The Peter Attia Drive 02月03日
#334 - Cardiovascular disease, the number one killer: development, biomarkers, apoB, cholesterol, brain health, and more | Tom Dayspring, M.D.
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本期节目中,专家Tom Dayspring深入探讨了动脉粥样硬化的基础知识,强调其作为全球头号死因的地位。他从病理学角度分析了疾病的发展过程,并指出了包括胰岛素抵抗和慢性肾病在内的关键风险因素。节目详细解读了胆固醇和脂蛋白的复杂性,特别是载脂蛋白B(apoB)在动脉粥样硬化中的关键作用。此外,还讨论了生物标志物检测的重要性,营养对血脂水平的影响,以及胆固醇在脑健康中的重要作用,包括脑部胆固醇的合成和管理方式。节目还涉及了药物干预如何影响脑部胆固醇代谢等内容。

🩺 动脉粥样硬化(ASCVD)是全球首要死因,其发展是一个长期且隐匿的过程,早期检测对于预防不良后果至关重要。胰岛素抵抗和慢性肾病是常常被忽视的重要风险因素。

🧬 载脂蛋白B(apoB)是导致动脉粥样硬化的关键因素,测量apoB比测量低密度脂蛋白胆固醇(LDL)更能准确地评估心血管风险。高甘油三酯血症会增加apoB颗粒浓度,从而促进动脉粥样硬化。

🧠 胆固醇对脑功能至关重要,脑部通过特殊途径管理胆固醇供应。ApoE基因型影响脑健康和阿尔茨海默病风险。他汀类药物可能影响脑部胆固醇合成和认知功能,需要探索替代的降脂策略。

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Tom Dayspring is a world-renowned expert in clinical lipidology and a previous guest on The Drive. In this episode, Tom explores the foundations of atherosclerosis and why atherosclerotic cardiovascular disease (ASCVD) is the leading cause of death worldwide for both men and women. He examines how the disease develops from a pathological perspective and discusses key risk factors, including often-overlooked contributors such as insulin resistance and chronic kidney disease. He breaks down the complexities of cholesterol and lipoproteins—including LDL, VLDL, IDL, and HDL—with an in-depth discussion on the critical role of apolipoprotein B (apoB) in the development of atherosclerosis. Additionally, he covers the importance of testing various biomarkers, the impact of nutrition on lipid levels, and the vital role of cholesterol in brain health, including how cholesterol is synthesized and managed in the brain, how it differs from cholesterol regulation in the rest of the body, and how pharmacological interventions can influence brain cholesterol metabolism.

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动脉粥样硬化 载脂蛋白B 胆固醇 心血管疾病 脑健康
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