دورية أكاديمية
Very low HDL levels: clinical assessment and management
| العنوان: | Very low HDL levels: clinical assessment and management |
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| المؤلفون: | Isabella Bonilha, Beatriz Luchiari, Wilson Nadruz, Andrei C. Sposito |
| المصدر: | Archives of Endocrinology and Metabolism, Vol 67, Iss 1, Pp 3-18 (2023) |
| بيانات النشر: | Brazilian Society of Endocrinology and Metabolism, 2023. |
| سنة النشر: | 2023 |
| المجموعة: | LCC:Medicine LCC:Diseases of the endocrine glands. Clinical endocrinology |
| مصطلحات موضوعية: | High-density lipoprotein, Tangier disease, LCAT deficiency, familial hypoalphalipoproteinemia, polygenic dyslipidemias, atherosclerosis, Medicine, Diseases of the endocrine glands. Clinical endocrinology, RC648-665 |
| الوصف: | ABSTRACT In individuals with very low high-density lipoprotein (HDL-C) cholesterol, such as Tangier disease, LCAT deficiency, and familial hypoalphalipoproteinemia, there is an increased risk of premature atherosclerosis. However, analyzes based on comparisons of populations with small variations in HDL-C mediated by polygenic alterations do not confirm these findings, suggesting that there is an indirect association or heterogeneity in the pathophysiological mechanisms related to the reduction of HDL-C. Trials that evaluated some of the HDL functions demonstrate a more robust degree of association between the HDL system and atherosclerotic risk, but as they were not designed to modify lipoprotein functionality, there is insufficient data to establish a causal relationship. We currently have randomized clinical trials of therapies that increase HDL-C concentration by various mechanisms, and this HDL-C elevation has not independently demonstrated a reduction in the risk of cardiovascular events. Therefore, this evidence shows that (a) measuring HDL-C as a way of estimating HDL-related atheroprotective system function is insufficient and (b) we still do not know how to increase cardiovascular protection with therapies aimed at modifying HDL metabolism. This leads us to a greater effort to understand the mechanisms of molecular action and cellular interaction of HDL, completely abandoning the traditional view focused on the plasma concentration of HDL-C. In this review, we will detail this new understanding and the new horizon for using the HDL system to mitigate residual atherosclerotic risk. |
| نوع الوثيقة: | article |
| وصف الملف: | electronic resource |
| اللغة: | English |
| تدمد: | 2359-4292 2359-3997 |
| Relation: | http://www.scielo.br/scielo.php?script=sci_arttext&pid=S2359-39972023000100003&tlng=en; https://doaj.org/toc/2359-4292 |
| DOI: | 10.20945/2359-3997000000585 |
| URL الوصول: | https://doaj.org/article/02e086e8e4a246ff97eb82f5a02fec79 |
| رقم الأكسشن: | edsdoj.02e086e8e4a246ff97eb82f5a02fec79 |
| قاعدة البيانات: | Directory of Open Access Journals |
Full Text Finder | تدمد: | 23594292 23593997 |
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| DOI: | 10.20945/2359-3997000000585 |