Klinische Bedeutung des HDL-Cholesterins

März, Winfried; Kleber, Marcus E.; Scharnagl, Hubert; Speer, Thimoteus; Zewinger, Stephen; Ritsch, Andreas; Parhofer, Klaus G.; Eckardstein, Arnold von; Landmesser, Ulf; Laufs, Ulrich

doi:10.1007/s00059-016-4499-0

Cited by 13 publications

(13 citation statements)

References 89 publications

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“…Even if medical therapy to increase HDL is out of the question, it is commonly known and accepted that lifestyle-induced HDL increase is strongly recommended. 38 There is some evidence that active acute coronary syndrome patients walking more than 7,500 steps per day for 12 months after hospitalization have higher HDL values. 18 This study confirms this correlation in CR patients, admittedly with no statistical significance.…”

Section: Discussionmentioning

confidence: 99%

Walking activity during ambulant cardiac rehabilitation is related to maximum working capacity, age, and smoking behavior

Najem¹,

Groll

Schmermund

et al. 2018

VHRM

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BackgroundA total of 6,500 to 8,000 steps per day are recommended for cardiovascular secondary prevention. The aim of this research was to examine how many steps per day patients achieve during ambulant cardiac rehabilitation (CR), and if there is a correlation between the number of steps and physical and cardiological parameters.MethodsIn all, 192 stable CR patients were included and advised for sealed pedometry. The assessed parameters included maximum working capacity and heart rate, body mass index (BMI), New York Heart Association (NYHA) class, ejection fraction (EF), coronary artery disease status, beta-blocker medication, age, sex, smoking behavior, and laboratory parameters. A regularized regression approach called least absolute shrinkage and selection operator (LASSO) was used to detect a small set of explanatory variables associated with the response for steps per day. Based on these selected covariates, a sparse additive regression model was fitted.ResultsThe model noted that steps per day had a strong positive correlation with maximum working capacity (P=0.001), a significant negative correlation with higher age (P=0.01) and smoking (smoker: P<0.05; ex-smoker: P=0.01), a positive correlation with high-density lipoprotein (HDL), and a negative correlation with beta-blockers. Correlation between BMI and walking activity was nonlinear (BMI 18.5–24: 7,427±2,730 steps per day; BMI 25–29: 6,448±2,393 steps/day; BMI 30–34: 6,751±2,393 steps per day; BMI 35–39: 5,163±2,574; BMI >40: 6,077±1,567).ConclusionWalking activity during CR is reduced in patients who are unfit, older, smoke, or used to smoke. In addition to training recommendations, estimated steps per day during CR could be seen as a baseline orientation that helps patients to stay generally active or even to increase activity after CR.

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Section: Discussionmentioning

confidence: 99%

Walking activity during ambulant cardiac rehabilitation is related to maximum working capacity, age, and smoking behavior

Najem¹,

Groll

Schmermund

et al. 2018

VHRM

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“…Mediated by SR-BI, HDL can deliver cholesteryl ester (and free cholesterol) to hepatocytes, steroid-producing cells and adipocytes. With permission of Springer [ 7 ] …”

Section: Role Of Hdl In Lipoprotein Metabolismmentioning

confidence: 99%

“…Model 1: adjusted for age and gender; Model 2: also adjusted for use of lipid-lowering drugs, CHD (none, stable, unstable CHD, NSTEMI, STEMI), body mass index, hypertension, smoking, LDL-C/HDL-C ratio, triglycerides, metabolic syndrome/type 2 diabetes mellitus [ 26 ]. With permission of Springer [ 7 ] …”

Section: Hdl Dysfunctionmentioning

confidence: 99%

HDL cholesterol: reappraisal of its clinical relevance

et al. 2017

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BackgroundWhile several lines of evidence prove that elevated concentrations of low-density lipoproteins (LDL) causally contribute to the development of atherosclerosis and its clinical consequences, high-density lipoproteins are still widely believed to exert atheroprotective effects. Hence, HDL cholesterol (HDL-C) is in general still considered as “good cholesterol”. Recent research, however, suggests that this might not always be the case and that a fundamental reassessment of the clinical significance of HDL-C is warranted.MethodThis review article is based on a selective literature review.ResultsIn individuals without a history of cardiovascular events, low concentrations of HDL-C are inversely associated with the risk of future cardiovascular events. This relationship may, however, not apply to patients with metabolic disorders or manifest cardiovascular disease. The classical function of HDL is to mobilise cholesterol from extrahepatic tissues for delivery to the liver for excretion. These roles in cholesterol metabolism as well as many other biological functions of HDL particles are dependent on the number as well as protein and lipid composition of HDL particles. They are poorly reflected by the HDL-C concentration. HDL can even exert negative vascular effects, if its composition is pathologically altered. High serum HDL-C is therefore no longer regarded protective. In line with this, recent pharmacological approaches to raise HDL-C concentration have not been able to show reductions of cardiovascular outcomes.ConclusionIn contrast to LDL cholesterol (LDL-C), HDL-C correlates with cardiovascular risk only in healthy individuals. The calculation of the ratio of LDL-C to HDL-C is not useful for all patients. Low HDL-C should prompt examination of additional metabolic and inflammatory pathologies. An increase in HDL-C through lifestyle change (smoking cessation, physical exercise) has positive effects and is recommended. However, HDL-C is currently not a valid target for drug therapy.

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“…Так же, как и ранее для ЛНП, был выявлен диапазон концентраций холестерина ЛВП в плазме для здоровых лиц (в среднем 0,9-1,6 ммоль/л). Снижение его ниже этих пределов считается уже более двух десятков лет дополнительным информативным фактором риска развития атеросклероза [5,9,[14][15][16][17]. Наряду с акцепцией холестерина, это сопряжено также и с рядом других антиатерогенных свойств ЛВПпротивовоспалительных, антитромботических и антиоксидантных [9,16,18], хотя основное их защитное действие связывают, в первую очередь, с выведением холестерина [12,19].…”

Section: юа терешкина* лв кострюкова ти торховская юю худоunclassified

Plasma high density lipoproteins phospholipds as an indirect indicator of their cholesterol efflux capacity — new suspected atherosclerosis risk factor

et al. 2021

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High density lipoproteins (HDL) are a unique natural structure, protecting the body from the development of atherosclerotic vascular lesions and cardiovascular diseases due to this ability to remove cholesterol from cells. Plasma HDL level estimated by their cholesterol content, is a common lipid parameter, and its decrease is considered as an established atherosclerosis risk factor. However, a number of studies have shown the absence of positive clinical effects after drug-induced increase in HDL cholesterol. There is increasing evidence that not only HDL concentration, but also HDL properties, considered in this review are important. Many studies showed the decrease of HDL cholesterol efflux capacity in patients with coronary heart diseases and its association with disease severity. Some authors consider a decrease of this HDL capacity as a new additional risk factor of atherosclerosis. The review summarizes existing information on various protein and lipid components of HDL with a primary emphasis on the HDL. Special attention is paid to correlation between the HDL cholesterol efflux capacity and HDL phospholipids and the ratio “phospholipids/free cholesterol”. The accumulated information indicates importance of evaluation in the HDL fraction not only in terms of their cholesterol, but also phospholipids. In addition to the traditionally used lipid criteria, this would provide more comprehensive information about the activity of the reverse cholesterol transport process in the body and could contribute to the targeted correction of the detected disorders.

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Klinische Bedeutung des HDL-Cholesterins

Cited by 13 publications

References 89 publications

Walking activity during ambulant cardiac rehabilitation is related to maximum working capacity, age, and smoking behavior

Walking activity during ambulant cardiac rehabilitation is related to maximum working capacity, age, and smoking behavior

HDL cholesterol: reappraisal of its clinical relevance

Plasma high density lipoproteins phospholipds as an indirect indicator of their cholesterol efflux capacity — new suspected atherosclerosis risk factor

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