2015讲课脂类生物标记物 ppt课件

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1、动脉粥样硬化性心脑血管病脂代谢相关性生物标记物Biomarkersrelatedtolipidmetabolism威海市立医院李振光10-10-2015动脉粥样硬化性心血管疾病(CVD)心血管疾病是全球的头号死因（约占31%）；估计740万死于冠心病，670万人死于中风;3/4以上CVD死亡发生在低、中等收入国家;早期发现高危人群并予以管理是改善预后的关键生物标记物在期中扮演重要角色。TRADITIONALCARDIOVASCULARRISKFACTORSMajor,classicortraditionalriskfactorsarethosedefinedfrom

2、theFraminghamstudies;TheFraminghamcohortsbeganin1948,andaremilestonesintheidentificationofcardiovascularfactors.Includingage;sex;totalcholesterol,LDL-CandHDL-Clevels;systolicpressure;smoking;highbloodglucose;bodyweight;dietaryhabits;andphysicalinactivity.Basedonthesefindings,cardiovasc

3、ularriskscalesweredevelopedinordertoevaluatetheriskofaneventinaten-yearperiod.EmergingbiomarkersItisestimatedthatabout10to20%oftheindividualsthatsufferfromaneventdonotpresenttraditionalriskfactors,andthat60%ofthempresenttwoorlessfactors.Thesefindingsemphasizetheimportanceofsearchingfor

4、evidencethatemergingbiomarkersmaybetteridentifyplaquesthataremorevulnerabletorupture.AtherosclerosisdevelopsActivationoftheendotheliumandrecruitmentofimmunecells;Monocytedifferentiationandfoamcellformation;Developmentoffibroticplaquesduetodeathoffoamcellsandmigrationandproliferationofs

5、moothmusclecells(SMCs);Plaqueruptureandthrombosis.AtherosclerosisdevelopsSecreteextracellularmatrix(ECM)proteinsthatstabilizestheplaques(fibrouscap).InflammatorymarkersforASSeveralinflammatorymarkersareaffiliatedwithlipidslevelandtheprocessofatherosclerosis.Themostknownofthemare：interl

6、eukin6andinterleukin1β;C-reactiveprotein;tumornecrosisfactor-alpha;pentraxin3(PTX-3);serumamyloidA;sCD40;adhesionmolecules;monocytechemoattractantprotein-1;sEndoglin;PAPP-A;chemokine16;insulinlikegrowthfactor;lipoprotein-associatedphospholipaseA2;galectin3;Adiponectin(脂联素);myeloperoxid

7、ase(MPO,髓过氧化物酶)BiomarkersrelatedtolipidmetabolismBiomarkersrelatedtolipidmetabolism（8）1、ModifiedLDLparticles；2、ApolipoproteinAI(apoAI)；3、ApolipoproteinB；4、Lipoprotein(a)[Lp(a)]；5、Cholesterylestertransferprotein(CETP)；6、SubtypesofLDLandHDLparticles；7、Lipoprotein-associatedphospholipas