Nomaphi lapho uphenduka khona, uyala ukuba unake amazinga akho e-cholesterol, futhi kancane kancane, amazinga akho e-triglyceride. I-cholesterol ne-triglyceride yizinhlobo ezimbili ze-lipid, noma amafutha, ajikeleza egazini lakho. Zombili zidingekile empilweni ngokwazo.
I-cholesterol ibalulekile ekwakheni nasekulondolozeni izingxenye eziyinhloko zamangqamuzana akho, njengezitho zomzimba zakho, nokwenza ama-hormone ambalwa adingekayo - kuhlanganise i-estrogens, i-progesterones, i-vitamin D, ne-steroids.
I-Triglycerides, eyimikhakha yama-acids ephezulu anamandla, inikeza amandla amaningi adingekayo ukuze izicubu zakho zisebenze. Ngakho awukwazi ukuhlala ngaphandle kwalezi zinhlobo ze-lipids.
Kodwa uma amazinga wegazi we-cholesterol noma i-triglycerides ephakeme kakhulu, ingozi yakho yokuhlaselwa isifo senhliziyo , isifo sohlangothi nesifo se- vascular is growing kakhulu. Futhi yingakho udinga ukukhathazeka ngamazinga akho e-lipid.
Sibutsetelo
Kunemithombo emibili ye-cholesterol ne-triglycerides - imithombo yokudla kanye nemithombo "endogenous" (eyenziwe ngaphakathi komzimba). I-cholesterol yezinto zokudla kanye ne-triglycerides ngokuyinhloko ivela ekudleni inyama nemikhiqizo yobisi . Lezi zinyosi zokudla zitholakala emathunjini akho bese zithunyelwa ngegazi egazini lakho, lapho zicutshungulwa khona.
Omunye wemisebenzi esemqoka yesibindi ukuqinisekisa ukuthi zonke izicubu zomzimba wakho zithola yonke i-cholesterol kanye ne-triglycerides okudingeka bayisebenze.
Ngokuvamile, cishe amahora ayisishiyagalombili emva kokudla, isibindi sakho sithatha i-cholesterol yokudla kanye ne-triglycerides ephuma egazini. Phakathi nezikhathi lapho i-lipids yokudla ingatholakali, isibindi sakho ngokwayo sikhiqiza i-cholesterol ne-triglycerides. Eqinisweni, cishe 75% we-cholesterol emzimbeni wakho yenziwa isibindi.
Isibindi sakho sabeka i-cholesterol ne-triglyceride, kanye nama-proteine akhethekile, zibe amaphakheji amancane afana ne- lipoproteins , akhululwa ekusakazeni. I-cholesterol ne-triglyceride zisuswa kuma-lipoproteins futhi zithunyelwa emangqamuzaneni omzimba wakho, nomaphi lapho kudingeka khona.
I-triglycerides eyengeziwe - leyo engadingeki ngokushesha ukuze ifakwe uphethiloli - igcinwa kuma-fat cells ukuze kusetshenziswe kamuva. Kubalulekile ukwazi ukuthi amaningi ama-acid acids agcinwe emizimbeni yethu avela njenge-carbs yokudla. Ngenxa yokuthi kunamkhawulo wamakhiloghyidrate amaningi esingayigcina emzimbeni wethu, noma yikuphi "ama-carbs" engeziwe esiwadlayo aguqulwa amafutha acids, ahlanganiswa njengama-triglycerides futhi agcinwe njengamafutha. (Lokhu kuchaza ukuthi kungani kulula ukuba okhululekile ngisho nokudla okunamafutha aphansi.) Ama-acids egciniwe egciniwe ahlukaniswa kusukela ku-triglycerides futhi ashiswa njengamafutha ngesikhathi sokuzila.
I-Cholesterol Enhle Nokubi
Uzovame ukuzwa odokotela nezidakamizwa bekhuluma ngezinhlobo ezimbili ezihlukene ze-cholesterol- low-level lipoprotein (LDL) ye-cholesterol (okuthiwa "i-cholesterol" embi), futhi i-cholesterol (i-cholesterol) noma i-cholesterol ephezulu ye-lipoprotein (HDL). Le ndlela yokukhuluma nge-cholesterol iyi-shorthand elula, kodwa ngokuqondile ayikho impela ngempela.
Ukukhuluma ngokuqinile, njenganoma imuphi umuthi wamakhemikhali omuhle uzokutshela, i-cholesterol ingumculi we-cholesterol nje. Elinye imvukuzane ye-cholesterol lifana kakhulu nelinye. Ngakho kungani odokotela bakhuluma nge-cholesterol enhle neyimbi?
Impendulo ihlobene nama-lipoproteins.
Lipoproteins. I-cholesterol (ne-triglycerides) yi-lipids, ngakho-ke ayichithi emphakathini wamanzi njengegazi. Ukuze i-lipids ihanjiswe egazini ngaphandle kokuhlanganiswa ndawonye, kudingeka ihlanganiswe zibe izinhlayiya ezincane ezibizwa ngokuthi i-lipoproteins. I-lipoproteins iyancibilika egazini, futhi ivumela i-cholesterol ne-triglycerides ukuba ihanjiswe kalula ngokusebenzisa igazi.
"Ukuziphatha" kwama-lipoprotein ahlukahlukene kunqunywa izinhlobo ezithile zama-protini (okuthiwa ama-apolipoprotein) avela phezulu. I-Lipoprotein imetabolism iyinkimbinkimbi kakhulu, futhi ososayensi basasebenza yonke imininingwane. Noma kunjalo, odokotela abaningi bazikhathalela izinhlobo ezimbili ezinkulu ze-lipoproteins: i-LDL ne-HDL.
I-LDL Cholesterol - "Cholesterol" Embi. Kubantu abaningi, iningi le-cholesterol egazini lihlanganiswe ezinhlayiyeni ze-LDL. I-cholesterol ye-LDL ivame ukubizwa ngokuthi "okubi" i-cholesterol.
Amazinga aphezulu we-cholesterol ye-LDL aye ahlotshaniswa kakhulu nenengozi eyengeziwe yokuhlasela kwenhliziyo nokushaywa isifo. Kucatshangwa yizazi eziningi ukuthi uma amazinga e-LDL ama-cholesterol ephakeme kakhulu, i-lipdrotein ye-LDL ijwayele ukunamathela emgqeni wegazi, okusiza ekuvuseleleni i- atherosclerosis . Ngakho-ke, izinga eliphezulu le-LDL le-cholesterol liyinhloko enkulu engozini yesifo senhliziyo nesifo sohlangothi.
Nakuba kungekho mbuzo wokuthi amazinga e-LDL ama-cholesterol aphakamisa kakhulu ekungeneni kwengozi yomzimba, eminyakeni yamuva ochwepheshe sebeqale ukubuza ukuthi ukunciphisa amazinga e-LDL ama-cholesterol ngokwawo kunciphisa ingozi. Ngokuyinhloko, ngenkathi ukwehlisa amazinga e-LDL ama-cholesterol nezidakamizwa ze-statin kunciphisa kakhulu ingozi yomzimba, ukunciphisa amazinga e-LDL ama-cholesterol nezinye izinhlobo eziningi zemithi akubonwanga nakanjani ukwenza kanjalo. Yingakho abanye ochwepheshe sebeqalile ukuphazamisa i-cholesterol hypothesis , futhi kungani imihlahlandlela yamanje ekwelapheni i-cholesterol incike kakhulu ekusetshenzisweni kwama-statins.
"I-HDL ye-Cholesterol - I-Good" i-Cholesterol. Amazinga aphezulu egazi amazinga e-HDL e-cholesterol ahlobene nengozi ephansi yesifo senhliziyo, futhi ngokungafani, amazinga aphansi e-HDL ama-cholesterol ahlotshaniswa nengozi eyandayo. Ngenxa yalesi sizathu, i-HDL ye-cholesterol i-HDL ibizwa ngokuthi " "i-cholesterol.
Kubonakala sengathi i-HDL lipoprotein "ihlaziya" izindonga zemithambo yegazi futhi isusa i-cholesterol eyengeziwe. Ngakho-ke i-cholesterol ekhona kwi-HDL, ngokuyinhloko, i-cholesterol eyedlulele esanda kususwa emangqamuzaneni nasezindongeni zezinguquko zegazi futhi ithunyelwa emuva esibindi sokubuyisela kabusha. Ephakeme amazinga we-HDL we-cholesterol , mhlawumbe, ukwanda kwe-cholesterol kususwa lapho kungabangela khona umonakalo.
Eminyakeni yamuva, umqondo wokuthi i- HDL ye-cholesterol ihlale "inhle" igcwele umlilo , futhi empeleni, kubonakala sengathi iqiniso liyinkimbinkimbi kunokuba nje "i-HDL = i-cholesterol enhle." Izinkampani ezidakamizwa zisebenza kanzima ukuhlela izidakamizwa ngokwandisa amazinga e-HDL, ngokwesibonelo, kuze kube manje ziye zangena odongeni lwezitini. Izidakamizwa eziningana eziphakamisa ngempumelelo amazinga e-HDL zihlulekile ukuthuthukisa imiphumela yomzimba. Imiphumela efana nalokhu iphoqa ochwepheshe ukuthi bahlaziye ukucabanga kwabo nge-cholesterol ye-HDL.
Izimbangela ze-Cholesterol ephezulu
Amazinga aphezulu we-LDL ama-cholesterol angabangelwa yizici eziningana, kufaka phakathi izimo ze-heredity ezifana ne- hypercholesterolemia yomndeni . Ngokuvamile, amazinga e-cholesterol aphakeme ahlobene nokudla okuncane, ukukhuluphala, ukuphila ngokwempilo, iminyaka yobudala, ukubhema, nobulili (abesifazane base-pre-menopausal banezinga eliphansi le-cholesterol kunamadoda).
Izimo eziningi zezokwelapha, kuhlanganise nesifo sikashukela , i- hypothyroidism , izifo zesibindi, nokuhluleka kwezinso ezingapheli zingabuye zenze amazinga e-cholesterol. Ezinye izidakamizwa, ikakhulukazi i-steroids kanye ne-progesterone, zingenza okufanayo.
I-Triglycerides ne-Cardiac Risk
Ucwaningo oluningi lwezokwelapha lubonise ukuthi izinga eliphezulu legazi lika-triglyceride - isimo esibizwa ngokuthi i- hypertriglyceridemia - sibhekene nengozi enkulu ye-cardiovascular. Nakuba le nhlangano ivunyelwa yizazi, akukavunyelwanga ukuthi amazinga aphezulu e-triglyceride ayimbangela eqondile ye-atherosclerosis, njengoba kucatshangwa sengathi i-LDL cholesterol. Ayikho into evunyelwe ngokuvamile "ye-triglyceride hypothesis."
Noma kunjalo, akukho umbuzo wokuthi i-hypertriglyceridemia ihlotshaniswa kakhulu nenengozi enkulu ye-cardiovascular. Ngaphezu kwalokho, amazinga aphezulu e-triglyceride ayingxenye evelele kwezinye izimo eziningana ezaziwa ukwandisa ingozi yomzimba. Lezi zihlanganisa ukukhuluphala, ukuhlala phansi, ukubhema, i-hypothyroidism - ikakhulukazi isifo sikashukela kanye nohlobo lwesibili lwesifo sikashukela.
Ubuhlobo bokugcina bubaluleke kakhulu. Ukuvimbela i-insulin eveza isifo somzimba nesifo sikashukela sesibili sikhiqiza iphrofayili ye-metabolism eyandisa kakhulu ingozi yomzimba. Le phrofayili engathandeki yemethamo ihlanganisa, ngaphezu kwe-hypertriglyceridemia, amazinga e-CRP aphakeme , amazinga aphezulu e-LDL ama-cholesterol, namazinga aphansi e-HDL ama-cholesterol. (Eqinisweni, kuvame ukuhlobana phakathi kwe-triglyceride ne-HDL ye-cholesterol amazinga - aphezulu, aphansi kwesinye.) Abantu abane-insulin ukumelana nabo banesifo somfutho wegazi nokukhuluphala. Ingozi yabo yonke yesifo senhliziyo nokushaya isifo sikhulu kakhulu.
Njengoba kunikezwe izici eziyingozi ezivame ukuhambisana namazinga aphezulu e-triglyceride, kuyaqondakala ukuthi abacwaningi kuze kube manje baye bakwazi ukukhipha ukuthi ingozi enkulu ekhonjwe ngqo yi-hypertriglyceridemia ngokwayo.
Ukuhlola
Kusukela eneminyaka engu-20, ukuhlolwa kwe-cholesterol ne-triglycerides kunconywa njalo eminyakeni emihlanu. Futhi uma amazinga akho e-lipid atholakala ukuthi aphakanyisiwe, phinda ukuhlolwa kufanele kwenziwe ngonyaka.
- Funda mayelana nokuhlolwa kwe-cholesterol ne-triglycerides .
Nini Ukufuna Ukwelashwa
Ukunquma ukuthi ngabe kufanele uphathwe nge-cholesterol ephakeme noma amazinga aphezulu e-triglyceride, ngabe ngabe ukwelashwa kufanele kufake ukuphathwa kwezidakamizwa, nokuthi yiziphi izidakamizwa okufanele zisetshenziswe akuzona njalo ngokuqondile ngqo. Noma kunjalo, uma ingozi yakho yenhliziyo ikhuphuka, ukwelashwa okufanele okuhloswe emazingeni akho e-lipid kunganciphisa amathuba akho okuba nesifo senhliziyo, noma ngisho nokufa ngaphambi kwesikhathi. Ngakho uma kuziwa ekwelapheni i-cholesterol ne-triglycerides, kubalulekile ukuyiqonda kahle.
Izwi elivela
Amazinga aphakeme we-LDL cholesterol kanye ne-triglycerides ahlotshaniswa kakhulu nengozi ephezulu yesifo senhliziyo. Ngenkathi kusekhona impikiswano mayelana nokuthi izinga lama-cholesterol eliphakanyisiwe namazinga e-triglyceride ngokwawo abangela ngqo isifo senhliziyo, akukho ukuphikisana ngalokhu: Uma ingozi yakho ye-cardiovascular iphakanyisiwe udinga ukunciphisa; futhi ngokuqhubekayo, izinyathelo ozithathayo zokunciphisa amazinga akho ajwayelekile we-lipid nazo zizokwehlisa ingozi yomzimba wakho. Ngakho-ke, ake ochwepheshe bephikisana ngokuthi izindlela ze-cholesterol ne-triglycerides zihlobene kanjani nesifo senhliziyo. Kufanele ugxile ekuthatheni izinyathelo ezifakazelwe ukwehliswa ngokwakho, ingozi ngayinye.
> Imithombo:
> Ford, ES, Li, C, Zhao, G, et al. I-Hypertriglyceridemia ne-Treatment yayo ye-Pharmacologic Phakathi kwabantu abadala base-US. I-Arch Intern Med 2009; 169: 572.
> Stone NJ, uRobinson J, uLichtenstein AH, et al. Umhlahlandlela we-ACC / AHA ka-2013 ekuPhileni kwegazi le-Cholesterol ukunciphisa ingozi ye-Atherosclerotic Inhliziyo kubantu abadala: Umbiko we-American College of Cardiology / American Heart Association. J Am Coll Cardiol 2013.