The role and function of HDL in patients with diabetes mellitus and the related cardiovascular risk.
The role and function of HDL in patients with diabetes mellitus and the related cardiovascular risk.
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DOI：
10.1186/s12944-017-0594-3
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发表时间：
2017-10-30
影响因子：
4.5
通讯作者：
Rysz J
中科院分区：
文献类型：
--
作者：
Femlak M;Gluba-Brzózka A;Ciałkowska-Rysz A;Rysz J
糖尿病（DM）是一个主要的公共卫生问题，患病率不断上升，特别是在低收入和中等收入国家。两种类型的糖尿病（DMT 1和DMT 2）都与发生慢性并发症的高风险相关，如视网膜病变、肾病、神经病变、内皮功能障碍和动脉粥样硬化。本文对糖尿病患者HDL亚组分谱及其心血管危险性的相关文献进行综述。本文就糖尿病中HDL功能障碍、HDL改变对糖尿病发生风险的影响以及糖尿病中HDL颗粒紊乱与心血管风险之间的关系进行了综述。在DMT 1和DMT 2的过程中，循环脂质（包括甘油三酯和LDL胆固醇以及HDL）的量的变化也很常见。在正常状态下，HDL发挥各种抗动脉粥样硬化特性，包括胆固醇逆向转运、抗氧化和抗炎能力。然而，已经提出，在病理状态下HDL变得“功能失调”，这意味着HDL中脂质和蛋白质的相对组成以及与HDL相关的酶活性，如对氧磷酶1（PON 1）和脂蛋白相关磷脂酶11（Lp-PLA 2）被改变。由于HDL蛋白质的氧化修饰和糖化以及HDL蛋白质组转化为促炎蛋白，HDL性质在糖尿病（DM）患者中受损。许多研究证实，HDL抑制炎症信号的能力在这组患者中显著降低。然而，确切的潜在机制仍有待于在体内解开。对HDL功能障碍的病理机制的理解可能有助于开发针对特定亚群的治疗方法，并专注于降低心血管风险。
Diabetes mellitus (DM) is a major public health problem which prevalence is constantly raising, particularly in low- and middle-income countries. Both diabetes mellitus types (DMT1 and DMT2) are associated with high risk of developing chronic complications, such as retinopathy, nephropathy, neuropathy, endothelial dysfunction, and atherosclerosis. This is a review of available articles concerning HDL subfractions profile in diabetes mellitus and the related cardiovascular risk. In this review, HDL dysfunction in diabetes, the impact of HDL alterations on the risk diabetes development as well as the association between disturbed HDL particle in DM and cardiovascular risk is discussed. Changes in the amount of circulation lipids, including triglycerides and LDL cholesterol as well as the HDL are frequent also in the course of DMT1 and DMT2. In normal state HDL exerts various antiatherogenic properties, including reverse cholesterol transport, antioxidative and anti-inflammatory capacities. However, it has been suggested that in pathological state HDL becomes “dysfunctional” which means that relative composition of lipids and proteins in HDL, as well as enzymatic activities associated to HDL, such as paraoxonase 1 (PON1) and lipoprotein-associated phospholipase 11 (Lp-PLA2) are altered. HDL properties are compromised in patients with diabetes mellitus (DM), due to oxidative modification and glycation of the HDL protein as well as the transformation of the HDL proteome into a proinflammatory protein. Numerous studies confirm that the ability of HDL to suppress inflammatory signals is significantly reduced in this group of patients. However, the exact underlying mechanisms remains to be unravelled in vivo. The understanding of pathological mechanisms underlying HDL dysfunction may enable the development of therapies targeted at specific subpopulations and focusing at the diminishing of cardiovascular risk.
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