人类疾病与生物化学第八章脂类代谢PPT.pptVIP

人类疾病与生物化学 ;第八章 脂类代谢与疾病 ;血脂 ;脂蛋白（Lipoprotein, Lp） ;Electron Microscopic Images of Negative Stained Lipoproteins;脂蛋白的结构;;Apo在调节血浆Lp代谢中的作用;载脂蛋白的合成场所、分布、功能及临床意义 ;几个与血浆脂蛋白代谢有关的酶;2、生理功能：;3、分泌机制;二、肝脂酶（hepatic lipase，HL）;三、卵磷脂胆固醇脂酰转移酶（LCAT）;CM和VLDL的合成;Metabolic fate of chylomicrons. (A, apolipoprotein A; B-48, apolipoprotein B-48; , apolipoprotein C; E, apolipoprotein E; HDL, high-density lipoprotein; TG, triacylglycerol; C, cholesterol and cholesteryl ester; P, phospholipid; HL, hepatic lipase; LRP, LDL receptor-related protein.) Only the predominant lipids are shown. ;Lipoprotein lipase;Metabolic fate of very low density lipoproteins (VLDL) and production of low-density lipoproteins (LDL). (A, apolipoprotein A; B-100, apolipoprotein B-100; ? apolipoprotein C; E, apolipoprotein E; HDL, high-density lipoprotein; TG, triacylglycerol; IDL, intermediate-density lipoprotein; C, cholesterol and cholesteryl ester; P, phospholipid.) Only the predominant lipids are shown. It is possible that some IDL is also metabolized via the LRP. ;LDL;Metabolism of high-density lipoprotein (HDL) in reverse cholesterol transport. (LCAT, lecithin:cholesterol acyltransferase; C, cholesterol; CE, cholesteryl ester; PL, phospholipid; A-I, apolipoprotein A-I; SR-B1, scavenger receptor B1; ABCA 1, ATP binding cassette transporter A1.) Preβ-HDL, HDL2, HDL3 - see Table 25–1. Surplus surface constituents from the action of lipoprotein lipase on chylomicrons and VLDL are another source of pre -HDL. Hepatic lipase activity is increased by androgens and decreased by estrogens, which may account for higher concentrations of plasma HDL2 in women. ;脂蛋白的功能;高血脂;高脂血症表型分类;原发性高血脂症 　　1.遗传因素 遗传可通过多种机制引起高脂血症，主要表现为细胞表面脂蛋白受体缺陷以及细胞内某些酶的缺陷(如脂蛋白脂酶的缺陷或缺乏)，也可发生在脂蛋白或载脂蛋白的分子上，多为基因缺陷引起。 　　2.饮食因素 高脂蛋白血症患者住院中有相当大的比例是与饮食因素密切相关的。 　　;继发性高血脂症 　　 继发性高血脂症是由于其他中间原发疾病所引起者，这些疾病包括：糖尿病、肝病、甲状腺疾病、肾??疾病、胰腺、肥胖症、糖原累积病、痛风、阿狄森病、柯兴综合症、异常球蛋白血症等。 ;继发性血脂异常;高脂血症的危害;高甘油三酯病人的非药物指导;超重与肥胖标准;运动指导;降脂药：;贝特类药物的主要作用方式是激活一组核受体PPARs中的一个，尤其