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14.11.2016 | Koronare Herzerkrankung | Übersichten

Klinische Bedeutung des HDL-Cholesterins

Erschienen in: Herz | Ausgabe 1/2017

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Zusammenfassung

Einleitung

In Deutschland werden pro Jahr 16–17 Mio. Bestimmungen des HDL („high-density lipoprotein“)-Cholesterins (HDL‑C) durchgeführt und interpretiert. Aktuelle Daten haben zu einer fundamentalen Neubewertung der klinischen Bedeutung des HDL‑C geführt.

Methode

Diese Übersichtsarbeit basiert auf einer selektiven Literaturrecherche.

Ergebnisse

Niedriges HDL‑C ist in der Regel ein Hinweis auf ein erhöhtes kardiovaskuläres Risiko, insbesondere in der Primärprävention, die epidemiologische Beziehung zwischen HDL‑C und dem Risiko ist jedoch komplex. HDL spielt eine Rolle für den Rücktransport und die Ausscheidung von Cholesterin. Die biologischen Funktionen von HDL sind dabei von der Protein- und Lipidzusammensetzung abhängig, die nicht durch den HDL-C-Gehalt erfasst werden. In pathologischer Zusammensetzung kann HDL auch negative vaskuläre Effekte ausüben.

Schlussfolgerung

Im Vergleich zum LDL („low-density lipoprotein“)-Cholesterin (LDL-C) kommt dem HDL‑C eine nachrangige Bedeutung für die kardiovaskuläre Risikostratifizierung zu, die generelle Berechnung von Quotienten aus LDL- und HDL‑C ist nicht sinnvoll. Niedriges HDL‑C sollte dazu veranlassen, die betroffene Person bezüglich metabolischer und inflammatorischer Pathologien zu untersuchen. Eine Anhebung des HDL‑C durch Lebensstilumstellung (Rauchstopp, körperliche Bewegung) hat positive Auswirkungen und ist empfehlenswert. Das HDL‑C stellt jedoch aktuell kein valides Ziel für eine medikamentöse Therapie dar.

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Titel: Klinische Bedeutung des HDL-Cholesterins
Publikationsdatum: 14.11.2016
Schlagwörter: Koronare Herzerkrankung
KHK in der Hausarztpraxis
Prävention und Rehabilitation in der Kardiologie
Prävention und Screening in der Hausarztpraxis
Erschienen in: Herz / Ausgabe 1/2017
Print ISSN: 0340-9937
Elektronische ISSN: 1615-6692
DOI: https://doi.org/10.1007/s00059-016-4499-0

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Einleitung

Methode

Ergebnisse

Schlussfolgerung

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