The role of advanced lipid testing in the prediction of cardiovascular disease.
The role of advanced lipid testing in the prediction of cardiovascular disease.
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DOI：
10.1007/s11883-013-0394-9
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发表时间：
2014-03
影响因子：
5.8
通讯作者：
Rohatgi, Anand
中科院分区：
文献类型：
--
作者：
Chandra, Alvin;Rohatgi, Anand
一些专家建议进行先进的血脂检测，以识别具有较大剩余风险的患者，从而更积极地针对生活方式和药物治疗。它测量脂蛋白和载脂蛋白亚群，包括脂蛋白（a）（Lp[a]）、载脂蛋白A-I（apo A-I）、载脂蛋白B（apo B），并测量脂蛋白颗粒组成，如LDL和HDL颗粒数量和颗粒大小。肥胖与较小的LDL-P和HDL-P大小相关。通过禁食/热量限制的中度体重减轻与LDL-P大小增加相关;而通过耐力运动的中度体重减轻与HDL-P大小增加相关。高碳水化合物饮食与更易致动脉粥样硬化的晚期脂蛋白谱相关，其特征在于LDL-P和HDL-P尺寸较小。总之，生活方式的改变，如减肥，运动和饮食调整与晚期脂蛋白的改善相关。令人遗憾的是，迄今为止，靶向HDL和HDL组成的疗法令人失望。
Advanced lipid testing has been suggested by some experts to identify patients with substantial residual risk for more aggressive targeting of lifestyle and pharmacologic therapies. It measures subpopulation of lipoproteins and apolipoproteins which include lipoprotein(a) (Lp[a]), apolipoprotein A-I (apo A-I), apolipoprotein B (apo B), and measures of lipoprotein particle composition such as LDL and HDL particle number and particle size. Obesity is associated with smaller LDL-P and HDL-P sizes. Moderate weight loss via fasting/calorie restriction is associated with LDL-P size increase; whereas moderate weight loss via endurance exercise is associated with HDL-P size increase. Diets high in carbohydrates are associated with a more atherogenic advanced lipoprotein profile characterized by smaller LDL-P and HDL-P sizes. In summary, lifestyle changes such as weight loss, exercise, and dietary modification correlate with improvement in advanced lipoproteins. Regrettably, therapies targeting HDL and HDL composition have been disappointing to date.
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