Plasma dyslipidemia: pathogenesis and diagnostic value. Literature review

Abstract

This review discusses the problem of diagnostics of atherosclerosis from the standpoint of the need of developing new approaches and principles for more effective detection of this disease at the early stages of its course in the humans. The insufficiently studied basic stages and mechanisms of lipid metabolism are indicated, which in the future may have diagnostic value. The lipid composition of blood plasma and its fractions, which are associated with a high risk of the occurrence and development of cardiovascular disease (CVD) is assessed. The determining of the role of cholesterol, lipoproteins and apolipoproteins in the pathogenesis of atherosclerosis, a wide variability of the atherogenic lipid profile and its direct relationship with calcium metabolism in atherosclerotic damage of the vascular wall is accentuated. It is shown that the basis of dyslipidemia and civilization diseases (atherosclerosis, obesity, diabetes mellitus) is a disorder of the mechanisms of neurohumoral regulation of lipid metabolism. The immunological mechanisms of the pathogenesis of atherosclerotic process and the marker signs that identify this process are discussed in details. A generalized scheme of peroxidation of blood plasma lipoproteins and the subsequent molecular-cellular stages of the formation of atherosclerotic plaques in the intima of the vascular wall is presented. The current modern methods of diagnosing dyslipidemia are briefly described and the lipid-lowering effects of certain drugs are noted, a forecast is given for the creation of new, more effective statins. In conclusion, the work confirms the importance of studying the qualitative composition of lipids and the expansion of physico-chemical and molecular genetic diagnostic methods for studying metabolism.