Kwa zaka makumi angapo, zakhala ngati chiphunzitso cha HDL cholesterol ndi "chabwino" cha cholesterol, chomwe chimapangitsa kuti ma HDL anu akhale otsika kwambiri, komanso kuti kukulitsa ma CDS m'thupi mwawo ndilo lingaliro labwino kwambiri. Koma zotsatira zokhumudwitsa kuchokera m'mayesero angapo aposachedwapa a zachipatala apeza kuti chiphunzitsochi n'chokayikira.
N'chifukwa Chiyani HDL Imayesedwa "Yabwino"
Cholesterol cha HDL chikuganiziridwa kuti chimayambitsa cholesterol kwambiri kuchokera pamakona a mitsempha ya magazi, motero imachotsa komwe ingapangitse ku matenda a atherosclerosis .
Kuwonjezera apo, pa matenda opatsirana ndi anthu oposa 100,000, anthu omwe ali ndi matenda a HDL a m'magazi aliwonse oposa 40 mg / dl ali ndi chiopsezo chachikulu cha mtima kusiyana ndi omwe ali ndi magulu akuluakulu a HDL. Izi ndizomwe ngakhale pamene LDL cholesterol (ma "choipa" cha ma cholesterol) ali otsika. MaseĊµera a HDL apamwamba akhala akugwirizanitsidwa ndi chiopsezo chochepa cha khansa, yamatenda ndi mapapo.
Kuchokera ku maphunziro amenewa kumabwera chikhulupiliro chakuti kutenga njira zowonjezera miyezo ya HDL ndi lingaliro labwino. Izi ndi zomwe zimatchedwa HDL hypothesis: zimakwera madigiri anu a HDL, kuchepetsa vuto lanu la mtima.
Kodi Mipingo ya HDL Ingapitirire Bwanji?
MaseĊµera a HDL amawoneka kuti amakhudzidwa kwambiri ndi chisakanizo cha zamoyo ndi zachilengedwe. Akazi amakonda kukhala ndi ma leveler a HDL kuposa amuna (mwa pafupifupi 10 mg / dL).
Anthu omwe ali olemera kwambiri, odwala kwambiri, kapena odwala matenda a shuga kapena matenda amadzimadzi amakhala ndi otsika kwambiri a HDL.
Mowa amaoneka kuti akuwonjezera HDL ndi pang'ono; Mafuta otsekemera mu zakudya amachepetsa.
Mankhwala omwe amagwiritsidwa ntchito kuchepetsa cholesterol cha LDL amakhala ndi zotsatira zochepa pa ma HDL. Statins , mankhwala osokoneza bongo wa kolesterolini, amachulukitsa HDL pokhapokha.
Mafuta ndi nkhono amachulukitsa HDL ndi kuchuluka kwa ndalama.
Kawirikawiri, chifukwa palibe mankhwala omwe amachititsa kuti kuwonjezeka kwa HDL kuwonjezedwe, malingaliro pa kuwonjezera cholesterol ya HDL yakhala ikuyang'anizana ndi kulemera kwa thupi ndi kupeza masewera olimbitsa thupi, ndi kusokonezeka kwa zakudya zomwe zimaperekedwa.
Kutaya Madzi pa HDL Hypothesis
Chifukwa chakuti kuchuluka kwa magulu a HDL akuganiziridwa kuti ndi kopindulitsa kwambiri, ndipo chifukwa palibe njira yosavuta kapena yodalirika yochitira zimenezi, kupanga mankhwala omwe amachititsa kuti vidiyo HDL ikhale cholinga chachikulu kwa makampani angapo a mankhwala. Ndipo ndithudi, mankhwala ena ambiri apangidwa, ndipo athandizidwa ku mayesero a zachipatala kuti asonyeze kuti ali otetezeka komanso ogwira ntchito.
Pakalipano, maphunziro awa akhala akukhumudwitsa, kunena pang'ono. Chiyeso chachikulu choyambirira (chomaliza mu 2006) ndi CETP yoyamba inhibitor mankhwala, torcetrapib (kuchokera Pfizer), sanangowonetsera kuchepetsa chiopsezo pamene HDL anawonjezeka koma makamaka anasonyeza kuwonjezeka kwa mtima mavuto. Phunziro lina ndi CETP inhibitor - dalcetrapib (yochokera ku Roche) - linaimitsidwa mu May 2012 chifukwa chosowa ntchito. Zotsatira zonsezi zowonjezera ma CDL, koma kuchita izi sizinapangitse phindu lililonse.
Phunziro lina lochititsa manyazi (AIM-HIGH) linasindikizidwa mu 2011, pofufuza ubwino wowonjezeretsa niacin (kuwonjezera ma level HDL) kuchipatala. Phunziroli silinayambe kusonyeza ubwino uliwonse pakuwonjezeka kwa vidiyo ya HDL ndi niacin komanso kunanenanso kuti chiopsezo cha stroke chinawonjezeka pakati pa odwala kutenga nicacin.
Pomaliza, kufufuza komwe kunachitika ku Lancet mu 2012 kunayesa ubwino wokhala ndi umodzi mwa mitundu yosiyanasiyana yomwe imayambitsa ma CDL. Ofufuzawo sanathe kusonyeza kuti anthu omwe anali ndi mitundu yosiyanasiyanayi anali ndi kuchepa kwa chiopsezo cha mtima.
Zotsatira za maphunzirowa zimakhala ndi aliyense (ngakhale asayansi omwe apereka ntchito zawo ku kafukufuku wa HDL) akukayika ngati maganizo a HDL ndi olondola.
Watsopano HDL Hypothesis
Pang'ono ndi pang'ono, zikuwoneka kuti mosavuta HDL hypothesis (kuti kuwonjezeka kwa "HDL cholesterol" nthawi zonse ndi chinthu chabwino) chatsutsidwa. Pamene HDL ya cholesterol yakula bwino ndi CETP-inhibitors, ndi niacin, kapena ndi mitundu yosiyanasiyana ya maumuna, palibe phindu lomwe lawonetsedwa.
Ofufuza a HDL akukonzanso ndondomeko yawo yosavuta ya HDL. Zimatuluka kuti tikayesa "HDL cholesterol," tikuyesa mitundu yosiyanasiyana ya particles. Zowoneka kuti pali zigawo zazikulu za HDL ndi zochepa, zomwe zimayimira magawo osiyanasiyana a HDL kagayidwe kake.
Ochepa a HDL particles amakhala ndi lipoprotein ApoA-1 , opanda cholesterol wambiri. Motero, tizilombo toyambitsa matenda a HDL tingaganize kuti ndi "chopanda pake" lipoproteins, omwe ali pa njira yopangira mafuta ambiri m'thupi. Mosiyana ndi zimenezi, zikuluzikulu za HDL zili ndi cholesterol. Ma particleswa ayamba kale kugwira ntchito yawo, ndipo akungoyembekezera kuti abwererenso ndi chiwindi.
Pansi pa kumvetsetsa kwatsopano kumeneku, kuchulukitsa chiwerengero cha zigawo zazikulu za HDL kungapangitse kuti magazi a HDL apitirire - koma sitingapititse patsogolo mphamvu yathu ya "cholesterol". Komabe, kukula kwazing'ono za HDL kuyenera kuchotsa kuchotsa cholesterol kupitirira magazi zipinda zamatabwa.
Pothandizira izi zowonongeka bwino ndizoti CETP inhibitors (mankhwala omwe alepheretsa mayesero a chipatala) akuwoneka kuti amachititsa kuwonjezeka kwa zigawo zazikulu za HDL, osati zazing'ono.
Zolinga Zatsopano za Thandizo la HDL
Maganizo atsopano a HDL amasonyeza kufunika koonjezera tinthu tating'ono ta HDL.
Pachifukwa ichi, mawonekedwe a ApoA-1 akupangidwa ndi kuyesedwa mwa anthu. Njirayi, mwatsoka, imafuna kulowetsedwa kwapadera kwa ApoA-1 - choncho imayesedwa ku zinthu zovuta, monga matenda aakulu . Maphunziro oyambirira akhala olimbikitsa kwambiri, ndipo mayesero a anthu akupitirira.
Komanso, mankhwala osokoneza bongo (omwe tsopano akutchedwa RVX-208 - Resverlogix) apangidwa omwe amachititsa kuti thupi likhale lopangidwa ndi ApoA-1. Mankhwalawa amayesedwanso m'mayesero a anthu.
Kuonjezera apo, ntchito ikuchitidwa kuti apange mankhwala omwe amachititsa ABCA1, mavitamini omwe amachititsa kuti feteleza ya feteleza ipitirire ku HDL.
Motero, ochita kafukufuku akuwongolera kupeza njira zowonjezera, kapena kupititsa patsogolo ntchito, yaing'ono ya HDL yomwe (pansi pa maganizo atsopano) ndi omwe amachititsa kuchepetsa chiopsezo cha mtima.
M'menemo
Pamene tikudikira asayansi kuti adziwe zonsezi, komanso kuti tiyese ndikuyesa njira zatsopano zowonjezeretsa "HDL" yowonjezera , tonsefe tikhoza kupitiriza kuchita zinthu zomwe tikudziwazo zimachulukitsa cholesterol cha HDL ndi kuchepetsa chiopsezo cha mtima wathu . Zonsezi ndi zomveka, zotetezeka komanso zothandiza.
> Zotsatira:
BF yowona, Peloso GM, Orho-Melander M, et al. Choleserala cha Plasma HDL komanso chiopsezo cha matenda a myocardial infarction: Kuphunzira kwa a Mendelian randomisation. Lancet 2012; DOI: 10.1016 / S0140-6736 (12) 60312-2.
Roche, Inc. Roche amapereka ndondomeko pa phunziro la Gawo III la dalcetrapib [makina osindikizira]. May 12, 2012.
Michos ED, Sibley CT, Baer JT, et al. Mankhwala othandizira kuti azitha kudwala matenda a atherosclerosis komanso kupewa matenda a mtima. J Am Coll Cardiol 2012; DOI: 10.1016 / j.jacc.2012.01.045.
Vergeer M, Bots ML, Van Leuven SI, ndi al. Cholesteryl ester kuteteza mapuloteni inhibitor torcetrapib ndi off-target poizoni. Kusanthula kwapadera kwa Matenda Atherosclerotic Matenda Kusintha ndi Kujambula ndi mayesero atsopano a CETP Inhibitor (RADIANCE). Kuyendayenda kwa 2008; DOI: 10.1161 / CIRCULATIONAHA.108.772665.