Sobre las asociaciones entre los lípidos séricos y el riesgo cardiovascular

Yanisel Cruz Gilarte

Sobre las asociaciones entre los lípidos séricos y el riesgo cardiovascular

Yanisel Cruz Gilarte

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El Estudio Framingham estableció por primera vez la asociación entre la hipercolesterolemia y la mortalidad causada por los eventos coronarios agudos. Desde ese entonces se han revelado otras interioridades de las estructuras, funciones y metabolismo de los lípidos séricos. Las fracciones del colesterol son agregados supramoleculares de lípidos y proteínas que se encargan del transporte, distribución y la disposición final de las grasas y otros lípidos ingeridos con la dieta o sintetizados endógenamente. En el núcleo central de cualquiera de las fracciones lipídicas pueden encontrarse cantidades variables de triglicéridos, colesterol libre y colesterol esterificado. La homeostasis de las fracciones lipídicas es estrictamente dependiente de la tasa de absorción intestinal, la síntesis hepática, la utilización periférica, y la disposición final de las mismas. Una disponibilidad aumentada de colesterol y triglicéridos, junto con una utilización periférica disminuida, y una disposición final afectada, resulta en el atrapamiento de los lípidos séricos en el lecho endotelial, y con ello, la deformidad de la luz arterial que puede progresar hasta la oclusión, y culminar en la ruptura de la túnica endotelial y el desencadenamiento de un evento cataclísmico como el infarto. El interés es permanente en el desarrollo de métodos analíticos superiores para la cuantificación exacta de las fracciones lipídicas séricas, y el refinamiento de los algoritmos de predicción del riesgo cardiovascular mediante la integración de la información analítica recogida. Igualmente, el reconocimiento de la influencia que los estilos de alimentación ejercen sobre el status de las fracciones lipídicas séricas ha justificado la emisión de recomendaciones poblacionales para limitar el consumo de las grasas alimenticias y el colesterol dietético, por un lado; y el diseño de diferentes estrategias nutricionales para intervenir situaciones de hipercolesterolemia e hipertrigliceridemia. Se espera que este ensayo contribuya a un mejor conocimiento del metabolismo lipídico, y una actuación efectiva en las dislipidemias hoy prevalentes dada la extensión del exceso de peso, la obesidad y el Síndrome metabólico.

Palabras clave

Ateroesclerosis; Coronarioesclerosis; Colesterol; Triglicéridos; Lipoproteínas; Apoproteínas; Hígado; Esteroidogénesis gonadal

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