(Plasma Lipoproteins and Its Metabolic Disorder)

AS

lipidstriacylglycerollipoid

(TC) (FC) (CE) (PL)(TG)(FFA)

:4.07.0g/L

( lipoprotein, LP) . +

:CETGPLFCFCPL

,

CMVLDLIDLLDLHDLLp(a)----TG(80-90%)TG(50-70%)TGCEChCE(40-50%)PLCEPLAIB48CCCB100ECCCB100EB100AIA(a)B100 TGTGTGCECECE

LpaLPa 1LDL(TC) Apo B100Apo 2Lp()Apo(a)Apo(a) LDL 3Lp()LDL 4Apoa

Lpa 1Lp(a) 2Lp(a)0.2-0.3g/L 0.30 g/LAS2LDL-C CHD5LPa CHD 3Lp(a)CHDLpa 4Lpa

(apolipoproteinApo) 1972AlaupovicApoABCDEFGHJ

123

1ApoAB(a)Apo ,/

ApoEApoC ApoCII

19q111q2 2 , , ,ApoCApoAApoAApoA

LDLVLDL

,

LDL836 36 115kD, LDLR LDL (LDLR)

1 ApoB100ApoEApoB-E ApoB48 LDLApoB100VLDL-VLDL 2

-VLDLVLDL -LP CEApoApoEApoCVLDL

ApoB/ELDL43 LDLApoB100LDLLDL LDL6570LDLR

LDLApoB100ELDL

LDLR

l 2 3 4 5 6 7 LDL LDLRLDLR LDLLDL: CECh+FFA TGFFA ApoBAA LDL

: FC HMGCoA LDLRLDLRLDLLDLR ACATChCE

LDLLDL 5

VLDLRLDLRLDLR,5552193246 1

VLDLRApoE(VLDL-VLDLVLDL)LDL

2

VLDL-VLDL LDLR VLDLRVLDL-VLDL VLDLVLDLVLDL VLDLR 3

SR-A(SR-A6I:scavenger receptor, SR SR:SR-A-B-C-D-E -F

SR LDL () () LDL

: LPLHLLCATHMGCoAase: CETP LPL LCAT HMGCoAaseHL(HTGL)

LPL 60kD LPLLPL ApoC

1CMVLDLTG 2PL 3PLApoCh 4CM

/HL/HTGL 53kD: ApoC

: 1.VLDL-VLDLTG 2HDL3HDL2 3. HDL

LCAT: HDL41663kD

: Apo AI

1. ()HDLFCCECEHDL FC CE 2. ChCh

CoA HMG CoA

CETP: 74ku

CETPHDLCEHDL-c

CMCM

VLDLIDL LDL HDL HDL

(TG)FFAMGTGPL TGTCPLApoB48ApoAICM

HDL (ApoC,E) CM() CM (TG) LPL MG+FFA

CMLPLCM CM CMTG

TGApoB100CEVLDLVLDL VLDL:TGVLDL

LDLVLDLCEHDL(CETP LDL

HDL2CETPVLDLLDLCETGVLDLLDLFC HDL(RCT) ()HDL HDLHDLn,PLApoA,HDLHDLHDL3CE HDL2

TCTG CMVLDLLDLHDL

:

1967Fredrickson:

1970(WHO)

WHO

1()412h()?

2TGTC

3LP()LP(%)(?)

1 ( ) TG TC TC/TG0.2 CM () 10 () ICM

2LPLApoC TG TG Apo C() LPL CMTG CMCM CM

1 TCTG TC/TG1.6;LDL -LP AS AS () IIa()

2LDL (1) LDL LDL LDL(1/2) (2) LDLLDL (3) LDLLDL LDL LDLLDL-ChAS

1 ;TG,TC, TC/TG>1.0LDLVLDL(- LP -LP) ,AS 2ApoB100VLDL LDL () b-LP-LP

1 ; TG,TC IDL-LP (-LP-LP )-VLDL AS() (-VLDL- )

2 ApoE ApoEApoE2E3E4ApoE(LDL)E2LDLApoE3/E3LDLApoE2/E2LDLLDL

1 TGTCTC/TG 0.6-1.6 VLDL-LP AS 2 VLDL/VLDL () (TGVLDL)

1 () TGTCTC/TG 0.6 CM-LP 20 2 ApoCLPLLPL CMVLDLTG() (CM-LP)

TG4:(1)CMVLDLI(2)CMVLDLV(3)4VLDLTC TCIIIIIbTC(4)IIa

CETPHTGL HDL

HDL HDL-C2.6mmol/LHDLCETPHTGLHDL

AS AS HDLAS

ASASAS

LDL-VLDL oxLDLAS HDLAS AS

CMVLDLLPLCMIDLApoE -VLDL(ApoE)-VLDLASAS

LDL LDLLDLLDL,LDL: LDL LDL LDL LDLApoB100LDLLDLAS

LDL-CAS LDLAB: B(LDL)AS,BLDL,LDLLDLCHD LDL(SD-LDL) BLDL

LP(a) 0l000mg/LApo(a),Apo(a), 37Kringle-4(K-4),1Kringle-5(K5)1(a) Lp(a) Kringle(3)

LDL HDLAS

HDL: : NCEHCEFCHDLNCEH FC: NCEH NCEH

TG HDL-C X

(deadly quartet) Kaplan

IDF IDF

2002(NCEP)ATP III 33 >102cm >88cm 150mg/dL1.69mmol/L) HDL-C < 40 mg/ dL1.04mmol/L) < 50 mg/dL(1.29mmol/L) 110mg/dL (6.1mmol/L) 130/85 mmHg

2004 (CDS) 53 85 cm ; 80 cm ) SBP130mmHg / DBP85 mmHg 150mg/dL < 40 mg/ dL 110mg/dL

ASAS : TCTGLDL HDL AS

1997: ()

(mmol/L1997)

TCTGLDL-CHDL-C

(mmol/L)

AS() TC>5.70>6.213.64>4.145.703.10>3.644.70>5.202.60>3.10

1993ATP: LDL-C 3.36mmol/L HDL-C 0.9mmol/L 82001ATP LDL-C 2.6mmol/L HDL-C 1.0mmol/L LDL-CAS LDL-C2.6mmol/L ()

LDL-CHDL-CTCATP(mmol/L)

LDL-CTCHDL-C

CHDVLDL-CVLDL()VLDL-C TG4 1.7mmol/L 1.7 2.25mmol/L 2.26 5.64mmol/L 5.65mmol/L

/ ASAS

CE70FC30

:

1

1

(2) 70

2.85.2mmol/L

TCTCTC TC TC

TG: 2 TG

11 2KOH 3 4(45--27-)(NH4+)

2 TGTGGKGOD

0.561.70mmol/L 0.361.50mmol/L

1.70mmol/L (150mg/dl)

TGTG TG

3 (PL)PL : , 1.33.2mmol/L

Cl0(FFA) : (C18:1)54 (C16:1)34 (C18:1)6 (C22:0)(C14:0)(C20:1) FFA12min 4

FFA: FFA,: 424h30

: 0.40.9mmol/L

:24h() 4831

24mol/L 4.140.78mol/L 3.970.77mol/L 5

() 1 (ultracentrifugation method)

2(electrophoresis Method (TGTC) 12hCM

4 16h24h: CM,VLDL LDL 3

HDL-C 0.9mmol/L LDL-C 2.13.1mmol/L 2.8mmol/L4

() +

(1) (precipitate method)

PEG2000LDL+VLDL () HDL()HDL-C

HDL+VLDL () LDL()LDL-C

(2)

(pH)

HDL-CHDL-C0.9 mmol/L HDL-C1.55mmol/L HDL-CTGHDL-CHDL-CHDL-CHDL-CHDL-C 0.9mmol/L

LDL-C TCTGHDL-CLDL-CFriedewald1972 LDL-C=TC[HDL-C+(TG1/5)] CM TG4.60mmol/L

2.1 3.1mmol/L 2.8mmol/L

LDL-CTCHDL-CLDL-CTCLDL-C

Lp(a)-C : Lp(a)01000mg/L 300mg/LLp(a):

ApoApo (1) sApoAApoB100Apoa (2) ApoAangier ApoC

ApoHDLCLDL , Apo AI Apo B100, , , Apo AI Apo B100 ApoINAITA

ApoAIHDL ApoBLDLApoAIApoBHDLLDL ApoAIHDLApoBLDLHDLLDLApoAIApoBApoAIApoB

135 2LDL-CHDL-C1214

3441-3

5 (1) 31730 (2)

(3) 24LDL-C12-2411224

(4) 510min10-15min9-10

1.2 2.24h 3. 4.TCTCTG12h 5.5min

CDC 6.1min 7.EDTA2-81.03 8.24h41-20-70

NCEP-ATPTCTGHDL-CLDL-CapoAIapoBLp(a)