Lipoprotein metabolism, dyslipidemia, and nonalcoholic fatty liver disease.

Lipoprotein metabolism, dyslipidemia, and nonalcoholic fatty liver disease.
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DOI:
10.1055/s-0033-1358519
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发表时间:
2013-11
影响因子:
4.2
通讯作者:
Fisher EA
Fisher EA
中科院分区:
医学2区
文献类型:
--
作者:
Cohen DE;Fisher EA

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心血管疾病是非酒精性脂肪肝(NAFLD)患者最常见的死亡原因。NAFLD患者表现出致动脉粥样硬化的血脂异常,其特征是血浆甘油三酯浓度升高,高密度脂蛋白(HDL)胆固醇浓度降低,低密度脂蛋白(LDL)颗粒比正常小而致密。NAFLD相关的动脉粥样硬化性血脂异常的发病机制是多方面的,但许多方面都归因于胰岛素抵抗的表现。在这里,我们回顾了脂蛋白的结构、功能和代谢,脂蛋白是脂类和蛋白质的大分子颗粒,在血浆中运输原本不溶的甘油三酯和胆固醇分子。我们提供了在胰岛素抵抗的背景下观察到的代谢紊乱的最新解释。对致动脉粥样硬化性血脂异常的病理生理学的进一步了解有望指导旨在降低非酒精性脂肪肝患者发病率和死亡率的治疗。
Cardiovascular disease represents the most common cause of death in patients with non-alcoholic fatty liver disease (NAFLD). NAFLD patients exhibit an atherogenic dyslipidemia that is characterized by an increased plasma concentration of triglycerides, reduced concentration of high density lipoprotein (HDL) cholesterol, and low density lipoprotein (LDL) particles that are smaller and more dense than normal. The pathogenesis of NAFLD-associated atherogenic dyslipidemia is multifaceted, but many aspects are attributable to manifestations of insulin resistance. Here we review the structure, function and metabolism of lipoproteins, which are macromolecular particles of lipids and proteins that transport otherwise insoluble triglyceride and cholesterol molecules within the plasma. We provide a current explanation of the metabolic perturbations that are observed in the setting of insulin resistance. An improved understanding of the pathophysiology of atherogenic dyslipidemia would be expected to guide therapies aimed at reducing morbidity and mortality in NAFLD patients.
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