Akatswiri ambiri a zamoyo ndi akatswiri a lipid akhala akulembetsa "cholesterol maganizo". Cholesterol (hypothesis), motsimikizika chabe, ndikuti mliri wambiri wamagazi wa LDL cholesterol ndi chifukwa chokhalira ndi matenda a atherosclerosis . Choncho, kuchita kanthu kuti tipewe matenda a LDL a cholesterol ndi njira yofunikira yochepetsera chiopsezo chathu chokhala ndi matenda a mtima odwala atherosclerotic.
Kwa zaka zambiri, akatswiri akutilimbikitsa kusintha zakudya zathu m'njira zothandizira kuchepetsa mafuta m'thupi lathu, ndipo makampani opanga mankhwala akhala akugwiritsa ntchito mankhwala ambirimbiri kuti azichepetsa mankhwala a kolesterol. Cholesterol hypothesis yakhazikika osati osati pakati pa madokotala ndi chipatala cha mafakitale, komanso pakati pa anthu ambiri.
Kotero, zingadabwe kumva kuti akatswiri ambiri a lipid ndi akatswiri a cardiologists tsopano akukayikitsa ngati cholesterol cholingalira ndi chowonadi pambuyo pa zonse. Pamene mkangano pakati pa akatswiri okhudza mafuta a kolesterolini umagwiritsa ntchito pamasewero osati m'magulu a anthu, zomwe sizichepetsa mphamvu ndi chilakolako cha mkangano. Kotero, ngakhale mauthenga onse a anthu a akatswiri ena otchuka, cholingaliro cha cholesterol sichiri "chosinthidwa sayansi."
Cholesterol Hypothesis
Cholesterol hypothesis imachokera pa zochitika ziwiri zofunika.
Choyamba, akatswiri a zachipatala adawonetsa kale kuti cholesterol deposits ndizofunikira kwambiri pa miyala ya atherosclerotic plaques. Chachiwiri, kufufuza kwa matenda a matenda-makamaka, Framingham Heart Study-kunasonyeza kuti anthu omwe ali ndi magazi ambiri a cholesterol ali ndi chiopsezo chachikulu cha matenda a mtima.
Kenaka, m'ma 1990, mayesero owonetsetsa kuti anthu ambiri omwe ali ndi makasitomala apamwamba amakhala ndi zotsatira zabwino zachipatala pamene mankhwala awo a LDL amachepetsedwa ndi mankhwala osokoneza bongo . Kwa akatswiri ambiri, mayeserowa adatsimikizira kuti cholesterol imagwiritsidwa ntchito kamodzi.
Mafunso atsopano Okhudza Cholesterol Opotopotos
Pakati pa zaka zotsatizana, komabe cholesterol chiwonongeko chakhala chikuyankhidwa mu funso lalikulu. Ngakhale mayesero angapo opatsirana pogwiritsa ntchito mankhwala osokoneza bongo akupitirizabe kubwereketsa chithandizo cholimba cha cholesterol, mayesero ena otsika kwa kolesterolini, pogwiritsa ntchito mankhwala osagwiritsa ntchito mankhwalawa kuti achepetse mitsempha ya cholesterol, alephera kusonyeza chithandizo chamankhwala.
Vuto ndiloti, ngati cholesterol chiwonetsero chowonadi chinali chenicheni, ndiye siziyenera kukhala ndi vuto lomwe mankhwala amagwiritsidwa ntchito kuchepetsa cholesterol; Njira iliyonse yochepetsera cholesterol iyenera kusintha zotsatira zachipatala.
Koma izi si zomwe zawoneka. Zofukufuku zomwe LDL za mthupi za mafuta m'thupi zimakhudzidwa kwambiri ndi niacin , ezetimibe , acid acid sequestrants , fibrates , CETP inhibitors , mavitamini othandizira odwala m'mimba pambuyo pa amayi am'maopa, ndi zakudya zochepa za mafuta, ambiri satha kusonyeza zotsatira za mtima wabwino .
Zoonadi, mwa zina mwa mayeserowa, zotsatira zowopsa kwambiri za mtima zimakhala zikuwoneka ndikuchiritsidwa, ngakhale kuti mafuta amapezeka m'thupi.
Monga zofotokozera mwachidule za thupi la mayesero otsika kwa kolesteroloni lomwe lapangidwa mpaka pano, ndizomveka kunena kuti kuchepetsa mitsempha ya cholesterol ndi statins zikuwoneka kuti kumapangitsa zotsatira za mtima, koma kuchepetsa iwo ndi zochitika zina sizimatero. Zotsatira izi zimasonyeza kuti ubwino wa kupatsika kwa mafuta m'thupi ndiwotchulidwa ndi statin enieni, ndipo sungathe kufotokozedwa kwathunthu mwa kungochepetsa cholesterol cha LDL. Pachifukwachi, cholesterol maganizo, makamaka mu mawonekedwe ake akale, tsopano akukayika kwambiri.
Kukayikira kwakukulu kokhudza cholesterol malingaliro ambiri kunakhala poyera kwambiri mu 2013, ndi kutulutsidwa kwa malangizo atsopano ochizira kolesterolini. Pakuphwanya kwakukulu ndi malangizo oyambirira a cholesterol, malemba a 2013 adasiya malangizowo kuti achepetse cholesterol cha LDL kuzinthu zinazake. M'malo mwake, malangizowa adangoganizira zogwirizana ndi anthu omwe ali ndi statins. Ndipotu, kwa odwala ambiri, malangizowa nthawi zambiri amalimbikitsa kuti asagwiritse ntchito mankhwala osokoneza bongo kuti achepetse cholesterol. Osachepera mwatsatanetsatane, malangizowa anasiya chiphunzitso cha cholesterol choyambirira, ndipo motero adayambitsa mikangano yaikulu mkati mwa anthu odwala matendawa.
Mlandu Wokwanira Kutaya Cholesterol Hypothesis
Mlandu wofotokozera cholesterol umoyo wakufa umapita ngati uwu: Ngati mkulu LDL cholesterol anali kwenikweni chifukwa cha atherosclerosis, ndiye kuchepetsa LDL mafuta m'thupi mwa njira iliyonse ayenera kusintha mtima maganizo. Koma, pambuyo pa mitsempha yambiri ya kuchepetsa kupatsirana pogwiritsa ntchito mawotchi osiyanasiyana ochepetsa kolesterolini, zotsatira zake zotere sizinali zowoneka. Choncho, cholingalira cha cholesterol chiyenera kukhala cholakwika.
Sitimayi imakhala yokhudza vuto la kupatsirana kwa kolesterolini. Statins imakhala ndi zotsatira zambiri pamaganizo a mtima kuphatikizapo kuchepetsa mitsempha ya cholesterol, ndipo zotsatira zina (zomwe zimagwirizanitsidwa pamodzi kuti zikhazikitse zizindikiro za atherosclerotic) zingathe kufotokozera zambiri, ngati sizinthu zambiri, zapadera. Mankhwala omwe amachepetsa cholesterol popanda kukhala ndi zina, zizindikiro zolimbitsa thupi siziwoneka kuti siziwathandiza. Choncho, ndizomveka kufotokozera kuti zilembozi sizimapangitsa kuti thupi liziyenda bwino mwa kuchepetsa mitsempha ya kolesterolini, komabe zingakhale zotero kupyolera mwa zina, osati cholesterol.
Madokotala ambiri, komanso akatswiri ambiri a katsulola, amawoneka kuti ali okonzeka kuvomerezana ndi maganizowa komanso kusiya cholesterol.
Mlandu wa Kubwezeretsanso Cholesterol Hypothesis
Akatswiri ena-mwinamwake ambiri-amatsutsanabe ndi lingaliro lakuti maola a cholesterol si ofunikira. Iwo amaganiza izi chifukwa chakuti, ziribe kanthu momwe mumadula, pakadutsa matenda a mtima waumulungu, cholesterol n'chabwino.
Mankhwala a atherosclerotic amangokhala ndi cholesterol. Timakhalanso ndi umboni wolimba wakuti cholesterol chomwe chimathera pamapangidwe amaperekedwa kumeneko ndi particle LDL. Kuwonjezera apo, pali umboni wina wosonyeza kuti, pamene mumachepetsa LDL cholesterol m'magazi kuti mukhale otsika kwambiri, mukhoza kuyamba kusintha njira yothetsera mavuto a Mulungu-ndi kupanga mapulotechete. Chifukwa cha umboni umenewu, zikuwoneka kuti sizingatheke kunena kuti ma cholesterol alibe kanthu.
Ngakhale kuti cholesterolongo choyambirira choyang'ana bwino chikufunikira kuti chikonzedwe, ndicho chikhalidwe cha malingaliro. Lingaliro ndi chinthu china choposa chitsanzo chogwira ntchito. Pamene mukuphunzira zambiri, mumasintha chitsanzo. Mwa kulingalira uku, ndi nthawi yoti cholesterol imaganiziridwa kuti ikonzedwe, osati yotsalira.
Zasinthidwa ku Chiyani?
Zikuwoneka kuti cholesterol ndi ofunika pakupanga atherosclerotic plaques. Zikuwonekeranso kuti, pamene kuwonjezeka kwa LDL cholesterol m'magazi ofanana kwambiri ndi chiopsezo cha matenda a atherosclerosis, pali zambiri ku nkhani kusiyana ndi magazi okha.
Nchifukwa chiyani anthu ena omwe ali ndi mitsempha yapamwamba ya cholesterol ya LDL sakhala ndi matenda aakulu a atherosclerosis? Nchifukwa chiani anthu ena omwe ali ndi "okalamba" a LDL a mthupi la cholesterol amatha kufalitsa tizirombo ta mafuta a mafuta a mafuta a mafuta m'thupi? Chifukwa chiyani kuchepetsa ma CD ya cholesterol ndi mankhwala amodzi akukwera bwino, pomwe kuchepetsa ma LDL ndi mankhwala ena sikutero?
Tsopano zikuwonekeratu kuti sizigawo za magazi zokha basi zomwe ziri zofunika-ndizo mtundu komanso khalidwe la lipoprotein particles zomwe zimakhala ndi cholesterol. Makamaka, ndi m'mene komanso lipoprotein particles zimagwirizanirana ndi endothelium ya mitsempha ya magazi kuti ikulimbikitse (kapena kuchepetsa) mapangidwe apangidwe. Mwachitsanzo, ife tsopano tikudziwa kuti LDL cholesterol particles imabwera "zokopa" zosiyanasiyana. Ena ali ang'onoang'ono, timene timene timakhala tambirimbiri ndipo ena ndi aakulu, "fluffy" particles, omwe poyamba amakhala otheka kwambiri chifukwa cha matenda a atherosclerosis kusiyana ndi omwe amatha. Komanso, LDL particles zomwe zimakhala zowonjezereka zili ndi poizoni ku thanzi la mtima, ndipo zimakhala zovuta kwambiri kudwala matenda a satanaclerosis. Mapangidwe ndi "khalidwe" la maselo athu a LDL amawoneka kuti akukhudzidwa ndi machitidwe athu, mtundu wa zakudya zomwe timadya, mahomoni athu, mankhwala omwe timapatsidwa, ndipo mwinamwake zinthu zina zomwe sizinafotokozedwe panobe.
Asayansi akuphunzira mofulumira kwambiri za zosiyanasiyana lipoprotein particles, ndipo chimawapangitsa iwo kuchita m'njira zosiyanasiyana, ndi pansi pa zosiyana.
Panthawi inayake, tidzakhala ndi maganizo atsopano a cholesterol omwe amalingalira maphunziro athu atsopano okhudza makhalidwe a LDL, HDL , ndi zina zotengera lipoproteins zomwe zimadziwika kuti, ndi kuchuluka kotani, cholesterol chomwe amanyamula chimaphatikizidwa mu makina . Ndipo ndondomeko yotereyi (kuti ikhale yothandiza) idzakonza njira zatsopano zothetsera makhalidwe a lipoproteinswa kuchepetsa matenda a mtima.
Bwanji Nanga PCSK9 Inhibitors?
Akatswiri ena amanena kuti zotsatira zachipatala zomwe zatchulidwa ndi PCSK9 zowonongeka zapulumutsa chiwerengero cha mafuta m'thupi, ndipo makamaka, kuti palibe ndondomeko yowonjezeretsa ya cholesterol yomwe ikufunika potsatira zotsatirazi.
Mayeserowa anatsimikizira kuti pamene PCSK9 inhibitor ikuwonjezeredwa kuchipatala chokwanira, ma ultrasound otchedwa LDL cholesterol amatha kufika, ndipo pang'onopang'ono cholesterol ichi chimakhala kusintha kwakukulu mu zotsatira zachipatala.
Koma zotsatirazi sizikutanthauza kuti chiwerengero cha cholesterol choyambirira chimayambanso kukhazikitsidwa. Anthu omwe adaphunzira mu mayeserowa, adakali akuchiritsidwa ndi mankhwala, ndipo potero anali kupeza phindu lokhazikitsa "mankhwala owonjezera" omwe mankhwala amtundu amapereka. Choncho, yankho lawo lachipatala silinali chifukwa cha kuchepa kwa "cholesterol". Komanso, zotsatira zabwino zopezeka ndi PCSK9 mankhwala + statins sizitsutsa kuti cholesterol kutsitsa ndi mankhwala ena ndi njira zina alephera kusonyeza phindu.
Ngakhale zotsatira zowoneka tsopano ndi PCSK9 zowonongeka, cholesterol hypothesis sichilongosola mokwanira zomwe zakhala zikuwonedwa m'mayesero a zamankhwala.
Mfundo Yofunika Kwambiri
Kodi zikuwoneka bwanji kuti cholesterol (hypothesis) chochepa-chochepa chanu cholesterol chomwe chimachepetsera chiwopsezo chanu-chimakhala chosavuta kwambiri kuti tifotokoze zotsatira za zotsatira zomwe taziwona ndi mayesero otsika kwa kolesterolini kapena njira zabwino zothetsera okhudzana ndi cholesterol matenda amtima.
Padakali pano, akatswiri adasiyidwa m'malo osasangalatsa komwe maganizo omwe adagwedeza mwa ife kwa zaka makumi ambiri ali osadalirika-koma sakanatha kukonzekera.
Ndili ndi malingaliro, ndikofunika kukumbukira kuti moyo umasintha ndi mankhwala omwe akuyenera kulandira matenda a coronary, kuphatikizapo mankhwala othandiza kumwa mankhwala osokoneza bongo, atsimikiziridwa kuti amapindula. Musayambe kumwa mankhwala popanda kulankhula ndi dokotala poyamba.
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