3 or apoE are subspecies that have opposing actions on HDL reverse cholesterol transport and opposing associations with risk of future CVD, apoC3 adverse and apoE beneficial. In addition to coronary heart disease, HDL that contains apoC3 is associated with risk of future type 2 diabetes and insulin resistance; ischemic stroke and cerebral infarction; dementia and the deposition of beta-amyloid in the brain. HDL that contains apoE and apoE itself are associated with lower risk of dementia. Other HDL subspecies that contain complement C3, alpha-2 macroglobulin, plasminogen, or haptoglobin are associated with higher future risk of coronary heart disease, whereas others such as HDL that contains apoC1 are associated with lower risk. At this time, these findings provide improved understanding of the multifaceted HDL system to better determine risk and targeting of therapy for the most prevalent chronic lifestyle diseases in our society.
高密度脂蛋白胆固醇与心血管疾病风险降低有关，在临床实践中用于风险分层。高密度脂蛋白由许多蛋白质定义的亚类组成，每个亚类仅占总量的百分之几，有些与心血管疾病的风险较低有关，有些则与风险较高有关。含有载脂蛋白 C3 或载脂蛋白 E 的高密度脂蛋白是对高密度脂蛋白胆固醇逆向转运具有相反作用的亚类，与未来发生心血管疾病的风险也具有相反的关联，载脂蛋白 C3 为不利因素，载脂蛋白 E 则为有利因素。除了冠心病，含有载脂蛋白 C3 的高密度脂蛋白还与未来发生 2 型糖尿病和胰岛素抵抗的风险相关；缺血性卒中和脑梗死；痴呆症以及β-淀粉样蛋白在大脑中的沉积。含有载脂蛋白 E 和载脂蛋白 E 本身的高密度脂蛋白与痴呆症的风险较低有关。其他含有补体 C3、α-2 巨球蛋白、纤溶酶原或触珠蛋白的高密度脂蛋白亚类与未来发生冠心病的风险较高有关，而其他如含有载脂蛋白 C1 的高密度脂蛋白则与较低的风险相关。目前，这些发现为更好地确定我们社会中最常见的慢性生活方式疾病的风险和治疗靶点，提供了对多方面高密度脂蛋白系统的深入了解。
