HDL-C, high-density lipoprotein cholesterol

HDL - C,高密度脂蛋白胆固醇
  • 文章类型: Journal Article
    动脉粥样硬化性心血管疾病(ASCVD)在全世界范围内流行,是心肌梗死等急性心血管事件的病因。缺血性卒中,不稳定型心绞痛,和死亡。ASCVD也会影响痴呆症的风险,慢性肾脏病外周动脉疾病和运动,性反应受损,以及许多其他内脏损伤,对衰老的质量和速度产生不利影响。低密度脂蛋白胆固醇(LDL-C)与ASCVD风险之间的关系是整个现代医学中最高度确定和研究的问题之一。LDL-C升高是动脉粥样硬化诱导的必要条件。基础科学调查,前瞻性纵向队列,和随机临床试验都验证了这种关联.然而,尽管有大量的临床试验支持需要减少血液中动脉粥样硬化脂蛋白的负担,实现危险分层LDL-C目标降低的高危和极高危患者的百分比较低,并且在过去30年中一直较低.动脉粥样硬化是一种可预防的疾病。作为临床医生,现在是我们更加认真地采取原始和初级预防的时候了。尽管治疗方法过多,大多数有ASCVD风险的患者治疗不良或不充分,让他们容易受到疾病进展的影响,急性心血管事件,以及由于多个内脏器官功能丧失而导致的不良老化。在这里,我们讨论了需要大大加大力度降低风险,减轻疾病负担,并提供更全面和更早的风险评估,以最佳地预防ASCVD及其并发症。提供的证据支持治疗应该针对低得多的胆固醇管理目标,应该考虑比今天普遍使用的更多的因素,并且应该在生命的早期开始。
    Atherosclerotic cardiovascular disease (ASCVD) is epidemic throughout the world and is etiologic for such acute cardiovascular events as myocardial infarction, ischemic stroke, unstable angina, and death. ASCVD also impacts risk for dementia, chronic kidney disease peripheral arterial disease and mobility, impaired sexual response, and a host of other visceral impairments that adversely impact the quality and rate of progression of aging. The relationship between low-density lipoprotein cholesterol (LDL-C) and risk for ASCVD is one of the most highly established and investigated issues in the entirety of modern medicine. Elevated LDL-C is a necessary condition for atherogenesis induction. Basic scientific investigation, prospective longitudinal cohorts, and randomized clinical trials have all validated this association. Yet despite the enormous number of clinical trials which support the need for reducing the burden of atherogenic lipoprotein in blood, the percentage of high and very high-risk patients who achieve risk stratified LDL-C target reductions is low and has remained low for the last thirty years. Atherosclerosis is a preventable disease. As clinicians, the time has come for us to take primordial and primary prevention more serously. Despite a plethora of therapeutic approaches, the large majority of patients at risk for ASCVD are poorly or inadequately treated, leaving them vulnerable to disease progression, acute cardiovascular events, and poor aging due to loss of function in multiple visceral organs. Herein we discuss the need to greatly intensify efforts to reduce risk, decrease disease burden, and provide more comprehensive and earlier risk assessment to optimally prevent ASCVD and its complications. Evidence is presented to support that treatment should aim for far lower goals in cholesterol management, should take into account many more factors than commonly employed today and should begin significantly earlier in life.
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  • 文章类型: Journal Article
    研究以站立代替坐着对临床试验中测试的心血管危险因素的影响。
    我们搜索了从成立到2019年8月28日的数据库,以研究以站立代替坐姿对空腹血糖的影响。空腹胰岛素,和血脂水平;血压;身体脂肪量;体重;健康成年人的腰围。平均值±SD值的差异用于汇集数据并计算平均差异和CI。
    搜索找到3507个摘要。9项临床试验(8项随机和1项非随机)877名(64.4%[n=565]名女性)参与者符合所有纳入标准。平均±SD年龄为45.34±5.41岁;平均随访时间为3.81个月,干预组和对照组站立时间的平均差异为每天1.33小时.与对照组相比,干预组的随访空腹血糖和体脂质量值略低于基线记录(-2.53;95%CI,-4.27至-0.79mg/dL;和-0.75;95%CI,-0.91至-0.59kg)。空腹胰岛素水平的分析,脂质水平,血压,体重,和腰围没有显着差异。
    用站立代替坐着可以导致空腹血糖水平和身体脂肪量的非常小但具有统计学意义的下降,而对血脂水平没有显着影响,血压,体重,和腰围。用站立代替坐着可以用作辅助干预措施,以减少心血管危险因素的负担,但不能用作身体活动的替代方法,以减少久坐时间。
    UNASSIGNED: To investigate the effect of replacing sitting with standing on cardiovascular risk factors tested in clinical trials.
    UNASSIGNED: We searched databases from inception up to August 28, 2019, for studies examining the effect of replacing sitting with standing on fasting blood glucose, fasting insulin, and lipid levels; blood pressure; body fat mass; weight; and waist circumference in healthy adults. Differences in mean ± SD values were used for pooling the data and calculating the mean differences and CIs.
    UNASSIGNED: The search found 3507 abstracts. Nine clinical trials (8 randomized and 1 nonrandomized) with 877 (64.4% [n=565] women) participants met all inclusion criteria. The mean ± SD age was 45.34±5.41 years; mean follow-up was 3.81 months, and mean difference in standing time between the intervention and control groups was 1.33 hours per day. The follow-up fasting blood glucose and body fat mass values were slightly but significantly lower than baseline records in the intervention groups compared with control groups (-2.53; 95% CI, -4.27 to -0.79 mg/dL; and -0.75; 95% CI, -0.91 to -0.59 kg). The analysis for fasting insulin levels, lipid levels, blood pressure, weight, and waist circumference revealed no significant differences.
    UNASSIGNED: Replacing sitting with standing can result in very small but statistically significant decreases in fasting blood glucose levels and body fat mass with no significant effect on lipid levels, blood pressure, weight, and waist circumference. Replacing sitting with standing can be used as an adjunctive intervention to decrease the burden of cardiovascular risk factors but cannot be used as an alternative to physical activity to decrease sedentary time.
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  • 文章类型: Journal Article
    桌上的橄榄,橄榄树(OleaeuropaeaL.)的产品,是地中海饮食的重要发酵产品。农艺因素,尤其是品种,成熟阶段和加工方法是影响食用橄榄营养和非营养成分及其感官特性的主要因素。该产品的重要营养价值是由于其丰富的单不饱和脂肪(MUFA),主要是油酸,纤维和维生素E以及几种植物化学物质的存在。其中,羟基酪醇(HT)是所有类型食用橄榄中存在的主要酚类化合物。体外有一种稀缺性,表橄榄的体内和人体研究。这篇综述全面关注了食用橄榄的营养成分和生物活性化合物含量以及健康益处。与它们的消费相关的可能的健康益处被认为主要与MUFA对心血管健康的影响有关。维生素E的抗氧化(AO)能力及其在保护机体免受氧化损伤中的作用以及HT的抗炎和AO活性。还讨论了多种因素对最终产品组成的影响以及通过降低其最终盐含量来生产食用橄榄的潜在创新。
    Table olives, a product of olive tree (Olea europaea L.), is an important fermented product of the Mediterranean Diet. Agronomical factors, particularly the cultivar, the ripening stage and the processing method employed are the main factors influencing the nutritional and non-nutritional composition of table olives and their organoleptic properties. The important nutritional value of this product is due to its richness in monounsaturated fat (MUFA), mainly oleic acid, fibre and vitamin E together with the presence of several phytochemicals. Among these, hydroxytyrosol (HT) is the major phenolic compound present in all types of table olives. There is a scarcity of in vitro, in vivo and human studies of table olives. This review focused comprehensively on the nutrients and bioactive compound content as well as the health benefits assigned to table olives. The possible health benefits associated with their consumption are thought to be primarily related to effects of MUFA on cardiovascular health, the antioxidant (AO) capacity of vitamin E and its role in protecting the body from oxidative damage and the anti-inflammatory and AO activities of HT. The influence of multiple factors on composition of the end product and the potential innovation in the production of table olives through the reduction of its final salt content was also discussed.
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