高胆固醇血症:发病机制和病理生理意义

D. Vučević, Dragoslav Đorđević, M. Stanojevic, Bojan Jorgačević, Danka Đorović, Đ. Radak, T. Radosavljević
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摘要

在这篇综述中,我们提供了有关高胆固醇血症及其病理生理意义的最新文献数据和实用知识的概述。血脂水平升高(高脂血症)是全球人群中最常见的代谢性疾病。人们一致认为,高胆固醇血症、高血压和吸烟是动脉粥样硬化血栓形成的三个主要危险因素,其后果包括心脑血管疾病,是全世界发病率和死亡率的主要原因。与此相关,家族性高胆固醇血症是冠状动脉疾病最有害的前兆。这种最严重的高脂血症是指由于低密度脂蛋白(LDL)受体缺陷而导致的遗传性胆固醇代谢紊乱。此外,包括药物在内的许多因素都可以影响血脂状态,并显著促进继发性高脂血症的发生。因此,不适当的饮食、肥胖、糖尿病和饮酒通常与高血脂水平有关。因此,在开始降脂治疗之前,每个患有脂质疾病的患者都应该考虑高血脂的继发原因。考虑到未来脂质代谢紊乱的患病率增加,有必要采取预防措施减少危险因素(富含碳水化合物和饱和脂肪的不适当饮食、肥胖、吸烟、久坐不动的生活方式和缺乏身体活动)。然而,尽管已经开展了与这一医学问题相关的各种研究,但科学家们对这一问题的分子基础仍远未完全了解。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Hypercholesterolemias: Pathogenesis and pathophysiological implications
In this review, we provide an overview of recent literature data and practical knowledge related to hypercholesterolemias and their pathophysiological implications. Elevated blood lipid levels (hyperlipidaemias) are the most common metabolic disorders in global population. There is consensus regarding hypercholesterolemia, hypertension and cigarette smoking as the three main risk factors for atherothrombosis, with consequences such as cardiovascular and cerebrovascular diseases, being the leading cause of morbidity and mortality worldwide. In relation to this, familial hypercholesterolemia is the most deleterious precursor of coronary artery disease. This severest form of hyperlipidaemia refers to an inherited disorder of cholesterol metabolism due to defects in the receptor for low density lipoprotein (LDL). Besides, numerous factors, including drugs, can influence lipid status and significantly contribute to the development of secondary hypelipidaemias. Thus, inappropriate diet, obesity, diabetes mellitus and alcohol use, in particular, are commonly associated with high blood lipid levels. Therefore, secondary causes of high blood lipids should be considered in each patient with a lipid disorder before lipid-lowering therapy is started. Having in mind the increase of prevalence of lipid metabolism disorders in future, it is necessary to take preventive actions to decrease risk factors (inappropriate diet rich in carbohydrates and saturated fat, obesity, cigarette smoking, sedentary lifestyle and physical inactivity). However, although various studies related to this medical problem have been carried out, scientists are still far from a complete understanding of the molecular basis of this problem.
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