High density lipoprotein--quality and function.
نویسنده
چکیده
Introduction Atherosclerosis is a focal disease of the large and medium sized arteries in areas of disturbed blood flow caused by endothelial injury, dysfunction and local inflammation [1]. Coronary heart disease (CHD) is the most common cause of death in western countries and in developing countries it accounts for over 4.5 million deaths annually [2]. Dyslipidaemia has been identified as a main cause of CHD and in particular an imbalance between the atherothrombotic (LDL-c and lipoprotein remnants) and atheroprotective (HDL-c) lipoproteins in plasma [3]. Reverse cholesterol transport has been described as a major function of high density lipoprotein (HDL) for the last few decades. In addition HDL also exerts antioxidant, antiinflammatory and antithrombotic properties. HDL functions against lipid peroxidation, alters the expression of cytokines and endothelial function, acts as an acceptor for oxidized phospholipids, blocks oxidation of apo B lipoproteins and opposes insulin resistance [4, 5]. When acute phase or chronic inflammatory response is present as in atherosclerosis, HDL can be proinflammatory and proatherogenic. Plasma HDL level is an inverse predictor of future atherothrombotic events. The Framingham study (HDL concentrations predicting cardiovascular risk) shows that 40% of events occurred in people with normal HDL levels [6]. In some instances increased plasma HDL levels can result from reduced catabolism due to blockage in the dynamic flow of HDL lipids from peripheral tissues to the liver [7]. In this scenario, measuring HDL levels alone may not be accurate in assessing the cardiovascular risk. This has raised the question of whether measuring HDL quality rather than quantity would help in better prediction of atherosclerotic coronary artery disease.
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عنوان ژورنال:
- The Ceylon medical journal
دوره 56 2 شماره
صفحات -
تاریخ انتشار 2011