Role of oxidized LDL and antioxidants in atherosclerosis.
Role of oxidized LDL and antioxidants in atherosclerosis.
复制标题
DOI：
10.1007/978-1-4615-1957-7_5
复制
发表时间：
1995
影响因子：
--
通讯作者：
D. Steinberg
中科院分区：
文献类型：
--
作者：
D. Steinberg
动脉粥样硬化比任何其他单一退行性疾病（包括癌症）造成更多的发病率和死亡率。其临床表现为心肌梗死、中风和周围血管疾病，约占发达国家所有死亡的50%。它是一种衰老疾病，从某种意义上说，临床上显着病变的发生率在五岁以后急剧增加，但同样清楚的是，临床表现与许多环境因素（例如高胆固醇血症、高血压、吸烟等）密切相关。纠正这些“危险因素”，尤其是高胆固醇血症，已被明确证明可以减少临床事件的数量。经常被忽视的重要一点是，动物（包括非人类灵长类动物）自发性动脉粥样硬化非常罕见。这与动物癌症的高发病率及其随着年龄的增长而上升形成鲜明对比。动物很少表现出 LDL 胆固醇水平超过 80 mg/dl；有些含量低至 5–25 mg/dl。此外，动物对动脉粥样硬化的明显免疫力几乎肯定不是由于其血管壁对动脉粥样硬化过程的内在抵抗力——几乎所有哺乳动物物种都通过简单地将血浆总胆固醇水平提高到足够高的值来诱导病变。因此，有充分的理由指出高胆固醇血症是人类动脉粥样硬化的一个核心重要因素。
Atherosclerosis is responsible for more morbidity and mortality than any other single degenerative disease, including cancer. Its clinical expression in the form of myocardial infarction, stroke and peripheral vascular disease accounts for about 50% of all deaths in developed countries. It is a disease of aging, in the sense that the occurrence of clinically significant lesions increases sharply past the 5th decade, but it is equally clear that clinical expression is strongly linked to a number of environmental factors (e.g., hypercholesterolemia, hypertension, cigarette smoking, etc.). Correction of these “risk factors”, especially hypercholesterolemia, has clearly been shown to reduce the number of clinical events. An important point that is often overlooked is that spontaneous atherosclerosis in animals, including non-human primates, is very rare. This stands in contrast to the very significant incidence of cancers in animals and their rising incidence with age. Animals rarely exhibit LDL cholesterol levels over 80 mg/dl; some have levels as low as 5–25 mg/dl. Furthermore, the apparent immunity of animals to atherosclerosis is almost certainly not due to an intrinsic resistance of their vessel wall to the atherogenic process — lesions have been induced in virtually every mammalian species by simply raising the total plasma cholesterol level to a sufficiently high value. Thus there is good reason to indict hypercholesterolemia as a centrally important factor in human atherosclerosis.