HDL-Stoffwechsel

Zusammenfassung

Lipide und Lipoproteine sind Hauptrisikofaktoren für das Entstehen und den Progress arteriosklerotischer kardiovaskulärer Erkrankungen. Störungen im Lipoproteinstoffwechsel können u. a. zur Manifestation eines Diabetes mellitus, zu einer akuten Pankreatitis und zum frühzeitigen Einsetzen arteriosklerotischer Veränderungen führen. Epidemiologische Studien zeigten, dass Plasmakonzentrationen der High-Density-Lipoproteine (HDL) jedoch invers mit dem Risiko einer koronaren Herzerkrankung korreliert sind. Den HDL wird eine entscheidende Rolle im reversen Cholesterintransport zugesprochen. Dabei wird überschüssiges freies Cholesterin des peripheren Gewebes im Plasma in die HDL eingebaut, verestert und auf diesem Weg zur Leber zurücktransportiert, wo eine Sekretion über die Galle stattfinden kann. Der Metabolismus der HDL ist bis heute nicht im Detail geklärt. Zahlreiche Faktoren, welche diesen Metabolismus beeinflussen, wurden bislang identifiziert. Insbesondere die Identifizierung des Cholesterinefflux-regulierenden Proteins erbrachte neue Erkenntnisse bezüglich des HDL-Stoffwechsels. Eine detaillierte Aufklärung des Stoffwechsels der HDL zur Entwicklung neuer Therapiestrategien ist zwingend notwendig, ebenso zur Regulation der Serumkonzentrationen dieses so lebenswichtigen Lipoproteins. In dieser Übersicht sollen hier die wesentlichen bislang bekannten Faktoren des HDL-Metabolismus beschrieben werden.

HDL metabolism

Lipids and lipoproteins represent main risk factors for the development and the progress of atherosclerotic and cardiovascular diseases. Disorders in lipoprotein metabolism may result in diabetes mellitus, acute pancreatitis, and in the early occurrence of atherosclerotic alterations. The plasma concentration of high density lipoproteins (HDL) is inverse correlated with the risk of cardiovascular diseases as shown in epidemiologic studies. HDL play an important role in the reverse cholesterol transport. Free cholesterol from peripheral cells can be assembled in HDL particles, transformed to cholesterol esters, transported to the liver, and secreted via the bile as bile acids. The metabolism of HDL is not known in detail. Numerous factors were identified to influence the metabolism of HDL. Particularly the identification of the cholesterol efflux regulating protein adduced new insights in HDL metabolism. A detailed description of HDL metabolism is necessary for the evaluation of new therapeutic strategies for the regulation of the serum concentration of this important lipoprotein. Here we describe the known influencing factors for a better understanding of HDL metabolism.

Schlüsselwörter

HDL - Apolipoproteine - CERP - Cholesterinefflux

Key words

HDL - Apolipoproteins - CERP - Cholesterol Efflux

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