[New trends in lipidology: the increasing role of HDL-cholesterol].
Previous epidemiological studies have demonstrated the low level of high-density lipoprotein (HDL) cholesterol as an independent risk factor for cardiovascular diseases, the increase of which is one of the cornerstones of preventive cardiovascular care. In addition to its major role in reverse cholesterol transport, HDL-C has other biological activities that may contribute to its protective effects against atherosclerosis. These include antioxidant, anti-inflammatory, antithrombotic/profibrinolytic and vasoprotective effects. Current guidelines recommend aggressive lifestyle modifications, niacin, fibrate, statin or a combination of these to increase HDL-cholesterol levels. In addition, several novel HDL-based therapeutic strategies have been or are currently being tested. These include newer formulations of nicotinic acid/receptor agonists, CETP inhibitors, cannabinoid-1 receptor antagonists, PPAR agonists, liver X receptor/farnesoid X receptor agonists, and apoA-I and/or phospholipid-derived therapies. In this article previous clinical trials, epidemiological observations, basic science studies and the most important trials of novel agents are reviewed.
Paragh
György
G
Debreceni Egyetem, Orvos- és Egészségtudományi Centrum, I. Belgyógyászati Klinika Anyagcsere-betegségek Tanszék, Debrecen. paragh@internal.med.unideb.hu
Harangi
Mariann
M
László
Márk
M
D000818:Animals; D016632:Apolipoprotein A-I / Q000096:biosynthesis; D050197:Atherosclerosis / Q000378:metabolism / Q000517:prevention & control*; D002318:Cardiovascular Diseases / Q000378:metabolism; D053480:Cholesterol Ester Transfer Proteins / Q000037:antagonists & inhibitors; D008076:Cholesterol, HDL / Q000097:blood / Q000187:drug effects* / Q000378:metabolism*; D002995:Clofibric Acid / Q000627:therapeutic use; D004268:DNA-Binding Proteins / Q000819:agonists; D004359:Drug Therapy, Combination; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use; D000071518:Liver X Receptors; D009525:Niacin / Q000627:therapeutic use; D018722:Nicotinic Agonists / Q000627:therapeutic use; D057093:Orphan Nuclear Receptors; D047492:Peroxisome Proliferator-Activated Receptors / Q000819:agonists; D010743:Phospholipids / Q000378:metabolism; D043884:Receptor, Cannabinoid, CB1 / Q000037:antagonists & inhibitors; D018160:Receptors, Cytoplasmic and Nuclear / Q000819:agonists; D012307:Risk Factors; D040242:Risk Reduction Behavior
D016632:Apolipoprotein A-I; C506642:CETP protein, human; D053480:Cholesterol Ester Transfer Proteins; D008076:Cholesterol, HDL; D004268:DNA-Binding Proteins; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D000071518:Liver X Receptors; D018722:Nicotinic Agonists; D057093:Orphan Nuclear Receptors; D047492:Peroxisome Proliferator-Activated Receptors; D010743:Phospholipids; D043884:Receptor, Cannabinoid, CB1; D018160:Receptors, Cytoplasmic and Nuclear; D009525:Niacin; D002995:Clofibric Acid