Образование рецепторов ЛНП на адекватном уровне

Некоторые люди не подвержены атеросклерозу, поскольку концентрация ЛНП в их крови не возрастает до опасного уровня, несмотря на высокое содержание жиров в рационе. Возможно, у них это наследственное, т.е. существуют гены, позволяющие каким- то образом обойти системы обратной связи и поддерживать образование рецепторов ЛНП на адекватном уровне. Б. Говард из Центра научных клинических исследований в Фениксе (система Национальных институтов здоровья) показала, например, что у индейцев племени пима сохраняются высокое содержание рецепторов и низкая концентрация ЛНП в крови даже при большом потреблении жиров. У других индивидуумов артерии, по-видимому, обладают такими свойствами, что им не вредят высокие концентрации ЛНП. Известно, например, что у 20% людей, гетерозиготных по признаку семейной гиперхолестеролемии, сердечных приступов не бывает вплоть до 60-летнего возраста, несмотря на очень высокую концентрацию ЛНП в крови.

ПОДВЕДЕМ итоги сказанному: как можно предотвратить развитие атеросклероза? Один из подходов — индивидуализация питания. Рацион с умеренно низким содержанием животных жиров может быть рекомендован большинству людей. Так, например, диета, предлагаемая Американской кардиологической ассоциацией, приводит к уменьшению содержания холестерола в крови почти на 15% и несколько снижает частоту инфарктов. В то же время людям с наследственным предрасположением к инфаркту и инсульту, которые, следовательно, могут быть особенно чувствительны к повреждающему действию ЛНП, следует придерживаться диеты, сильно ограничивающей потребление холестерола и насыщенных жирных кислот, даже если у них концентрация ЛНП в крови близка к среднему, «нормальному» уровню. Вероятно, дальнейшие исследования выявят и другие факторы, влияющие на чувствительность человека к эффектам избытка ЛНП.

Наконец, применение веществ, повышающих содержание рецепторов ЛНП, может оказаться благоприятным по крайней мере для части людей — тех, кто не страдает семейной.



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