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Klin Lab Diagn. 2011 Feb;(2):4-15.

[Prevention of atherosclerosis. Excess of palmitic acid in food--a cause of hypercholesterolemia, inflammatory syndrome, insulin resistance in myocytes, and apoptosis].

[Article in Russian]


Unity of the pathogenesis of atherosclerosis, type 2 diabetes mellitus, and metabolic syndrome gives rise to impaired biological function of adaptation, altered biological function of exotrophy (external feeding) and endoecology ("purity" of the intercellular medium). Biological reactions of inflammation and hydrodynamic pressure, or blood pressure, are in vivo activated to compensate for intercellular debris accumulation by endogenous phlogogens--ligand-free low density lipoproteins (LDL). The biological reactions jointly remove LDL from blood to the intima of elastic type arteries, to interstitial tissue for the local pool of the intravascular medium. The causes of formation of aphysiological LDLs are a preponderance of palmitate-oleate-palmitate triglycerides in the latter and impaired hydrolysis upon exposure to post-heparin lipase to give rise to small, dense LDLs; intimal macrophages utilize the debris only partially and develop atheromatosis from polyenic fatty acids (FA) etherified by cholesterol alcohol. Excess of palmitic saturated fatty acid (sFA) is responsible for the lowered permeability of the plasma membrane, cell death via the mechanism similar to apoptosis. Aphysiological protein palmitoylation (covalent interaction with palmitic sFA) increased the debris accumulation of the intercellular medium and the activity of both biological reactions. Elevated plasma palmitic sFA and its enhanced passive absorption in the form of unetherified FA, as well as high C-reactive protein levels are a cause of insulin resistance. The only way to prevent atherosclerosis in the population is to normalize the biological function of exotrophy when the energy value ratio of FA, proteins and carbohydrates is 1:1:1 and that of sFA, monoenic, and polyenic FA is also 1:1:1. The lower amount of palmitic sFA and the higher concentration of essential polyenic FA, the lower blood levels of cholesterol alcohol and triglycerides are. At the same time, simultaneously activations and the biological function of locomotion are a level of physical activity.

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