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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Anschrift für die Verfasser
PD Dr. med Hartmut Schmidt
Medizinische Klinik mit Schwerpunkt
Gastroenterologie, Hepatologie und
Endokrinologie
Campus Charité Mitte
Schumannstraße 20/21
10117 Berlin
Fax: 0 30/28028141
Email: janine.genschel@charite.de
