A cikin shekarun da suka gabata, ya zama akidar da aka gano cewa HDL cholesterol shine "mai kyau" irin cholesterol, wanda ya fi girma ga matakanka na HDL ya rage ƙananan ƙwayar zuciyarka, da kuma samar da matakan HDL cholesterol abu ne mai kyau. Amma sakamako mai ban mamaki daga wasu gwaji na asibitocin da suka gabata sun kira wannan hadisin cikin tambaya.
Me ya sa ake ganin HDL "mai kyau"
HDL cholesterol ana tsammanin zai zubar da ƙwayar cholesterol daga ganuwar jini, don haka cire shi daga inda zai iya taimakawa wajen atherosclerosis .
Bugu da ƙari kuma, a cikin nazarin annoba da ke dauke da mutane fiye da 100,000, mutanen da HDL cholesterol sun kasance a kasa game da 40 mg / dL suna da haɗariyar ƙwayar zuciya kamar waɗanda suke da matakan HDL mafi girma. Wannan shi ne yanayin koda LDL cholesterol ("mummunan" cholesterol) matakan suna ƙasa. Matsakanin Higher HDL an haɗa su tare da rage yawan ƙwayar nono, ciwon daji da ciwon huhu.
Daga irin wannan nazari ya zo da imani cewa daukar matakai don ƙaddamar matakan HDL kyauta ne mai kyau. Wannan shi ne abin da ake kira HDL hypothesis: mafi girman matakan HDL, ƙananan ƙwayar zuciyarka.
Ta yaya Za a Ƙara Matsayi na HDL?
Matsakanin HDL suna nuna rinjayen rinjaye ta hanyar cakuda kwayoyin halitta da muhalli. Mata suna da matsayi mafi girma na HDL fiye da maza (ta matsakaicin 10 mg / dL).
Mutanen da suke da kisa, rashin zama, ko kuma suna da ciwon sukari ko ciwo na rayuwa suna da ƙananan matakan HDL.
Barasa ya nuna ƙarar HDL ta karamin adadin; trans fats a rage cin abinci rage shi.
Magunguna da aka saba amfani dashi don rage LDL cholesterol suna da ƙananan ƙananan sakamako a kan matakan HDL. Statins , mafi yawan amfani da ƙwayoyin cholesterol-rage kwayoyi, ƙara HDL kawai kadan.
Fibrates da kuma niacin ƙarar HDL ta matsakaicin adadi.
A mafi yawancin, saboda babu kwayoyi da suke da alaƙa da yawa a cikin HDL, shawarwari game da ƙara HDL cholesterol sun kewaye da kula da nauyin nauyi da kuma samun yawancin gwaje-gwajen, tare da rage yawan shawarwarin da ake amfani da su.
Ruwan Yarda akan Harshen HDL
Saboda ƙananan matakai na HDL ana tunanin su zama abin amfani, kuma saboda babu hanyar da za ta iya sauƙi ko abin dogara don yin hakan, ƙwayoyi masu tasowa wadanda suka haifar da matakan HDL sun zama babban burin ga kamfanoni da dama. Kuma lalle ne, an samu ci gaba da yawa daga waɗannan kwayoyi, kuma sun kai ga gwajin gwaji don nuna lafiyarsu da ingancin su.
Ya zuwa yanzu, waɗannan nazarin sun kasance masu ban mamaki, don su ce kalla. Babban gwaji na farko (kammala a shekara ta 2006) tare da magungunan magungunan CETP na farko na CETP, torcetrapib (daga Pfizer), ba kawai ya kasa nuna alamar hadarin lokacin da HDL ya karu ba amma ya nuna haɓaka a hadarin zuciya. Wani bincike tare da wani mai hana CETP - dalcetrapib (daga Roche) - an dakatar da shi a watan Mayun 2012 don rashin inganci. Dukkanin wadannan kwayoyi masu alaka sun kara yawan matakai na HDL, amma yin hakan bai haifar da wani amfani na asibiti ba.
Wani bincike mai banƙyama (AIM-HIGH) aka buga a shekara ta 2011, yayi la'akari da amfani da ƙara niacin (don ƙara yawan matakan HDL) zuwa tsarin likita. Wannan binciken ba kawai ya kasa nuna duk wani amfani daga karuwar nau'o'i na HDL da niacin amma ya nuna cewa haɗarin annoba ya karu a tsakanin marasa lafiya shan niacin.
A ƙarshe, binciken da aka bayyana a Lancet a shekara ta 2012 ya kimanta yiwuwar samun ɗayan bambancin kwayoyin da ke ƙara matakan HDL. Masu binciken basu iya nuna cewa mutanen da ke da irin wannan bambancin suna jin daɗin rage yawan cututtukan zuciya ba.
Sakamakon waɗannan nazarin suna da kowa (ko da masanan kimiyya da suka kware da aikin su zuwa HDL bincike) suna shakka ko bayyanar HDL daidai ne.
Sabon Magana na New HDL
A mahimmanci, yana nuna cewa ƙaddarar harshen HDL mai sauki (ƙananan matakan "HDL cholesterol" wani abu ne mai kyau) an ɓace. Lokacin da CETP-inhibitors, da niacin, ko kuma wasu bambancin jinsin suka samu nasarar bunkasa HDL cholesterol, babu wani amfani da aka nuna.
Masu bincike na HDL suna cikin hanyar sake dawowa da ra'ayi na HDL mai sauki. Ya bayyana cewa lokacin da muka auna "cholesterol HDL," muna zahiri da yawa daban-daban nau'in barbashi. Musamman, akwai manyan nau'o'in HDL da ƙananan, wanda ya wakilta nau'i daban-daban na tsarin na HDL metabolism.
Ƙananan ƙananan HDL sun ƙunshi lipoprotein ApoA-1 , ba tare da yawan cholesterol ba. Sabili da haka, ƙananan nau'o'i na HDL za a iya dauka a matsayin "lipoproteins" maras kyau, wadanda suke kan hanyar su zubar da ƙananan cholesterol daga kyallen takarda. Ya bambanta, manyan nau'o'in HDL sun ƙunshi yawan cholesterol. Wadannan ƙwayoyin sun riga sun aikata aikin su, kuma suna jira ne kawai hade su hade.
A karkashin wannan sabon fahimta, kara yawan adadin babban launi na HDL zai haifar da matakin jinin jini na HDL - amma ba zai inganta "ƙwarewar cholesterol ba." A gefe guda, kara ƙananan ƙwayoyin HDL ya kamata ya inganta cire ƙwayar cholesterol daga jini jirgin ruwa ganuwar.
A goyan baya ga wannan batu na baya-bayan nan shine gaskiyar cewa masu hana CETP (magungunan da suka kāsa cikin gwaji na asibiti) suna ganin sun haifar da karuwa a cikin manyan nau'o'in HDL, ba ma kananan ba.
New Targets for HDL Far
Sabuwar ma'anar HDL ta nuna cewa an buƙatar ƙara ƙananan matakan HDL.
A karshen wannan, ana samar da siffofin roba na ApoA-1 da kuma gwada su cikin mutane. Wannan tsari, da rashin alheri, yana buƙatar jigilar jigilar ApoA-1 - don haka an shirya shi ne ga yanayin da ya faru, irin su ciwo mai jijiyar zuciya . Ilimi na farko sun kasance masu ƙarfafa, kuma gwajin ɗan adam yana gudana.
Har ila yau, an yi amfani da miyagun ƙwayoyi (wanda ake kira RVX-208 - Resverlogix) wanda ya kara ƙarfin jiki na ApoA-1. Wannan magungunan maganin kuma ana jarraba shi a gwajin mutum.
Bugu da ƙari, an yi aiki don ƙirƙirar kwayoyi da ke motsa ABCA1, ƙwayar enzyme a cikin kyallen takarda wanda ke karfafa canja wurin cholesterol akan nau'o'in HDL.
Saboda haka, masu bincike suna mayar da hankalinsu don gano hanyoyin da za su kara, ko kuma inganta aikin, ƙananan nau'in HDL wanda (ƙarƙashin sabon tunanin) yana da alhakin rage ƙwayar zuciya.
Kafin nan
Yayin da muke jira masana kimiyya su warware wannan duka, kuma su ci gaba da gwada sababbin hanyoyin da za su bunkasa "nau'in 'yancin" na HDL , zamu iya ci gaba da yin abubuwan da muka sani duka suna ƙara yawan cholesterol na HDL da rage dancin mu . Dukkan waɗannan abubuwa suna da kyau, aminci da tasiri.
> Sources:
Voight BF, Peloso GM, Orho-Melander M, et al. Plasma HDL cholesterol da kuma hadarin ƙananan ƙananan ƙwayar cuta: Mendelian binciken bazuwar. Lancet 2012; DOI: 10.1016 / S0140-6736 (12) 60312-2.
Roche, Inc. Roche ya bada sabuntawa game da binciken na Phase III na dalcetrapib [latsa release]. Mayu 12, 2012.
Michos ED, Sibley CT, Baer JT, et al. Niacin da magungunan statin don maganin atherosclerosis da rigakafin cututtukan cututtukan zuciya na zuciya. J Am Coll Cardiol 2012; DOI: 10.1016 / j.jacc.2012.01.045.
M M, Bots ML, van Leuven SI, et al. Cholesteryl ester mai yalwaci mai yaduwa mai sauƙin ƙwayar cuta torcetrapib da kashewa mai ma'ana. Wani bincike mai mahimmanci game da Cutar Atherosclerotic Cigaba tare da Sabuwar CETP Mai Rarraba CETP (RADIANCE). Yanayi na 2008; DOI: 10.1161 / CIRCULATIONAHA.108.772665.