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循环中低HDL-C水平被认为是动脉粥样硬化性心血管疾病(ASCVD)的主要危险因素。尽管HDL-C浓度与ASCVD风险具有较强的负相关性,近期大型研究显示药物升高HDL-C的干预手段未能减少心血管事件发生率,同时可能具有明显的不良反应。日益增加的证据支持HDL功能而非HDL-C浓度对于评价ASCVD风险、判断临床预后更有分析价值。将来的研究应当着眼于测量方法的标准化,并进一步阐释胆固醇外排能力(CEC)在预测疾病风险、反映治疗效果等方面的作用。
Low circulating levels of HDL-C are considered to be major risk factors for atherosclerotic cardiovascular disease (ASCVD). Although HDL-C concentrations are strongly negatively correlated with ASCVD risk, a large recent study showed that interventions to elevate HDL-C by drugs did not reduce the incidence of cardiovascular events and may have significant adverse effects. Increasing evidence supporting HDL function rather than HDL-C concentration is more analytical value in assessing ASCVD risk and judging clinical outcome. Future research should focus on the standardization of measurement methods and further elucidate the role of cholesterol efflux capacity (CEC) in predicting disease risk and reflecting treatment outcomes.