The last ten years focused on the relevance of the endothelium in the onset and progression of atherosclerosis. It has been established that the impact of a recognized risk factor such as low-density lipoproteins (LDL) begins on the endothelial surface by impairing endothelial function. The relevance of lipid metabolism in atherosclerosis is complex and extends to other lipid subfractions such as triglycerides, high-density lipoproteins (HDL) and postprandial lipaemia. All these variables can influence endothelial function. Triglyceride levels are associated with altered endothelial function in healthy subjects probably via an oxidative mechanism. HDL exerts a protective action on endothelial reactivity via antioxidant and anti-inflammatory properties attenuating the damage produced by LDL. Postprandial lipaemia may impair endothelial reactivity; this transient injury of the endothelium favours atherosclerotic lesions. Several reports suggested that endothelial dysfunction represents a reversible phase of atherosclerosis; this consideration underlines the significance of dietary and lipid-lowering treatment in the prevention of atherosclerosis. However, additional strategies are needed to treat the cluster of risk factors in high-risk patients.
Keywords: low-density lipoproteins (ldl), triglycerides, cholesterol, interleukin, atherosclerosis, no synthase, lipaemia
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