Health Behavior News Service - With 40 percent of all heart attacks and related cardiovascular problems being related to low levels of so-called “good” HDL cholesterol, researchers have long sought medications to increase the amount of HDL cholesterol in the body’s circulation.健康行为的新闻服务与40 % ,占全部心脏病和心血管疾病有关的问题涉及到低水平所谓的"好"胆固醇水平,科学家长期以来一直在寻找药品金额增加高密度脂蛋白胆固醇在体内的循环系统中.

But a new review of 31 randomized controlled trials published in the Journal of the American Medical Association suggests that so far, only modest evidence supports the use of most medications to raise levels of high-density lipoprotein (HDL) — good cholesterol.但一项新的审查31随机对照试验发表在美国医学会杂志协会表明,到目前为止,只有少量证据支持使用最多的药物,以提高水平的高密度脂蛋白(高密度脂蛋白)胆固醇. Some are even harmful.有的甚至是有害的.

The authors concluded that while efforts to lower low-density lipoprotein (LDL or “bad cholesterol”) “have consistently reduced cardiovascular disease risk, HDL-based approaches are much more complex and sometimes disappointing.” As a result, “the primary focus should be on LDL,” said review co-author Mehdi Shishehbor, D.O., of the Cleveland Clinic.作者的结论是,尽管努力降低低密度脂蛋白(低密度脂蛋白或"坏胆固醇" ) "不断降低心血管疾病风险,高密度脂蛋白的做法要复杂得多,有时令人失望"作为一个结果, "应该把主要焦点对低密度脂蛋白,说: "检讨合著梅迪shishehbor , d.o. ,克利夫兰诊所.

“The news is that not everything that raises HDL will be beneficial,” said Ronald Krauss, M.D., spokesman for the American Heart Association and director of atherosclerosis research at Children’s Hospital Oakland Research Institute in California. "的消息是不妥当引起高密度脂蛋白将是有益的, "罗纳德说,克劳斯,医学博士,发言人为美国心脏协会主任及动脉硬化研究,在儿童医院奥克兰研究所,在美国加州.

“HDL is a much more complicated issue than LDL,” said Prediman Shah, M.D., director of the Atherosclerosis Research Center at Cedars-Sinai Medical Center in Los Angeles. "高密度脂蛋白是一个更复杂的问题,低密度脂蛋白比说: " prediman沙阿,医学博士,主任动脉粥样硬化研究中心218.103.220.197 -西奈医学中心在洛杉矶举行. “It’s not only important how much HDL there is, but what kind it is. "这不仅是重要的多少,高密度脂蛋白有,但什么样是的. Quality is as important as quantity.质量与数量同等重要. Is the function good or is it [a form of HDL] that doesn’t do the job properly?”功能是好抑或是[一种高密度脂蛋白]不做好这方面的工作? "

There are many types of HDL, not all of which nurture the heart and blood vessels.有许多种类的高密度脂蛋白,不是所有的培育心脏和血管. The good kinds of HDL seem to carry fat out of arteries to the liver and perform functions in cell membranes and elsewhere.好种脂蛋白似乎携带发出血管,肝脏和履行职能的细胞膜及其他地方. However, HDLs vary considerably in size, density and other chemical properties that change their ability to sustain health.不过, hdl的差别相当大的规模,密度和其他化学性质变化的能力,以维持健康.

Certain kinds of HDL could even increase inflammation, clogging arteries rather than clearing them, and doctors currently do not have a simple way to tell this “bad” type of “good” cholesterol from the genuinely beneficial kind in their patients.某些类型的高密度脂蛋白,甚至可以增加炎症,血管堵塞,而非结算,其中,医生目前还没有一种简单的方式告诉大家"坏"式的"好胆固醇" ,从真正有利于这类病人. Right now, only expensive tests used in research settings can sort the different types of HDL cholesterol.现在,只有昂贵的测试研究中所用的设置,可以解决不同类型的高密度脂蛋白胆固醇.

Fortunately, lifestyle changes can help without negative side effects, according to the review.幸运的是,生活方式的变化,可以帮助无不良副作用,根据审查. “The safest way to raise HDL is by weight loss, exercise and smoking cessation,” Shishehbor said. "最安全的方式,以提高高密度脂蛋白是减肥,运动,戒烟, " shishehbor说.

The review also found support for moderate alcohol use — one or two drinks a day for men, one for women — although physicians do not recommend that nondrinkers take up drinking to protect their hearts.审查还发现,支持适度饮酒使用一至两每天饮酒为男性,一名为女性,虽然医生不建议没过多久负起饮用水,以保障他们的心声. Raising HDL by eating fish or taking fish oil to increase intake of omega-3 fatty acids is another effective strategy, the review suggested.提高高密度脂蛋白,由吃鱼或鱼油等,以增加摄取奥米加-3脂肪酸,是另一种有效的策略,检讨建议.

As for pharmacological approaches, the review found that the most effective currently available drug to raise HDL is the vitamin niacin, taken in high doses.至于药理办法,审查发现,最有效的现有药物,提高高密度脂蛋白是抗癞皮病维生素,采取高剂量. “Statins, niacin and fibrates are available pharmacologic agents that increase HDL; however, they may be associated with adverse side effects,” said Shishehbor, who recommended close medical supervision. "他汀类,烟酸和贝特都是可用的药物增加高密度脂蛋白;不过,他们可能与不良的副作用, " shishehbor说,世卫组织建议医务人员的密切监督.

At least one-third of patients cannot tolerate high-dose niacin, according to Shah.至少有三分之一的病人不能耐受高剂量的抗癞皮病,据沙阿. “The most common side effect is flushing and itching that drives some people nuts.” He said methods exist to minimize the problem, but they do not work for everyone. "最常见的副作用是潮红及瘙痒驱使一些人发疯"他说,方法存在的问题降至最低,但他们却没有工作,为每一个人.

Meanwhile, new medications have proved disappointing.同时,新的药物,已证明令人失望. Trials of one drug, torcetrapib, ended abruptly because the drug increased mortality risk and raised blood pressure.试验一种药物,药物torcetrapib ,突然断绝,因为药物死亡率上升的危险,血压升高. The class of diabetes drugs called thiazolidinediones (which include Avandia and Actos) increase HDL, but also seem to raise the risk of cardiovascular problems.一类糖尿病药物名为噻(其中包括迪雅和血糖) ,提高高密度胆固醇,但似乎还可能会引起心血管问题.

The once highly touted weight-loss drug rimonabant, which blocks the brain receptors activated by marijuana, does raise HDL; however, the U.S. Food and Drug Administration recently refused to approve it because it also seems to elevate risk for psychiatric problems like depression.一度极受追捧,减肥药利莫那班,可以阻断大脑受体激活大麻,不提高高密度脂蛋白;然而,美国食品和药物管理局近日拒绝批准,因为它似乎也提升风险精神科问题,如抑郁.

“I’m much more excited about the prospect of what’s coming in this area in the next three to five years,” said Shah, who is studying approaches to boosting HDL that use different mechanisms from those that have been associated with problems. "我更兴奋的前景怎样的未来,在这方面,在未来三到五年内, "沙阿说,他们正在研究办法,以增加高密度脂蛋白,采用不同的机制,从那些已经与相关问题. Clinical trials of a gene therapy based on his research are currently under way.临床试验的基因疗法基于他的研究,目前正在进行之中.

People with blood levels of HDL cholesterol lower than 35 mg/dL have eight times the risk of heart disease compared to those with 65mg/dL or more.人血高密度脂蛋白胆固醇低于35毫克/消旋有8倍,患心脏病的人相比,患与65mg/dl或以上. Some 16 percent to 18 percent of men have low HDL cholesterol levels, compared with 3 percent to 6 percent of women.约16 %至18 %的男性低高密度脂蛋白胆固醇水平,相比3 %至六%的妇女.