<\/p>\n
Cholesterol je voskovit\u00e1, tukov\u00e1 l\u00e1tka v krvi. \u010c\u00e1st cholesterolu je produkov\u00e1na t\u011blem, p\u0159edev\u0161\u00edm v j\u00e1trech, a zbytek poch\u00e1z\u00ed z konzumace \u017eivo\u010di\u0161n\u00fdch produkt\u016f, jako je \u010derven\u00e9 maso, s\u00fdr, m\u00e1slo a vejce. Cholesterol je hlavn\u00ed slo\u017ekou bun\u011b\u010dn\u00fdch membr\u00e1n (vn\u011bj\u0161\u00ed bari\u00e9ra bun\u011bk) a surovinou pro mnoho hormon\u016f a vitam\u00edn\u016f. Cholesterol jako takov\u00fd je nezbytn\u00fd pro \u017eivot a zdrav\u00ed. Cholesterol jako tukov\u00fd materi\u00e1l se \u0161patn\u011b m\u00eds\u00ed s vodou. To znamen\u00e1, \u017ee se nem\u016f\u017ee voln\u011b vzn\u00e1\u0161et v krvi a mus\u00ed b\u00fdt zabalen do ur\u010dit\u00fdch protein\u016f. Tyto proteiny se naz\u00fdvaj\u00ed lipoproteiny, nejzn\u00e1m\u011bj\u0161\u00ed jsou lipoproteiny s n\u00edzkou hustotou (LDL) a lipoproteiny s vysokou hustotou (HDL).<\/p>\n
LDL-cholesterol je \u017eivotn\u011b d\u016fle\u017eit\u00fd lipoprotein zodpov\u011bdn\u00fd za transport cholesterolu v krvi t\u011blem. V\u011bt\u0161ina lid\u00ed m\u00e1 v\u0161ak p\u0159\u00edli\u0161 vysok\u00e9 hladiny LDL, kter\u00e9 se pravd\u011bpodobn\u011b hromad\u00ed na st\u011bn\u00e1ch c\u00e9v, kde jsou zachyceny a modifikov\u00e1ny: to p\u0159edstavuje za\u010d\u00e1tek tvorby takzvan\u00e9ho \u201eaterosklerotick\u00e9ho pl\u00e1tu\u201c. Tyto pl\u00e1ty (tak\u00e9 plaky \u010di ateromy) mohou vznikat v jak\u00e9koli c\u00e9v\u011b va\u0161eho t\u011bla, v\u010detn\u011b srdce, doln\u00edch kon\u010detin a mozku. \u010c\u00edm v\u00edce cholesterolu pl\u00e1t zachyt\u00ed, t\u00edm v\u00edce roste. Kdy\u017e se zv\u011bt\u0161\u00ed natolik, \u017ee \u010d\u00e1ste\u010dn\u011b zablokuje pr\u016ftok krve v srde\u010dn\u00edch c\u00e9v\u00e1ch, m\u016f\u017ee p\u0159i fyzick\u00e9 n\u00e1maze zp\u016fsobit p\u0159\u00edznaky zn\u00e1m\u00e9 jako \u201eangina pectoris\u201c (nep\u0159\u00edjemn\u00fd a\u017e bolestiv\u00fd pocit na hrudi). Zcela ucpan\u00e1 tepna p\u0159iv\u00e1d\u011bj\u00edc\u00ed krev do srdce vede k infarktu myokardu, co\u017e je nej\u010dast\u011bj\u0161\u00ed p\u0159\u00ed\u010dina smrti v z\u00e1padn\u00edm sv\u011bt\u011b.<\/p>\n
Velmi vysok\u00e9 hladiny LDL-cholesterolu (> 190 mg\/dl; > 5 mmol\/l) by m\u011bly v\u00e9st k dal\u0161\u00ed diagnostice, proto\u017ee mohou b\u00fdt zp\u016fsobeny famili\u00e1rn\u00ed hypercholesterol\u00e9mi\u00ed (viz n\u00ed\u017ee). Zm\u011bny \u017eivotn\u00edho stylu mohou sn\u00ed\u017eit v\u00e1\u0161 LDL p\u0159ibli\u017en\u011b o 10\u201315 %. Pokud to nesta\u010d\u00ed k dosa\u017een\u00ed c\u00edlov\u00fdch hodnot, lze p\u0159idat l\u00e9ky, jako jsou statiny, ezetimib nebo inhibitory PCSK9 (viz kapitola o medikaci<\/a>).<\/p>\n Obvykle se naz\u00fdv\u00e1 \u201edobr\u00fd cholesterol\u201c, proto\u017ee vysok\u00e9 hladiny HDL byly spojov\u00e1ny s men\u0161\u00edm v\u00fdskytem onemocn\u011bn\u00ed srdce a c\u00e9v. Tento pohled se v posledn\u00edch letech zm\u011bnil. Samotn\u00e1 hladina HDL n\u00e1m ne\u0159ekne nic o kvalit\u011b HDL, kter\u00e1 se nem\u011b\u0159\u00ed b\u011b\u017en\u00fdm laboratorn\u00edm testem. Tak\u00e9 l\u00e9ky zvy\u0161uj\u00edc\u00ed hladiny HDL nevedly ve studi\u00edch k men\u0161\u00edmu v\u00fdskytu srde\u010dn\u00edch chorob. Proto by se hladiny HDL nem\u011bly pou\u017e\u00edvat k anal\u00fdze va\u0161eho rizika, v\u010detn\u011b takzvan\u00fdch \u201epom\u011br\u016f\u201c, kter\u00e9 nazna\u010duj\u00ed, \u017ee vysok\u00fd HDL m\u016f\u017ee vyv\u00e1\u017eit vysok\u00e9 hladiny LDL.<\/p>\n Lp (a) je dal\u0161\u00ed lipoprotein, kter\u00fd v sou\u010dasn\u00e9 dob\u011b st\u00e1le nen\u00ed obecn\u011b zn\u00e1m\u00fd a m\u011b\u0159en\u00fd, i kdy\u017e je siln\u00fdm rizikov\u00fdm faktorem pro srde\u010dn\u00ed onemocn\u011bn\u00ed. Hladina Lp (a) se uv\u00e1d\u00ed v mg\/dl (po\u017eadovan\u00e1 hladina je pod <30 mg\/dl) nebo v nmol\/l (po\u017eadovan\u00e1 hladina je < pod 75 nmol\/l). Va\u0161e hodnota Lp (a) je d\u00e1na va\u0161imi geny a b\u011bhem va\u0161eho \u017eivota se p\u0159\u00edli\u0161 nem\u011bn\u00ed. Proto ji obvykle sta\u010d\u00ed zm\u011b\u0159it pouze jednou za \u017eivot. V sou\u010dasn\u00e9 dob\u011b je k dispozici jen n\u011bkolik terapi\u00ed pro sn\u00ed\u017een\u00ed hladin Lp (a). Pat\u0159\u00ed mezi n\u011b: 1) Inhibitory PCSK-9: protil\u00e1tky na sn\u00ed\u017een\u00ed LDL-cholesterolu, kter\u00e9 tak\u00e9 sni\u017euj\u00ed hladiny Lp (a) p\u0159ibli\u017en\u011b o 30 %; 2) Afer\u00e9za: forma dial\u00fdzy odstra\u0148uj\u00edc\u00ed Lp (a) z va\u0161eho t\u011bla. Pokud m\u00e1te i nad\u00e1le srde\u010dn\u00ed p\u0159\u00edhody, jako jsou infarkty myokardu<\/a>, m\u00e1te zaveden stent nebo bypass, m\u016f\u017ee b\u00fdt zapot\u0159eb\u00ed terapie, i kdy\u017e m\u00e1te n\u00edzkou hladinu LDL-cholesterolu. Mo\u017enosti l\u00e9\u010dby je t\u0159eba posoudit ve specializovan\u00fdch lipidov\u00fdch ambulanc\u00edch.<\/p>\n Triglyceridy jsou nejb\u011b\u017en\u011bj\u0161\u00ed formou lipid\u016f ve va\u0161em t\u011ble, kter\u00e9 se pou\u017e\u00edvaj\u00ed hlavn\u011b pro ukl\u00e1d\u00e1n\u00ed tuk\u016f. Vysok\u00e9 hladiny triglycerid\u016f jsou spojov\u00e1ny se srde\u010dn\u00edmi chorobami a faktory \u017eivotn\u00edho stylu v\u010detn\u011b cukrovky<\/a>, nadv\u00e1hy a obezity<\/a>, konzumace alkoholu a tak\u00e9 sedav\u00e9ho \u017eivotn\u00edho stylu<\/a>. Jejich hladina poskytuje dal\u0161\u00ed informace o va\u0161em riziku. Terapie se zam\u011b\u0159uj\u00ed na zm\u011bny \u017eivotn\u00edho stylu v\u010detn\u011b prevence a l\u00e9\u010dby cukrovky, sportov\u00e1n\u00ed, omezen\u00ed p\u0159\u00edjmu alkoholu a optimalizace stravovac\u00edch n\u00e1vyk\u016f v\u010detn\u011b stravy bohat\u00e9 na omega-3 mastn\u00e9 kyseliny. Mezi l\u00e9ky sni\u017euj\u00edc\u00ed hladinu triglycerid\u016f pat\u0159\u00ed fibr\u00e1ty. Mohou b\u00fdt nezbytn\u00e9, pokud m\u00e1te z\u00e1va\u017en\u00e9 srde\u010dn\u00ed onemocn\u011bn\u00ed, n\u00edzk\u00e9 hladiny LDL a zv\u00fd\u0161en\u00e9 triglyceridy i po optimalizaci \u017eivotn\u00edho stylu.<\/p>\n Famili\u00e1rn\u00ed hypercholesterol\u00e9mie (FH) je jedn\u00edm z nej\u010dast\u011bj\u0161\u00edch genetick\u00fdch onemocn\u011bn\u00ed charakterizovan\u00fdch velmi vysokou hladinou cholesterolu, zejm\u00e9na LDL-cholesterolu, co\u017e vede k z\u00e1va\u017en\u00fdm srde\u010dn\u00edm onemocn\u011bn\u00edm u mlad\u00fdch lid\u00ed. Genov\u00fd defekt v jednom z protein\u016f \u00fa\u010dastn\u00edc\u00edch se vychyt\u00e1v\u00e1n\u00ed LDL do jater zp\u016fsobuje velmi vysok\u00e9 hladiny LDL ve va\u0161\u00ed krvi.<\/p>\n Dnes v\u00edme, \u017ee FH je \u010dast\u011bj\u0161\u00ed, ne\u017e jsme si d\u0159\u00edve mysleli, postihuje p\u0159ibli\u017en\u011b 1 z 200 a\u017e 300 jedinc\u016f. FH je takzvan\u00e1 \u201eautozom\u00e1ln\u011b dominantn\u00ed porucha\u201c, co\u017e znamen\u00e1, \u017ee onemocn\u011bn\u00ed bude p\u0159\u00edtomno, i kdy\u017e bude posti\u017een jenom jeden gen. D\u011bti s jedn\u00edm nemocn\u00fdm rodi\u010dem maj\u00ed 50% \u0161anci, \u017ee zd\u011bd\u00ed gen a nemoc.<\/p>\n Posti\u017een\u00ed lid\u00e9 maj\u00ed velmi vysok\u00e9 hladiny LDL-cholesterolu od 190 mg\/dl (5 mmol\/l) do 400 mg\/dl (10 mmol\/l) a ji\u017e v mlad\u00e9m v\u011bku trp\u00ed srde\u010dn\u00edmi chorobami, srde\u010dn\u00edmi infarkty a mrtvicemi. U lid\u00ed s FH se srde\u010dn\u00ed onemocn\u011bn\u00ed zpravidla rozvine ji\u017e ve \u010dty\u0159iceti letech kv\u016fli jejich vysok\u00fdm hladin\u00e1m LDL-cholesterolu v pr\u016fb\u011bhu cel\u00e9ho \u017eivota. Jako genetick\u00e9 onemocn\u011bn\u00ed se FH vyskytuje v rodin\u011b, co\u017e znamen\u00e1, \u017ee \u010dasn\u00e9 srde\u010dn\u00ed onemocn\u011bn\u00ed (< do 55 let u mu\u017e\u016f, <do 60 let u \u017een) v rodin\u011b a\/nebo u rodinn\u00fdch p\u0159\u00edslu\u0161n\u00edk\u016f s LDL-cholesterolem > nad 190 mg\/dl by m\u011blo v\u00e9st k podez\u0159en\u00ed na FH. Dal\u0161\u00edmi p\u0159\u00edznaky mohou b\u00fdt \u017elut\u00e9 usazeniny cholesterolu na r\u016fzn\u00fdch m\u00edstech, nap\u0159\u00edklad kolem o\u010dn\u00edch v\u00ed\u010dek (xanthelasma), \u201e\u017elut\u00fd \u201c prstenec kolem o\u010dn\u00ed duhovky a\/nebo bulky ve \u0161lach\u00e1ch rukou a lokt\u016f a \u010dast\u011bj\u0161\u00ed na Achillov\u011b \u0161la\u0161e a dal\u0161\u00edch \u0161lach\u00e1ch nohou.<\/p>\n P\u0159\u00edtomnost FH m\u016f\u017ee prok\u00e1zat pouze genetick\u00fd test; diagn\u00f3zu v\u0161ak lze stanovit i bez genetick\u00e9ho vy\u0161et\u0159en\u00ed.<\/p>\n Jestli\u017ee m\u00e1te vysokou hladinu cholesterolu (LDL-C> nad 190 mg\/dl se rovn\u00e1 > 5 mmol\/L) nebo usazeniny cholesterolu v k\u016f\u017ei, oku nebo \u0161lach\u00e1ch, jestli\u017ee se vysok\u00e1 hladina LDL-cholesterol (LDL-C> nad 190 mg\/dl rovn\u00e1 >5 mmol\/l) vyskytuje ve va\u0161\u00ed rodin\u011b a pokud jste vy nebo n\u011bkter\u00fd z va\u0161ich rodinn\u00fdch p\u0159\u00edslu\u0161n\u00edk\u016f prod\u011blali srde\u010dn\u00ed infarkt, mozkovou mrtvici, m\u00e1te bypass nebo zaveden\u00fd koron\u00e1rn\u00ed stent d\u0159\u00edve ne\u017e ve v\u011bku 55\u201360, m\u011bli byste se poradit s kardiologem zam\u011b\u0159en\u00fdm na lipidovou l\u00e9\u010dbu, endokrinologem nebo lipidologem ve va\u0161\u00ed nemocnici.<\/p>\n Jakmile je famili\u00e1rn\u00ed hypercholesterol\u00e9mie diagnostikov\u00e1na u \u010dlena rodiny genetick\u00fdm testem, m\u011bli by b\u00fdt informov\u00e1ni a testov\u00e1ni v\u0161ichni \u010dlenov\u00e9 rodiny. Zd\u011bd\u011bn\u00ed genu FH zp\u016fsobuje, \u017ee osoba je vystavena vysok\u00e9mu riziku srde\u010dn\u00edch onemocn\u011bn\u00ed, a proto by m\u011bla b\u00fdt okam\u017eit\u011b zah\u00e1jena zm\u011bna \u017eivotn\u00edho stylu a pod\u00e1v\u00e1n\u00ed l\u00e9k\u016f na sn\u00ed\u017een\u00ed hladiny lipid\u016f, a to i v mlad\u00e9m v\u011bku! P\u0159i v\u010dasn\u00e9m zji\u0161t\u011bn\u00ed a l\u00e9\u010db\u011b m\u016f\u017ee b\u00fdt srde\u010dn\u00ed onemocn\u011bn\u00ed odlo\u017eeno o des\u00edtky let. U pacient\u016f s FH bez onemocn\u011bn\u00ed srdce nebo c\u00e9v by m\u011bl b\u00fdt LDL-cholesterol pod 70 mg\/dl (1,8 mmol\/l), u pacient\u016f s FH s onemocn\u011bn\u00edm srdce nebo c\u00e9v by m\u011bl b\u00fdt d\u00e1le sn\u00ed\u017een, a to pod 55 mg\/dl (1,4 mmol\/l).<\/p>\n Zm\u011bny \u017eivotn\u00edho stylu zahrnuj\u00ed dietu prosp\u011b\u0161nou srdci<\/a>, pravideln\u00e9 cvi\u010den\u00ed<\/a> a nekou\u0159en\u00ed<\/a> v jak\u00e9koli form\u011b. S touto zm\u011bnou \u017eivotn\u00edho stylu je t\u0159eba za\u010d\u00edt okam\u017eit\u011b. Vzhledem k tomu, \u017ee zm\u011bny \u017eivotn\u00edho stylu obvykle sni\u017euj\u00ed hladiny LDL-C asi o 10\u201315 %, jsou zapot\u0159eb\u00ed dal\u0161\u00ed terapie sni\u017euj\u00edc\u00ed hladinu lipid\u016f (obvykle statiny). Nelze dostate\u010dn\u011b zd\u016fraznit, \u017ee v\u010dasn\u00e9 rozpozn\u00e1n\u00ed a l\u00e9\u010dba je kl\u00ed\u010dem k prevenci zbyte\u010dn\u00fdch a p\u0159ed\u010dasn\u00fdch infarkt\u016f, kter\u00e9 dramaticky ovliv\u0148uj\u00ed \u017eivoty mlad\u00fdch lid\u00ed.<\/p>\n <\/p>\n","protected":false},"excerpt":{"rendered":" Co je cholesterol? Cholesterol je voskovit\u00e1, tukov\u00e1 l\u00e1tka v krvi. \u010c\u00e1st cholesterolu je produkov\u00e1na t\u011blem, p\u0159edev\u0161\u00edm v j\u00e1trech, a zbytek poch\u00e1z\u00ed z konzumace \u017eivo\u010di\u0161n\u00fdch produkt\u016f, jako je \u010derven\u00e9 maso, s\u00fdr, m\u00e1slo a vejce. Cholesterol je hlavn\u00ed slo\u017ekou bun\u011b\u010dn\u00fdch membr\u00e1n (vn\u011bj\u0161\u00ed bari\u00e9ra bun\u011bk) a surovinou pro mnoho hormon\u016f a vitam\u00edn\u016f. Cholesterol jako takov\u00fd je nezbytn\u00fd […]<\/p>\n","protected":false},"author":1,"featured_media":6878,"parent":6912,"menu_order":2,"comment_status":"closed","ping_status":"closed","template":"","meta":{"_acf_changed":false,"footnotes":""},"categories":[144],"tags":[],"class_list":["post-6874","page","type-page","status-publish","has-post-thumbnail","hentry","category-udrzujte-sve-srdce-zdrave"],"acf":[],"yoast_head":"\nHDL-cholesterol<\/strong><\/h3>\n
Lipoprotein (a) (Lp (a))<\/strong><\/h3>\n
Triglyceridy<\/strong><\/h3>\n
Famili\u00e1rn\u00ed hypercholesterol\u00e9mie (FH)<\/strong><\/h3>\n
Co je FH?<\/h4>\n
M\u00e1m famili\u00e1rn\u00ed hypercholesterol\u00e9mii?<\/h3>\n
L\u00e9\u010dba<\/strong><\/h3>\n