aterosklerozАтеросклерозAteroscleroz2078-256X2949-3633НИИТПМ-филиал ИЦиГ СО РАН10.52727/2078-256X-2021-17-2-61-71ateroskleroz-437Research ArticleОБЗОРЫREVIEWSФункциональная многогранность липопротеинов высокой плотности: поиск золотой серединыFunctional diversity of high-density lipoproteins: finding the golden meanhttps://orcid.org/0000-0001-8665-9129МетельскаяВ. А.MetelskayaV. A.

 д-р биол. наук, проф.

101990, Москва, Петроверигский пер., 10, стр. 3

101990, Moscow, Petroverigskiy ln., 10, bldg. 3

vmetelskaya@gnicpm.ruФГБУ Национальный медицинский исследовательский центр терапии и профилактической медицины Минздрава РоссииNational Medical Research Center of Therapy and Preventive Medicine2021100820211726171Copyright © Метельская В.А., 20212021Метельская В.А.Metelskaya V.A.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://ateroskleroz.elpub.ru/jour/article/view/437

 Настоящий обзор посвящен анализу зависимости между содержанием в плазме крови холестерина липопротеинов высокой плотности (ХС ЛПВП) и риском заболеваний,  связанных с атеросклерозом. Рассмотрено клиническое  значение крайне высоких концентраций ХС ЛПВП и их вклад в атеропротективные свойства этих липопротеинов. Поскольку научные дискуссии относительно роли уровня ХС ЛПВП в детерминации риска атеросклеротических заболеваний продолжаются до сих пор, в обзоре  представлены и проанализированы доводы ведущих  специалистов как «за», так и «против» новых взглядов на  ЛПВП. Существенное внимание уделено анализу возможных  причин и механизмов проатерогенных эффектов ЛПВП, обнаруживаемых у лиц с очень высоким содержанием ХС ЛПВП, которые изучаются с помощью методов протеомики и метаболомики. Обсуждается вопрос, все ли субпопуляции ЛПВП обладают одинаковым антиатерогенным потенциалом или становятся одинаково  проатерогенными, в какой степени биологическая  активность ЛПВП определяется вариациями их субфракционного спектра. Рассматриваются принципы  разработки доступного метода оценки функциональной активности ЛПВП. 

 The review is devoted to the analysis of the relationship between blood levels of high-density lipoprotein cholesterol (HDL-С) and atherosclerosis-related diseases. The review considers the clinical significance of extremely high HDL-C levels in connection with atheroprotective roles of HDL. While scientific discussions regarding the role of HDL-C level in determining the risk of  atherosclerosisrelated diseases are still ongoing, the review presents and  analyzes the arguments of leading experts both «pro» and «contra» new views on HDL. Significant attention is paid to the analysis of possible causes and mechanisms of HDL proatherogenic effects found in subjects with very high HDL-C levels, which are studied using proteomics and metabolomics methods. The question of whether all HDL subpopulations have the same anti- or proatherogenic potential, and to what extent the biological activity of HDL is determined by variations in their subfractional spectrum, is discussed. The principles of developing an accessible method for assessing the functional  activity of HDL are considered. 

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The authors declare that there are no conflicts of interest present.