Lipoprotein metabolism
The realization that raised concentrations of plasma lipids, particularly cholesterol, are associated with an increased risk of coronary heart disease has stimulated the study of factors regulating plasma lipid metabolism. With the use of increasingly refined methodology, our understanding of normal plasma lipoprotein metabolism and its derangements due to the influence of genetic and environmental factors is continuously expanding. This chapter summarizes some current concepts regarding plasma lipoprotein transport in normal humans, forming a basis for the discussion of the development of various dyslipidaemias in the following chapters. Lipids represent a heterogeneous group of substances with several biological functions. Phospholipids and cholesterol are essential components of cell membranes, and cholesterol is also the precursor of steroid hormones and bile acids. Some fatty acids form the origin of bioactive compounds such as prostaglandins, thromboxanes, and leukotrienes; phospholipids, fatty acids, and cholesterol may also serve as signalling molecules in their own right. Furthermore, lipid complexes are necessary for the transport of lipid-soluble vitamins, and may have a protective role in the defence against toxins and infectious agents. From an overall physiological perspective, however, the major function of plasma lipid metabolism is the exchange of fat as energy substrates.