young people, don’t take high cholesterol lightly! two nature studies simultaneously pointed out that uncontrolled blood lipids can lead to endless troubles
2024-09-09
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have you checked your blood lipids recently? according to the "guidelines for blood lipid management in chinese adults (2023)", the results of a 2018 survey showed that chinese adults aged 18 and above had abnormal blood lipids, including hypercholesterolemia, hypertriglyceridemia, mixed hyperlipidemia, and low high-density lipoprotein cholesterol.the overall prevalence rate is as high as 35.6%。dyslipidemia often does not cause obvious symptoms in the early stages, but blood vessels are gradually damaged. as the disease progresses, fat, cholesterol, and other substances in the blood circulation accumulate in the blood vessels to form "plaques," causing the blood vessels to harden and narrow.atherosclerosissignificantly increased risk of cardiovascular disease。image source: 123rf
many people may think that high blood lipids are a problem that only middle-aged and elderly people need to worry about. indeed, in the past, screening, prevention and intervention measures for atherosclerosis were mostly targeted at people over 50 years old with high cholesterol levels.however, a new study recently published in the journal nature points out thatprevention of atherosclerosis requires us to pay attention to blood lipid levels earlier than in the past, especially to control the intake of high-fat diets when we are young (including children and adolescents).。in this study, researchers from the cambridge university heart and lung institute first conducted an experiment in mice to observe the effect of high-fat diet-induced increase in blood lipids on the formation of atherosclerosis. unlike previous similar studies, the mice in the experimental group were not induced to have high blood lipids by continuous feeding of high-fat food when they were older. the mice in the experimental group had a few high-fat "meals" from time to time when they were very young.although the total amount of high-fat diet consumed was the same and the level of low-density lipoprotein cholesterol (ldl-c, commonly known as "bad cholesterol") accumulated in the blood circulation was similar, compared with the mice that continued to eat a high-cholesterol diet in their later years,mice fed an intermittent high-fat diet at a young age had a higher risk of developing atherosclerosis。similar results were further verified in the general population. the research team analyzed cohort data from the cardiovascular risk in young finns study. this cohort has been tracking children and adolescents since 1980 and has been followed up for decades, recording changes in participants' blood pressure, blood lipids, and body mass index. more than 2,000 of them underwent carotid artery ultrasound scans around the ages of 30 and 50. the results of the data analysis showed thatparticipants who had high cholesterol levels as children had the most severe plaques。taking these phenomena into consideration, the authors pointed out in the paper:elevated cholesterol in early life is significantly associated with the incidence and size of carotid atherosclerotic plaques in mid-adulthood。the author analyzed the reasons and believed thatthis is related to the resident macrophages in the arteriesnormally, these immune cells clear damaged cells and lipid molecules such as cholesterol from the arteries, helping to prevent plaque from forming. but experiments in mice showed that when cholesterol levels spiked early on, the gene expression of these macrophages was permanently altered, rendering the cells no longer protective.it is noteworthy that this study showed thatintermittent cholesterol spikes appear to cause the most damagesome people may temporarily change their eating habits, such as paying special attention to healthy eating before and after a physical examination, but after a while they start to "reward" themselves with high-fat foods, resulting in fluctuations in cholesterol levels. in addition, some patients with hyperlipidemia take statins to lower their cholesterol levels, but stop taking them after a period of time. the authors of the paper believe that the results of this study help explainwhy some patients who take medications irregularly may have an increased risk of heart disease。in another paper published in the same issue of nature, a research team from université paris cité in france also observed that compared with a continuous high-fat diet,intermittent high-fat meals accelerate atherosclerosisusing a mouse model, the authors found that intermittent high-fat diets also cause neutrophil reprogramming, thereby accelerating the onset of atherosclerosis.[1] Minoru Takaoka et al., Early intermittent hyperlipidaemia alters tissue macrophages to fuel atherosclerosis. Nature (2024) Doi: https://doi.org/10.1038/s41586-024-07993-x
