The Effect of Select Nutrients on Serum High-Density Lipoprotein Cholesterol and Apolipoprotein A-I Levels
Arshag D. Mooradian,
Michael J. Haas and
Norman C. W. Wong
Division of Endocrinology, Diabetes and Metabolism (A.D.M., M.J.H.), Department of Internal Medicine, St. Louis University School of Medicine, St. Louis, Missouri 63104; and Department of Medicine and Biochemistry & Molecular Biology (N.C.W.W.), University of Calgary, Alberta, Canada T2N 1N4
Correspondence: Address all correspondence and requests for reprints to: Arshag D. Mooradian, M.D., Division of Endocrinology, St. Louis University, 1402 South Grand Boulevard, St. Louis, Missouri 63104. E-mail: mooradad{at}slu.edu
One of the factors contributing to the increased risk of developingpremature atherosclerosis is low plasma concentrations of high-densitylipoprotein (HDL) cholesterol (HDLc). Multiple potential mechanismsaccount for the cardioprotective effects of HDL and its mainprotein apolipoprotein A-I (apo A-I). The low plasma concentrationsof HDL could be the result of increased fractional clearanceand reduced expression of apo A-I. To this end, nutrients playan important role in modulating the fractional clearance rate,as well as the rate of apo A-I gene expression. Because medicalnutrition therapy constitutes the cornerstone of managementof dyslipidemias, it is essential to understand the mechanismsunderlying the changes in HDL level in response to alterationsin dietary intake. In this review, we will discuss the effectof select nutrients on serum HDLc and apo A-I levels. Specifically,we will review the literature on the effect of carbohydrates,fatty acids, and ketones, as well as some of the nutrient-relatedmetabolites, such as glucosamine and the prostanoids, on apoA-I gene expression. Because there are multiple mechanisms involvedin the regulation of serum HDLc levels, changes in gene transcriptiondo not necessarily correlate with clinical observations on serumlevels of HDLc.
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