Kolesterolisäätely

Kolesterolisäätely refers to the physiological and therapeutic regulation of blood cholesterol levels. The process involves the body's metabolic pathways that control the synthesis, transport, and elimination of lipids, particularly low‑density lipoprotein (LDL) and high‑density lipoprotein (HDL). In a healthy state, the liver produces cholesterol and also secretes it into bile for excretion. Cellular uptake and conversion of cholesterol into steroid hormones and vitamin D are also crucial parts of the regulation loop.

Imbalances arise when the synthesis outpaces clearance, leading to elevated LDL and reduced HDL. Cholesterol excess is closely associated with atherosclerosis, ischemic heart disease, and peripheral vascular disorders. Consequently, kolesterolisäätely is a major focus of preventive medicine and treatment.

Lifestyle measures that aid regulation include a diet low in saturated fats and trans fatty acids, increased intake of soluble fiber, regular aerobic exercise, and avoidance of tobacco. These interventions can lower LDL by 5–15 % and raise HDL modestly.

Pharmacological agents are used when lifestyle changes are insufficient. Statins inhibit HMG‑CoA reductase, reducing cholesterol synthesis by 20–60 %. Other drugs such as bile acid sequestrants, ezetimibe, PCSK9 inhibitors, and fibrates target different steps in cholesterol handling to achieve the desired lipid profile.

Monitoring typically involves fasting lipid panels measuring total cholesterol, LDL, HDL, and triglycerides. Target levels are individualized; many guidelines recommend LDL below 100 mg/dL for high‑risk patients. Kolesterolisäätely remains a dynamic field, with ongoing research into novel mechanisms like RNA interference and gene editing to achieve more precise and long‑lasting control.