Atherosclerosis, diabetes and lipoproteins.
The enormous burden of vascular disease is likely to expand rapidly as sedentary obesity and diabetes increase. Although cholesterol plays a major role in atherosclerosis and LDL is the major carrier of cholesterol in the blood, the importance of the postprandial triglyceride-rich lipoproteins in the development of atherosclerosis is gaining recognition. The role of HDL-cholesterol is also receiving more attention. These changes have been forced upon us by the realization that statins, which primarily lower LDL-cholesterol, only reduce the risk of atherosclerosis by 30%, suggesting that 70% of the risk still has to be explained and treated. In diabetes, abnormality in the metabolism of the triglyceride-rich lipoproteins and the inter-relationship with HDL-cholesterol appears to be of primary importance in atherosclerotic risk. Postprandial studies are difficult to carry out, which is one reason why large studies have not so far been performed. The important new findings in chylomicron metabolism suggest new treatments for the future.
Tomkin
Gerald H
GH
Diabetes Institute of Ireland, Beacon Clinic, Dublin 18, Ireland. gerald.tomkin@tcd.ie
D000071018:ATP Binding Cassette Transporter, Subfamily G, Member 5; D000071019:ATP Binding Cassette Transporter, Subfamily G, Member 8; D018528:ATP-Binding Cassette Transporters / Q000378:metabolism; D050197:Atherosclerosis / Q000209:etiology* / Q000503:physiopathology; D001327:Autoimmune Diseases; D002352:Carrier Proteins / Q000378:metabolism; D002784:Cholesterol / Q000096:biosynthesis / Q000378:metabolism; D008076:Cholesterol, HDL / Q000097:blood; D008078:Cholesterol, LDL / Q000097:blood; D002914:Chylomicrons / Q000378:metabolism; D048909:Diabetes Complications; D018450:Disease Progression; D006801:Humans; D007249:Inflammation / Q000150:complications; D007333:Insulin Resistance; D007408:Intestinal Absorption; D007413:Intestinal Mucosa / Q000378:metabolism; D008074:Lipoproteins / Q000097:blood* / Q000737:chemistry / Q000378:metabolism; D008565:Membrane Proteins / Q000378:metabolism; D026901:Membrane Transport Proteins; D014280:Triglycerides / Q000097:blood
C416945:ABCG5 protein, human; C416946:ABCG8 protein, human; D000071018:ATP Binding Cassette Transporter, Subfamily G, Member 5; D000071019:ATP Binding Cassette Transporter, Subfamily G, Member 8; D018528:ATP-Binding Cassette Transporters; D002352:Carrier Proteins; D008076:Cholesterol, HDL; D008078:Cholesterol, LDL; D002914:Chylomicrons; D008074:Lipoproteins; D008565:Membrane Proteins; D026901:Membrane Transport Proteins; C410800:NPC1L1 protein, human; D014280:Triglycerides; C106092:microsomal triglyceride transfer protein; D002784:Cholesterol