高膽固醇血症

高膽固醇血症
Hypercholesterolemia
高膽固醇血症; Hypercholesterolemia
	膽固醇的結構
類型	高脂血症
分類和外部資源
醫學專科	心臟病學
ICD-11	5C80.00
ICD-10	E78.0
DiseasesDB	6226
MedlinePlus	000403
eMedicine	121424
	[編輯此條目的維基數據]

高膽固醇血症（英語：Hypercholesterolemia）是指血液中的膽固醇偏高的情形^[1]。高膽固醇血症屬於高脂血症及高脂蛋白血症（hyperlipoproteinemia，血液中脂蛋白過高的病症）^[1]。

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血液中非高密度脂蛋白膽固醇（non-HDL cholesterol）及低密度脂蛋白膽固醇（LDL cholesterol）的偏高可能是飲食、肥胖症、遺傳性疾病（例如家族性高膽固醇血症中，低密度脂蛋白受體的突變）、或是像糖尿病或是甲狀腺機能低下症等疾病的影響^[1]。

膽固醇是三種主要脂類之一，所有動物細胞都需要膽固醇來建構其細胞膜，因此所有細胞都會製造膽固醇，植物細胞不會製造膽固醇。膽固醇也是甾體激素及膽汁酸的前體。因為膽固醇不溶於水，在血漿中是以蛋白質粒子脂蛋白的形式存在。脂蛋白會依其密度分類：極低密度脂蛋白（VLDL）、低密度脂蛋白（LDL）、中密度脂蛋白（英語：intermediate density lipoprotein）（IDL）及高密度脂蛋白（HDL）^[2]。所有的脂蛋白都會攜帶膽固醇，但高密度脂蛋白以外的其他脂蛋白（特別是低密度脂蛋白）上昇，和動脈粥樣硬化及冠狀動脈疾病風險的上昇有關^[3]。相反的，較高的高密度脂蛋白比例對身體有幫助^[4]。

為了減少成人血液中的膽固醇及低密度脂蛋白，建議在飲食中避免反式脂肪，並且用多元不飽和脂肪代替飽和脂肪^[5]^[6]。若血液中膽固醇含量很高的人（例如家族性高膽固醇血症），無法只靠飲食來達到減低低密度脂蛋白的效果，會需要降血脂的藥物^[7]。若有必要，也會進行低密度脂蛋白膽固醇去除術（英語：apheresis）或是手術（特別是對嚴重的家族性高膽固醇血症患者）^[7]。美國約有三千四百萬名成人有高膽固醇血症^[8]。

[1]
Durrington, P. Dyslipidaemia. The Lancet. 2003-08, 362 (9385): 717–31. PMID 12957096. doi:10.1016/S0140-6736(03)14234-1.
[2]
Biggerstaff KD, Wooten JS. Understanding lipoproteins as transporters of cholesterol and other lipids. Adv Physiol Educ. December 2004, 28 (1–4): 105–6. PMID 15319192. doi:10.1152/advan.00048.2003.
[3]
Carmena R, Duriez P, Fruchart JC. Atherogenic lipoprotein particles in atherosclerosis. Circulation. June 2004, 109 (23 Suppl 1): III2–7. PMID 15198959. doi:10.1161/01.CIR.0000131511.50734.44.
[4]
Kontush A, Chapman MJ. Antiatherogenic small, dense HDL--guardian angel of the arterial wall?. Nat Clin Pract Cardiovasc Med. 2006-03, 3 (3): 144–53. PMID 16505860. doi:10.1038/ncpcardio0500.
[5]
Healthy diet - Fact sheet N°394. World Health Organization. 2015-09 [2016-07-06]. （原始內容存檔於2014-09-27）.
[6]
de Souza, RJ; Mente, A; Maroleanu, A; Cozma, AI; Ha, V; Kishibe, T; Uleryk, E; Budylowski, P; Schünemann, H; Beyene, J; Anand, SS. Intake of saturated and trans unsaturated fatty acids and risk of all cause mortality, cardiovascular disease, and type 2 diabetes: systematic review and meta-analysis of observational studies.. BMJ (Clinical research ed.). 11 August 2015, 351: h3978. PMC 4532752 . PMID 26268692. doi:10.1136/bmj.h3978.
[7]
Ito MK, McGowan MP, Moriarty PM. Management of familial hypercholesterolemias in adult patients: recommendations from the National Lipid Association Expert Panel on Familial Hypercholesterolemia. J Clin Lipidol. June 2011, 5 (3 Suppl): S38–45. PMID 21600528. doi:10.1016/j.jacl.2011.04.001.
[8]
Hypercholesterolemia. Genetics Home Reference. [2016-05-16]. （原始內容存檔於2016-05-08）.

[Durrington-1] [1]
Durrington, P. Dyslipidaemia. The Lancet. 2003-08, 362 (9385): 717–31. PMID 12957096. doi:10.1016/S0140-6736(03)14234-1.

[2] [2]
Biggerstaff KD, Wooten JS. Understanding lipoproteins as transporters of cholesterol and other lipids. Adv Physiol Educ. December 2004, 28 (1–4): 105–6. PMID 15319192. doi:10.1152/advan.00048.2003.

[3] [3]
Carmena R, Duriez P, Fruchart JC. Atherogenic lipoprotein particles in atherosclerosis. Circulation. June 2004, 109 (23 Suppl 1): III2–7. PMID 15198959. doi:10.1161/01.CIR.0000131511.50734.44.

[4] [4]
Kontush A, Chapman MJ. Antiatherogenic small, dense HDL--guardian angel of the arterial wall?. Nat Clin Pract Cardiovasc Med. 2006-03, 3 (3): 144–53. PMID 16505860. doi:10.1038/ncpcardio0500.

[5] [5]
Healthy diet - Fact sheet N°394. World Health Organization. 2015-09 [2016-07-06]. （原始內容存檔於2014-09-27）.

[BMJ2015-6] [6]
de Souza, RJ; Mente, A; Maroleanu, A; Cozma, AI; Ha, V; Kishibe, T; Uleryk, E; Budylowski, P; Schünemann, H; Beyene, J; Anand, SS. Intake of saturated and trans unsaturated fatty acids and risk of all cause mortality, cardiovascular disease, and type 2 diabetes: systematic review and meta-analysis of observational studies.. BMJ (Clinical research ed.). 11 August 2015, 351: h3978. PMC 4532752 . PMID 26268692. doi:10.1136/bmj.h3978.

[Ito2011-7] [7]
Ito MK, McGowan MP, Moriarty PM. Management of familial hypercholesterolemias in adult patients: recommendations from the National Lipid Association Expert Panel on Familial Hypercholesterolemia. J Clin Lipidol. June 2011, 5 (3 Suppl): S38–45. PMID 21600528. doi:10.1016/j.jacl.2011.04.001.

[GHR2016-8] [8]
Hypercholesterolemia. Genetics Home Reference. [2016-05-16]. （原始內容存檔於2016-05-08）.

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