{"id":10855,"date":"2016-12-06T12:53:53","date_gmt":"2016-12-06T09:53:53","guid":{"rendered":"https:\/\/www.synevo.ro\/informatii-medicale\/particulele-ldl-small-dense-sdldl-factor-de-risc-independent-pentru-ateroscleroza\/"},"modified":"2021-01-20T15:02:45","modified_gmt":"2021-01-20T13:02:45","slug":"particulele-ldl-small-dense-sdldl-factor-de-risc-independent-pentru-ateroscleroza","status":"publish","type":"synevo_medical","link":"https:\/\/old.synevo.md\/ru\/informatii-medicale\/particulele-ldl-small-dense-sdldl-factor-de-risc-independent-pentru-ateroscleroza\/","title":{"rendered":"Particulele LDL \u201esmall-dense\u201d (sdLDL) \u2013 factor de risc independent pentru ateroscleroz\u0103"},"content":{"rendered":"<h2 class=\"has-text-color wp-block-heading\" style=\"color:#00539f\">Colesterol LDL<\/h2><div class=\"container synevo-content-box title-icon-inline box-text-center\">\n    <div class=\"sycbox-items\">\n        \n                <div class=\"sycbox-item\">\n            <div class=\"sycbox-head\">\n                <div class=\"sycbox-image\">\n                                             <img decoding=\"async\" src=\"https:\/\/old.synevo.md\/wp-content\/themes\/synevo-sage\/resources\/assets\/images\/icons\/icon-blood-tests.svg\" alt=\"-\">\n                                    <\/div>\n                <div class=\"sycbox-title\">Factor de risc pentru bolile cardiovasculare<\/div>\n            <\/div>\n            <div class=\"sycbox-description\"><p>Colesterolul LDL (Low-density lipoprotein cholesterol, LDL-C) este considerat a fi unul dintre cei mai importan\u021bi factori de risc pentru bolile cardiovasculare. Cu toate acestea, multe persoane cu nivel de LDL-C \u00een intervalul de referin\u021b\u0103 dezvolt\u0103 afec\u021biuni cardiovasculare1.<\/p>\n<\/div>\n            \n                    <\/div>\n                \n                \n    <\/div>\n<\/div><p><strong>Lipoproteinele cu densitate joas\u0103 (LDL) <\/strong>sunt o popula\u021bie heterogen\u0103 de particule lipidice ce variaz\u0103 \u00een dimensiune, densitate, sarcin\u0103 electric\u0103 \u0219i compozi\u021bie chimic\u0103 (lipide \u0219i apoproteine). Heterogenitatea particulelor LDL a fost identificat\u0103 pentru prima data \u00een anii \u201940 prin ultracentrifugare analitic\u0103 \u0219i, mai t\u00e2rziu, prin ultracentrifugare \u00een gradient de densitate \u0219i electroforez\u0103 \u00een gel cu gradient. <\/p><div class=\"synevo-shop-products\">\r\n    <div class=\"sysprod\">\r\n        \r\n        <div class=\"sysprod-products\">\r\n                            <div class=\"sysprod-product\">\r\n                    <a class=\"sysprod-product-title\" href=\"https:\/\/old.synevo.md\/ru\/shop\/colesterol-ldl\/\">Colesterol LDL<\/a>\r\n                    <div class=\"sysprod-product-price\">\r\n                        <span>Pre\u021b:<\/span>\r\n                        <span>90.00 lei<\/span>\r\n                    <\/div>\r\n                                            <div class=\"sysprod-product-addcart\">\r\n                            <a\r\n                                href=\"?add-to-cart=11934\"\r\n                                data-quantity=\"1\"\r\n                                class=\"addToCart button product_type_simple add_to_cart_button ajax_add_to_cart \"\r\n                                data-product_id=\"11934\"\r\n                                data-product_sku=\"CH23\"\r\n                                rel=\"nofollow\"\r\n                            ><div><\/div><\/a>\r\n                        <\/div>\r\n                                    <\/div>\r\n                    <\/div>\r\n        \r\n    <\/div>\r\n<\/div>\r\n\r\n<style>\r\n.synevo-shop-products {\r\n    padding: 24px 0;\r\n    margin: 24px 0;\r\n    border-radius: 10px;\r\n    background: #F6F7F9;\r\n}\r\n.synevo-shop-products .sysprod-product {\r\n    position: relative;\r\n    margin: 0 24px;\r\n    margin-bottom: 24px;\r\n    border-radius: 10px;\r\n    background: #fff;\r\n    display: flex;\r\n    flex-direction: row;\r\n    align-items: center;\r\n}\r\n.synevo-shop-products .sysprod-product:last-child {\r\n    margin-bottom: 0;\r\n}\r\n.synevo-shop-products .sysprod-product-title {\r\n    flex-grow: 1;\r\n    padding: 15px;\r\n    margin-left: 14px;\r\n    font-family: Poppins,sans-serif;\r\n    font-weight: 600;\r\n    font-size: 16px;\r\n    color: #29263F;\r\n}\r\n.synevo-shop-products .sysprod-product-price {\r\n    flex-shrink: 0;\r\n    font-family: Poppins,sans-serif;\r\n    font-weight: 600;\r\n    font-size: 18px;\r\n    color: #FDB813;\r\n}\r\n.synevo-shop-products .sysprod-product-addcart {\r\n    flex-shrink: 0;\r\n    position: relative;\r\n    width: 38px;\r\n    height: 38px;\r\n    margin-left: 24px;\r\n    margin-right: 24px;\r\n}\r\n.synevo-shop-products .sysprod-product-addcart .button {\r\n    top: unset;\r\n    right: unset;\r\n}\r\n<\/style><p>Aplicarea combinat\u0103 a acestor tehnici a stabilit c\u0103 \u00een plasm\u0103 exist\u0103 mai multe subclase de LDL ce pot fi clasificate pe baza densit\u0103\u021bii \u0219i dimensiunii particulelor \u00een <strong>3 frac\u021biuni majore<\/strong>, denumite<strong> LDL I-III<\/strong>: <\/p><div class=\"wp-block-columns is-layout-flex wp-container-core-columns-is-layout-1 wp-block-columns-is-layout-flex\"><div class=\"wp-block-column is-layout-flow wp-block-column-is-layout-flow\"><\/div>\n\n<div class=\"wp-block-column is-layout-flow wp-block-column-is-layout-flow\"><figure class=\"wp-block-table\"><table><thead><tr><th>LDL I-III<\/th><\/tr><\/thead><tbody><tr><td>LDL-I cu intervalul de densitate: 1.022-1.032 Kg\/L<\/td><\/tr><tr><td>LDL-II: 1.032-1.038 kg\/L<\/td><\/tr><tr><td>LDL-III: 1.038-1.050 kg\/L<\/td><\/tr><\/tbody><\/table><\/figure><\/div>\n\n<div class=\"wp-block-column is-layout-flow wp-block-column-is-layout-flow\"><\/div><\/div><p> \u0219i o <strong>frac\u021biune minor\u0103, LDL-IV (1.050-1.063 kg\/L)<\/strong>. \u00cen plus, \u00een func\u021bie de predominan\u021ba unei anumite subclase LDL au fost definite urm\u0103toarele fenotipuri: <strong>feniotipul A<\/strong>, \u00een care predomin\u0103 <strong>particulele LDL mari, u\u0219oare<\/strong> (LDL-I \u0219i LDL-2, \u201elarge buoyant\u201d, lbLDL), <strong>fenotipul B c<\/strong>aracterizat prin predominan\u021ba p<strong>articulelor LDL mici, dense <\/strong>(LDL-III, \u201esmall dense\u201d LDL, sdLDL &gt;50%) \u0219i un fenotip intermediar A\/B (40-50% LDL-III)<sup>2<\/sup>.<\/p><div class=\"wp-block-image\"><figure class=\"aligncenter\"><img decoding=\"async\" src=\"\/wp-content\/uploads\/2016\/09\/1.jpg\" alt=\"1\" class=\"wp-image-22217\"\/><\/figure><\/div><p class=\"has-text-align-center has-small-font-size\"><em>Tipuri particule LDL \u2013 https:\/\/drjockers.com\/11-steps-to-beat-heart-disease\/<\/em><\/p><p><strong>Dimensiunea particulelor LDL<\/strong> reprezint\u0103 un <strong>marker predictiv important <\/strong>pentru e<strong>venimentele cardiovasculare \u0219i progresia bolii coronariene<\/strong>, iar predominan\u021ba particulelor sdLDL a fost acceptat\u0103 de National Cholesterol Education Program Adult Treatment Panel III ca un factor de risc cardiovascular emergent<sup>3<\/sup>.<\/p><div class=\"wp-block-image\"><figure class=\"aligncenter\"><img decoding=\"async\" src=\"\/wp-content\/uploads\/2016\/09\/2.jpg\" alt=\"2\" class=\"wp-image-22218\"\/><\/figure><\/div><p class=\"has-text-align-center has-small-font-size\"><em>Dimensiunea si numarul particulelor LDL reprezint\u0103 un marker predictiv important pentru evenimentele cardiovasculare \u2013 https:\/\/www.onewellnessplace.com\/blog\/particlesize<\/em><\/p><p>Pentru a explica a<strong>terogenitatea crescut\u0103 a sdLDL comparativ cu lbLDL<\/strong> au fost propuse o serie de mecanisme: <strong>o afinitate mai sc\u0103zut\u0103 pentru receptorul LDL<\/strong>; un grad de penetrare mai mare \u00een peretele arterial; interac\u021biune crescut\u0103 cu componentele matricei extracelulare (reten\u021bie arterial\u0103 crescut\u0103 datorit\u0103 leg\u0103rii la proteoglicani) \u0219i o mai mare sensibilitate la oxidare. Deoarece particulele sdLDL sunt mai mici \u0219i con\u021bin mai pu\u021bin colesterol, nivelurile crescute de sdLDL reprezint\u0103, de asemenea, un num\u0103r mai mare de particule aterogene, care nu pot s\u0103 nu fie reflectate de nivelul de LDL-C<sup>1<\/sup>.<\/p><p>\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Distribu\u021bia subclaselor de LDL este determinat\u0103 at\u00e2t genetic, c\u00e2t \u0219i de factorii de mediu. Mai mult, concentra\u021bia de sdLDL este puternic corelat\u0103 cu nivelul <a href=\"https:\/\/www.synevo.md\/shop\/trigliceride\/\" class=\"rank-math-link\" rel=\"nofollow noopener\" target=\"_blank\">trigliceridelor<\/a> \u0219i este crescut\u0103 la persoanele cu diabet sau sindrom metabolic<sup>1<\/sup>.<\/p><p>          Studii clinice recente au demonstrat c\u0103 a<strong>cumularea particulelor sdLDL \u00een plasm\u0103 este asociat\u0103 cu un risc crescut de boli cardiovasculare si sindrom metabolic. <\/strong>Mai mult, m\u0103surarea concentra\u021biei colesterolului sdLDL (sdLDL-C) s-a dovedit a fi util\u0103 \u00een evaluarea prezen\u021bei \u0219i severit\u0103\u021bii bolilor cardiovasculare. \u00cen plus, un studiu efectuat de Arai et al. a demonstrat <strong>utilitatea sdLDL-C ca marker predictiv pentru inciden\u021ba afec\u021biunilor cardiace<\/strong><sup>4<\/sup>.<\/p><p>          De asemenea, prezen\u021ba unor concentra\u021bii crescute de sdLDL este un predictor negativ \u00een ceea ce prive\u0219te evolu\u021bia pacien\u021bilor cu angioplastie periferic\u0103. Prin urmare, m\u0103surarea acestui parametru ar trebui luat\u0103 \u00een considerare la pacien\u021bii care vor suferi acest tip de interven\u021bie. \u00cen plus, pentru a \u00eembun\u0103t\u0103\u021bi rezultatele clinice dup\u0103 o astfel de interven\u021bie vascular\u0103 trebuie aplicate terapiile de reducere a concentra\u021biei de sdLDL<sup>5<\/sup>.<\/p><p>          \u00cen ceea prive\u0219te patologia neurologic\u0103, un studiu recent a ar\u0103tat c\u0103 <strong>prezen\u021ba sdLDL ar putea fi independent asociat\u0103 cu un prognostic nefavorabil dup\u0103 un accident vascular ischemic acut<\/strong><sup>6<\/sup>.<\/p><div class=\"container synevo-content-box title-icon-inline box-text-center bullet-list\">\n    <div class=\"sycbox-items\">\n        \n                <div class=\"sycbox-item\">\n            <div class=\"sycbox-head\">\n                <div class=\"sycbox-image\">\n                                             <img decoding=\"async\" src=\"https:\/\/old.synevo.md\/wp-content\/themes\/synevo-sage\/resources\/assets\/images\/icons\/icon-diagnostics.svg\" alt=\"-\">\n                                    <\/div>\n                <div class=\"sycbox-title\">Recomand\u0103ri pentru efectuarea testului:<\/div>\n            <\/div>\n            <div class=\"sycbox-description\"><p>Hiperlipemie familial\u0103 combinat\u0103<\/p>\n<p>Diabet zaharat tip II, rezisten\u021b\u0103 la insulin\u0103, sindrom metabolic<\/p>\n<p>Sindromul ovarelor polichistice<\/p>\n<p>Hipertrigliceridemie postprandial\u0103 marcat\u0103<\/p>\n<p>Pacien\u021bi dializa\u021bi<\/p>\n<p>Boal\u0103 renal\u0103 cronic\u0103<\/p>\n<p>Pacien\u021bi cu profil lipidic clasic normal dar cu istoric familial pozitiv de afec\u021biuni cardiovasculare<\/p>\n<p>Monitorizarea terapiei hipolipemiante<\/p>\n<\/div>\n            \n                    <\/div>\n                \n                \n    <\/div>\n<\/div><h3 class=\"has-text-color wp-block-heading\" style=\"color:#00539f\">Condi\u021bii de recoltare, transport \u0219i stocare a probelor:<\/h3><p>Este obligatoriu ca <strong>probele de s\u00e2nge s\u0103 fie recoltate \u00e0 jeun <\/strong>(dup\u0103 12 ore de la ultima mas\u0103) \u00een vacutainer f\u0103r\u0103 anticoagulant, cu\/f\u0103r\u0103 gel separator; serul ob\u021binut \u00een urma centrifug\u0103rii va fi transport \u0219i stocat la (-15)-(-25)\u00b0C p\u00e2n\u0103 \u00een momentul efectu\u0103rii testului.<\/p><p>\u00cen laboratoarele Synevo sdLDL este determinat printr-o <strong>metod\u0103 fotometric\u0103 automat\u0103 \u0219i este raportat la LDL-C total<\/strong>. Valorile procentuale &lt; 35% sunt considerate fiziologice, \u00een timp ce valorile &gt; 50% sunt critice din punct de vedere fiziopatologic.<\/p><p>          Nivelul de sdLDL poate fi redus prin diet\u0103, activitate fizic\u0103<sup>7 <\/sup>\u0219i administrarea de statine<sup>8<\/sup>.<\/p><hr class=\"wp-block-separator\"\/><p><strong>Referin\u021be<\/strong><\/p><ol class=\"wp-block-list\"><li>Hoogeveen RC1, Gaubatz JW, Sun W, Dodge RC, Crosby JR, Jiang J, Couper D, Virani SS, Kathiresan S, Boerwinkle E, Ballantyne CM. Small dense low-density lipoprotein-cholesterol concentrations predict risk for coronary heart disease: the Atherosclerosis Risk In Communities (ARIC) study. Arterioscler Thromb Vasc Biol. 2014 May;34(5):1069-77.<\/li><\/ol><ol class=\"wp-block-list\" start=\"2\"><li>Davies IG, Graham JM, Griffin BA. Rapid separation of LDL subclasses by iodixanol gradient ultracentrifugation. <a href=\"http:\/\/www.ncbi.nlm.nih.gov\/pubmed\/?term=Rapid+Separation+of+LDL+Subclasses+by+Iodixanol+Gradient+Ultracentrifugation\" rel=\"nofollow noopener\" target=\"_blank\">Clin Chem.<\/a> 2003 Nov;49(11):1865-72.<\/li><li>Rizzo M, Berneis K. Low-density lipoprotein size and cardiovascular risk assessment. <a href=\"http:\/\/www.ncbi.nlm.nih.gov\/pubmed\/16371404\" rel=\"nofollow noopener\" target=\"_blank\">QJM.<\/a> 2006 Jan;99(1):1-4. 4. Cho Y, Lee SG, Jee SH, Kim JH. \u2013 Hypertriglyceridemia is a major factor associated with elevated levels of small dense LDL cholesterol in patients with metabolic syndrome. Ann Lab Med. 2015 Nov;35(6):586-94.<\/li><li>Jacomella V, Gerber PA, Mosimann K, Husmann M, Thalhammer C, Wilkinson I, Berneis K, Amann-Vesti BR. Small dense low density lipoprotein particles are associated with poor outcome after angioplasty in peripheral artery disease. PLoS One. 2014 29;9(9):e108813.<\/li><li>Manabe Y, Morihara R, Matsuzono K, Nakano Y, Takahashi Y, Narai H, Omori N, Abe K. Estimation of the Presence of Small Dense Lipoprotein Cholesterol in Acute Ischemic Stroke. Neurol Int. 2015 Jun 3;7(1):5973.<\/li><li>Dutheil F, Walther G, Chapier R, Mnatzaganian G, Lesourd B, Naughton G, Verney J, Fogli A, Sapin V, Duclos M, Vinet A, Obert P, Courteix D, Lac G. Atherogenic subfractions of lipoproteins in the treatment of metabolic syndrome by physical activity and diet \u2013 the RESOLVE trial. Lipids Health Dis. 2014 Jul 11;13:112.<\/li><li>Ai M, Otokozawa S, Asztalos BF, Nakajima K, Stein E, Jones PH, Schaefer EJ. Effects of maximal doses of atorvastatin versus rosuvastatin on small dense low-density lipoprotein cholesterol levels. Am J Cardiol. 2008 Feb 1;101(3):315-8.<\/li><\/ol>","protected":false},"featured_media":22720,"template":"","synevo_medical_category":[889],"class_list":["post-10855","synevo_medical","type-synevo_medical","status-publish","has-post-thumbnail","hentry","synevo_medical_category-articole"],"synevo_medical_metadata_title":["Particulele LDL \u201esmall-dense\u201d (sdLDL) \u2013 factor de risc independent pentru ateroscleroz\u0103"],"synevo_medical_metadata_author":[",5549"],"_links":{"self":[{"href":"https:\/\/old.synevo.md\/ru\/wp-json\/wp\/v2\/synevo_medical\/10855","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/old.synevo.md\/ru\/wp-json\/wp\/v2\/synevo_medical"}],"about":[{"href":"https:\/\/old.synevo.md\/ru\/wp-json\/wp\/v2\/types\/synevo_medical"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/old.synevo.md\/ru\/wp-json\/wp\/v2\/media\/22720"}],"wp:attachment":[{"href":"https:\/\/old.synevo.md\/ru\/wp-json\/wp\/v2\/media?parent=10855"}],"wp:term":[{"taxonomy":"synevo_medical_category","embeddable":true,"href":"https:\/\/old.synevo.md\/ru\/wp-json\/wp\/v2\/synevo_medical_category?post=10855"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}