![[HA SINH] H坦a sinh th畉n v n動畛c ti畛u - ThS.Lan.pdf](https://cdn.slidesharecdn.com/ss_thumbnails/hasinhhasinhthnvnctiu-ths-240619100535-0bac2b05-thumbnail.jpg?width=560&fit=bounds)
More Related Content
What's hot (20)
Similar to 10.CHUYEN HOA LIPID.pdf (20)
10.CHUYEN HOA LIPID.pdf
- 2. M畛C TIU BI GI畉NG 1. Tr狸nh by 動畛c s畛 ti棚u h坦a, h畉p thu lipid v c叩c y畉u t畛 畉nh h動畛ng . 2. Tr狸nh by 動畛c qu叩 tr狸nh tho叩i h坦a v t畛ng h畛p AB, triglycerid v cholesterol 3. Tr狸nh by 動畛c s畛 t畉o thnh c叩c th畛 ceton v s畛 OXH ch炭ng trong t畉 bo 4. Tr狸nh by qu叩 tr狸nh chuy畛n h坦a chuy棚n bi畛t 畛 m畛t s畛 m担: m畛, gan v 畉nh h動畛ng c畛a c叩c hormon 畛i v畛i chuy畛n h坦a lipid 5. Tr狸nh by 動畛c c叩c d畉ng lipid v畉n chuy畛n 畛 trong m叩u, 畉c i畛m v vai tr嘆 c畛a ch炭ng
- 3. CC D畉NG LIPID TRONG C TH畛 Lipid d畛 tr畛 Lipid mng Lipid v畉n chuy畛n (lipid h嘆a tan)
- 4. Lipid d畛 tr畛 - Triclycerd b畉o v畛 c董 th畛, t鱈ch tr畛 v cung c畉p nng l動畛ng. L動畛ng lipid d畛 tr畛 thay 畛i theo ch畉 畛 n ho畉t 畛ng th畛 l畛c, theo tu畛i. Khi n th畛a m畛 d畛 tr畛 tng. Khi 坦i n oxy h坦a m畛 畛 cung c畉p nng l動畛ng. Lipid chi畉m 30% t畛ng s畛 calo/ngy > 30%/M c董 th畛: y畉u t畛 nguy c董. Nhu c畉u: 60-100g. CC D畉NG LIPID TRONG C TH畛
- 5. Lipid mng - Phospholipid, cholesterol, glycolipid c畉u tr炭c n棚n mng t畉 bo, mng bo quan. - Kho畉ng 10% tr畛ng l動畛ng kh担 c畛a t畛 ch畛c. CC D畉NG LIPID TRONG C TH畛
- 6. Lipid v畉n chuy畛n (lipid h嘆a tan) - Acid b辿o + albumin - Cholesterol, phospholipid, triglycerid + apoprotein Lipoprotein. - Hormon steroid + protein mng CC D畉NG LIPID TRONG C TH畛
- 7. T畉o, t鱈ch tr畛 v cung c畉p nng l動畛ng Nhi畛m v畛 c畉u tr炭c (ch畛c nng t畉o h狸nh) N畛i ti畉t t畛 quan tr畛ng Nhi畛m v畛 b畉o v畛 Ho tan Vitamin Cung c畉p Vit F VAI TR SINH H畛C C畛A LIPID
- 8. - 畉m 1 : Lipid 1 : Glucid 4 - Lipid ngo畉i sinh, n畛i sinh. - Ng動畛i tr動畛ng thnh: 60-100g, tr畉 em: 30 80 g. - Nng l動畛ng lipid> glucid, protid. - L動畛ng lipid d畛 tr畛 s畛 d畛ng: 20 30 ngy. VAI TR SINH H畛C C畛A LIPID
- 9. TIU HA, H畉P THU V V畉N CHUY畛N LIPID B畉t 畉u 畛 t叩 trng, ch畛 y畉u 畛 ru畛t non Acid m畉t, mu畛i m畉t: - nh滴 岳動董稼乙 h坦a lipid - H坦a ho畉t lipase
- 10. C畉u tr炭c nh滴 岳動董稼乙
- 11. TIU HA, H畉P THU V V畉N CHUY畛N LIPID B畉t 畉u 畛 t叩 trng, ch畛 y畉u 畛 ru畛t non Acid m畉t, mu畛i m畉t: - nh滴 岳動董稼乙 h坦a lipid - H坦a ho畉t lipase Enzym: - lipase d畛ch t畛y - 1 ph畉n nh畛 畛 ru畛t TG Glycerol + 3 a.b辿o Cholesterol este CholesterolTD + a.b辿o GlyceroPL Glycerol + a.b辿o + H3PO4 + Base nito (Base nit董: cholin, ethanolamin, serin, inositol)
- 12. R2 R1 R3 R1 R2 OH TG.lipase R3COOH DG.lipase R1COOH OH R2 OH 則奪ng ph息n ho存 TG DG MG MG OH R2 OH R2COOH MG.lipase OH OH OH Glycerol S畛 th畛y ph但n triglycerid Triglycerid
- 13. S畛 th畛y ph但n cholesterol ester h坦a Cholesterol
- 14. C畉u tr炭c c畛a phospholipid
- 15. Hp thu 谷 ph畉n cu畛i ru畛t non. H畉p thu t畛 do (a.b辿o< 10C, MG, glycerol,) NMRNTMCGan T畉i tb NMRN - Ti畉p t畛c th畛y ph但n MG AB + Glycerol - T叩i t畛ng h畛p lipid (# G v袖 P) AcylCoA + glycerol TG Cholesterol TD + a. b辿o Cholesterol E AB + glycerol + H3PO4 + base nit董 PL
- 16. T脱 ch淡c kh存c (c測,tim, thn) acid bo t湛 do acid bo t湛 do Chylomicron VLDL VLDL Chylomicron VLDL T脱 ch淡c m狸 Ru辿t non Gan Lipid ( t脱ng h樽p) Lipid ( th淡c 即n) v畉n chuy畛n
- 17. 4 d孫ng vn chuyn lipoprotein: + Chylomicron + LP c達 t短 tr辰ng rt thp (VLDL - very low density lipoprotein) + LP c達 t短 tr辰ng thp (LDL - low density lipoprotein) + LP c達 t短 tr辰ng cao (HDL - high density lipoprotein) C畉u tr炭c c畛a lipoprotein
- 18. - oxy ho存 Acid bo 駈 - Oxy ho存 AB no, C ch遜n X其y ra trong ty th c単a t b袖o + Ho孫t ho存 AB: AB + CoA + ATP Acyl CoA + AMP + PPi Ii. chuyn ho存 acid bo Acyl CoA Syntethase AMP + PPi R-CH2-CH2-CH2-COOH Acid b辿o (n ch畉n, no) Acyl-CoASyntetase HS-CoA ATP Acyl-CoA R-CH2-CH2-CH2-CO~S-CoA
- 19. + V畉n chuy畛n acid b辿o vo 岳動董稼乙 ty th畛 - Acyl CoA + Carnitin Acyl-Carnitin - Acyl-Carnitin chuy畛n t畛 bo 岳動董稼乙 ty th畛 - Gi畉i ph坦ng Carnitin AcylCoA V畉n chuy畛n acid b辿o vo trong ty th畛 theo h畛 th畛ng v畉n chuy畛n acyl-carnitin/carnitin
- 20. + - oxy ho叩存 AcylCoA (nC) trong ty th畛 qua 4 ph畉n 畛ng 1. Kh畛 hydro l畉n 1 t畉o . -Dehydro Acyl CoA 2. H畛p H2O t畉o -Hydroxy Acyl CoA 3. Kh畛 hydro l畉n 2 t畉o -Ceto Acyl CoA 4. Ph但n c畉t -Ceto Acyl CoA Acyl CoA (n-2)C + Acetyl CoA (2C) Thiolase Acyl CoA (n-2)C -> 1, 2, 3, 4 ->. -> Acyl CoA (4C) Acyl CoA (4C) => 2 Acetyl CoA S畉n ph畉m thu 動畛c: Acetyl CoA
- 21. + V嘆ng -Oxy ho叩存 R-CH2-CH2-CH2-CO~S-CoA R-CH2-CH=CH-CO~CoA R-CH2-CH-CH2 -CO~S.CoA OH R-CH2-C-CH2-CO~S.CoA O R-CH2-CO~S-CoA + CH3CO~S-CoA Acyl-CoA DH Acyl-CoA (n-2)C Acetyl-CoA CoA.HS -HydroxyacylCoA DH Enoyl Hydrase FAD+ FADH + H+ HOH NAD+ NADH + H+ -CetoAcyl-CoA -HydroxyAcyl-CoA ,-DehydroAcyl-CoA ( Enoyl-CoA) Thiolase Acyl-CoA (1) (2) (3) (4)
- 22. V嘆ng xo畉n Lynen Feodor Lynen (則淡c) 1911-1979 Gi畉i th動畛ng Nobel 1964
- 23. 箪 ngha -oxy ho存 acid bo N即ng l動畛ng: + 1 vng -Oxy ho存: 5 ATP - f/ 1: 1 FADH2 qua HHTB 2 ATP - f/ 3: 1 NADH2 qua HHTB 3 ATP ATP = 5 ATP + Oxy ho存 ho袖n to袖n 1 acid bo c達 2n C - S竪 vng -OXH: (n -1) ATP= 5(n -1) - S竪 Acetyl-CoA: n ATP= 12 n ATP = 17n 5 Tr探 速i 2ATP s旦 d担ng 速 ho孫t h達a ATP = 17n 7 Chuyn ho存: Cung cp SPTG quan tr辰ng: AcetylCoA
- 24. CH3-CH2-CH2-CO~S-CoA CH3-CH=CH-CO~CoA CH3-CH-CH2 -CO~S.CoA OH CH3-C-CH2-CO~S.CoA O 2 CH3-CO~S-CoA Acyl-CoA DH Acetyl-CoA CoA.HS -HydroxyacylCoA DH Enoyl Hydrase FAD+ FADH + H+ HOH NAD+ NADH + H+ -CetoButyryl-CoA -HydroxyButyryl-CoA ,-DehydroButyryl-CoA ( Enoyl-CoA) Thiolase Butyryl-CoA (1) (2) (3) (4) + -Oxy ho叩 butyric acid (2n=4C) 2n C = 4 n=2 S竪 vng -OXH: 1 ATP= 5 S竪 Acetyl-CoA: 2 ATP=12x2= 24 Tr畛 i 2ATP ho畉t h坦a ATP = 29
- 25. Nhn xt - oxy ho存 Acid bo 1. Ho畉t h坦a acid b辿o 畛 bo 岳動董稼乙. 2. v畉n chuy畛n vo ty th畛 theo h畛 th畛ng acyl-carnitin/carnitin. 3. - oxy ho存 trong ty th畛 qua 4 ph畉n 畛ng: Kh畛-H畛p-Kh畛-C畉t. 4. S畉n ph畉m thu 動畛c: Acetyl CoA 5 T畛ng s畛 nng l動畛ng: 17n - 7
- 26. CHUY畛N HAACID BO T畛NG H畛P ACID BO X畉y ra ch畛 y畉u 畛 bo 岳動董稼乙, m畛t ph畉n 畛 ty th畛 v microsome C叩c ch畉t tham gia qu叩 tr狸nh sinh t畛ng h畛p: 1. Act CoA v h畛 th畛ng v畉n chuy畛n ra bo 岳動董稼乙 2. Malonyl CoA 3. Ph畛c h畛p multienzym AB synthetasepyy 4. NAPH,H+ 5. C董 ch畉t Act CoA t畉o thnh t畛 ty th畛 v畉n chuy畛n ra bo 岳動董稼乙
- 27. CC CH畉T THAM GIA QU TRNH T畛NG H畛P Ph畛c h畛p multienzym acid b辿o synthetase: 1 protein v畉n chuy畛n acyl (ACP-Acyl carrier protein) g畉n 6 enzym bao quanh: 1. Act CoA (Acyl CoA ACP transferase) 2. Malonyl CoA-ACP transferase 3. 硫-ceto acyl ACP synthetase 4. 硫-ceto acyl ACP reductase (NADHH+) 5. D 硫-OH acyl ACP (de) hydratase 6. Cis Enoyl-ACP reductase (NADPHH+) 7. ACP (Acyl carrier protein)
- 28. M担 h狸nh 7 protein:
- 29. CC CH畉T THAM GIA QU TRNH T畛NG H畛P NAPH,H+ c坦 3 ngu畛n g畛c ch鱈nh: T畛 chuy畛n h坦a glucose theo HMP T畛 ph畉n 畛ng kh畛 carboxyl oxh malat 畛 bo 岳動董稼乙 Kh畛 carboxyl oxh isocitrat ngoi ty th畛
- 30. T脱ng h樽p acid bo 谷 b袖o 岳動董稼乙 + Nguy捉n liu: Acetyl-CoA/ Malonyl-CoA E* v/c nh達m acyl (Acyl Carrier Protein - ACP) CoE kh旦 NADPH2 (Pentose-P) & f/ t探 a.malic + V/c t探 ty th -> B袖o 岳動董稼乙: nh棚 citrat, carnitin + G奪m 6 f/: 1. Carboxyl ho存 (+ CO2) Acetyl CoA Malonyl-CoA 2. V/c acetyl-CoA, malonyl-CoA + E* Acetyl-E* + Malonyl-E* 3. Ng動ng t担, lo孫i CO2 Acetoacetyl-E* (-CetoAcyl-E*) 4. Acetoacetyl- E* kh旦 Ceto t孫o -Hydroxy Butyryl- E* (OH/C) 5. Lo孫i H2O, t孫o -Dehydro Acyl- E* (Crotonyl-E*) 6. Kh旦 ln 2 b揃o ho袖 LK =, t孫o Butyryl E* (4C). f/ 速動畛c lp l孫i, n竪i d袖i b損ng Malonyl-E* Acyl-E* (C<16) T存ch E* => Acid bo (C <16)
- 31. Malonyl-CoA ATP; CO2 ADP + Pi HS-ACP (E*) 1 Acetyl-CoA Acetoacetyl-E* Acetyl-E* -Hydroxy Butyryl-E* -Dehydro Acyl- E* Butyryl E* Acyl-E* (C<16) Malonyl-E* + (n-1)Malonyl-E* 2 3 CO2 HS-ACP (E*) 4 5 6 4 - Kh畛Ceto 5 Lo畉i H2O 6 Kh畛 l畉n 2 H2O NADPH2 NADPH2 CH3 -CO-CH2- CO~SACP CH3-CH(OH)-CH2-CO~SACP CH3 CH=CH-CO~SACP CH3CH2-CH2-CO~SACP 3 - Ng動ng t畛 2-V畉n chuy畛n 1- Carboxyl ho叩 T畛ng h畛p acid b辿o 畛 bo 岳動董稼乙 K畉t th炭c: Lo畉i E* Acid b辿o HOOC- CH2- CO~S-CoA
- 32. AcylCoA (C<16) 谷 ty th畛 + V/c Acid b辿o (C <16) t畛 bo 岳動董稼乙 -> ty th畛 + 谷 bo 岳動董稼乙: N畛i di b畉ng Acetyl-CoA CoE: NADPH2/ NADH2 + K畉t qu叩: t畛ng h畛p AB (C > 16) Ty th畛 Mng ty th畛 Bo 岳動董稼乙 Oxaloacetat Krebs HSCoA AB (C>16) <-- AcylCoA Acyl Carnitin Carnitin Carnitin Acetyl-CoA Acetyl Carnitin Acetyl-CoA Citrat Citrat Citrat (1) - O ATP Pi + ADP HSCoA Oxaloacetat W (C <16) Acetyl-CoA
- 33. H畛 th畛ng tricarboxylic v畉n chuy畛n ActCoA
- 34. T畛ng h畛p acid b辿o trong ty th畛
- 35. CHUY畛N HA TRIGLYCERID Tho存i ho存 triglycerid(TG) Thu短 ph息n TG: +X其y ra ch単 yu 谷 m束 m狸 (谷 gan, thn). +Enzym : lipase tu綻 R2 R1 R3 R1 R2 OH TG.lipase R3COOH DG.lipase R1COOH OH R2 OH 則奪ng ph息n ho存 TG DG MG MG OH R2 OH R2COOH MG.lipase OH OH OH Glycerol
- 36. + TG Glycerol + 3 Acid bo + AB: - Oxy ho存 AcetylCoA Krebs (ATP) - Nguy捉n liu 速 t脱ng h樽p TG, Cholesterol este, PL + Glycerol tip t担c tho存i bin theo c存c k/n: Sau 速達: Ng樽c, xu束i 速棚ng ph息n Glycerol Glycerophosphat GAP DOAP " P " " O " " iso " " O " GAP + DOAP F-1,6DP Adolase hoc GAP... Acid pyruvic AcetylCoA Krebs Glucose Ho畉c
- 37. T脱ng h樽p TG + X其y ra 谷 b袖o 岳動董稼乙 c単a TB/ (gan, t脱 ch淡c m狸 ). + Nguy捉n liu: - T探 lipid: glycerol (TG), acid bo/acyl-CoA - T探 glucid: DOAP, GAP (sp 速動畛ng ph息n) + C存c f/: - T孫o glycero phosphat: P glycerol hoc kh旦 DOAP - T孫o a. phosphatidic t探 f/: Glycero-P + acyl CoA - T孫o diglycerid: lo孫i H3PO4 c単a a. phosphatidic - Diglycerid + Acyl.CoA Triglycerid + 箪 ngha: t脱ng h樽p lipid d湛 tr歎 cho c測 th.
- 38. ch2oH choh ch2oh ch2oH choh Ch2o -p ch2oH c=o Ch2o -p Ch2o-cor1 Cho-cor2 Ch2o -p Ch2o-cor1 Cho-cor2 Ch2oh Ch2o-cor1 Cho-cor2 Ch2o-cor3 NAD NADH2 ATP ADP Acid phosphatidic 1,2-Diglycerid Triglycerid 2RCO~CoA(AcylCoA) 2HSCoA HSCoA R3CO~CoA Glycerokinase Glycerophosphat-DH Glycerophosphat H2O H3PO4 1 2 3 Glycerol DOAP S董 畛 t畛ng h畛p triglycerid
- 39. CHUY畛N HA PHOSPHOLIPID (PL) Tho叩i h坦a PL (Lecithin/t畛 ch畛c) Lecithin Lysolecithin Glycerophosphorylcholin (~) Glycerophosphat + cholin (?) Phospholipase A LysoPhospholipase H2O H2O (~) esterase R2COOH R1COOH H2O N畛c 畛c r畉n: N P-Lipase A qu叩 cao ->LysoLecithin -> Peroxy h坦a mng TB -> -> 畛 b畛n mng TB -> Tan m叩u
- 40. C畉u tr炭c c畛a phospholipid
- 41. H2C-O-C-R1 R2-C-O-CH H2C-O-P-O-X Phospholipase B Phospholipase C Phospholipase D Phospholipid Phospholipase A O O O O S畛 th畛y ph但n glycerophospholipid S畛 th畛y ph但n lecithin
- 42. T畛NG H畛P LECITHIN Cholin PhosphoCholin XDP-Cholin PhosphatidylCholin (Lecithin) ATP ADP XTP PPi XMP Diglycerid (CH3)3N+-CH2-CH2OH ( ho畉c Ethanolamin) (CH3)3N+-CH2-CH2O- ( ho畉c P-ethanolamin) P (CH3)3N+-CH2-CH2O-XDP ( ho畉c XDP-thanolamin) T畛 base nit董 (Cholin, Ethanolamin) P H.H坦a
- 43. Acid Phosphatidic XDP-diglycerid Phosphatidyl cholin (Lecithin) Phosphatidyl serin Phosphatidyl ethanolamin XTP PPi XMP Serin CO2 S-Adenosyl methionin S-Adenosyl homocystein HOCH2-CHNH2-COOH (Serin) CH2O-COR1 CHO-COR2 CH2O- - OCH 2 CHNH2 - COOH P + CH3 t畛 acid Phosphatidic (Ch畛 y畉u v quan tr畛ng) 1- GPL 2- GPL 3- GPL
- 44. CHUY畛N HA CC TH畛 CETON 3 th ceton: Aceton CH3COCH3 Acetoacetic acid (CH3COCH2COOH) - hydroxybutyric acid (CH3CHOHCH2COOH) (賊2H) -CO2 Oxyh坦a: 畛 c叩c t畛 ch畛c (tim, c董, n達o), cung c畉p NL (W) - Hydroxybutyrat (- H. Butyrat) : - H.Butyrat - H. Butyryl CoA AcetoacetylCoA 2 AcetylCoA ATP AMP + PPi HSCoA NAD NADH2 Thiolase O Krebs CoA W
- 45. THO存I HO存 C存C TH CETON Acetoacetat: => AcetoacetylCoA- 2 c叩ch: + ho畉t h坦a存 (~ ho畉t h坦a存 AB): (CH3-CO-CH2-COOH) CH3-CO-CH2-CO~SCoA ATP AMP + PPi HSCoA Acetoacetat AcetoacetylCoA + nh畛 succinylCoA: Acetoacetat AcetoacetylCoA SuccinylCoA Acid Succinic SuccinylCoAAcetoacetat transferase Ph但n c畉t Acetoacetyl-CoA = 2 AcetylCoA -> Krebs --> W
- 46. T畛NG H畛P CC TH畛 CETON (CS-TK) - 谷 gan, - Acetyl-CoA, AB t湛 do - NADH2 Thiokinase ATP CoA Acyl-CoA -Oxy ho叩存 -Hydroxybutyryl-CoA NAD NADH2 O n (Acetyl-CoA) 2 Acetyl-CoA AcetoAcetyl-CoA CoA CoA H2O HMG-CoA H2O CoA Acetoacetat Lyase HMG-CoA -Hydroxybutyrat NADH2 NAD DH Krebs CO2 Acid b辿o TD
- 47. Aceton: : - Hm l動畛ng aceton r畉t th畉p/m叩u - Kh畛 CO2 t畛 ph叩t acetoacetat -> Aceton (ko c坦 箪 ngh挑a sinh l箪) 2 AcetylCoA Acetoacetyl-CoA CoA HMG-CoA (.Hydroxy- Metyl- Glutaryl-CoA) AcetylCoA CoA H2O AcetylCoA Acetoacetat -Hydroxybutyrat Thiolas HMG-CoA Syntethase HMG-CoA Lyase K NADH2 NAD
- 48. CHUY畛N HA C畛A CHOLESTEROL Vai tr嘆: T畛ng h畛p acid m畉t, mu畛i m畉t: Gan: NL -> t畛ng h畛p acid m畉t ti棚n ph叩t (Litocholic, chenodeoxycholic). Acid m畉t theo m畉t -> ru畛t -> t畛ng h畛p acid m畉t th畛 ph叩t: a.cholic, a.deoxycholic (ti棚u h坦a lipid). 1 ph畉n acid m畉t theo m叩u v畛 gan -> chu tr狸nh ru畛t + gan. T畛ng h畛p hormon: hormon steroid 畛 v探 th動畛ng th畉n, tuy畉n sinh d畛c, T畛ng h畛p Vit D3: nh畛 叩nh s叩ng m畉t tr畛i: cholesterol => ti畛n vit D3 -> t畛ng h畛p Vit D3. Bi ti畉t theo ph但n: Cholesterol d動畛i t叩c d畛ng c畛a vi khu畉n 動畛ng ru畛t bi畉n 畛i thnh cholestanol r畛i o th畉i theo ph但n. Este h坦a
- 49. + 畛 huy畉t 岳動董稼乙: nh畛 lecithin cholesterol transferase (LCAT) Cholesterol TD Cholesterol este Lecithin Lisolecithin LCAT P/ t畉o cholesterol este t畛 cholesterol TD c坦 t叩c d畛ng ch畛ng XVM LCAT ( gan b畛 t畛n th動董ng) => cholesterol este h坦a -> -> Choles este/ Choles TP. Este h坦a + 畛 t畛 ch畛c: (gan, v畛 th動畛ng th畉n, ru畛t non): Cholesterol este h坦a 動畛c th畛c hi畛n nh畛 f/chuy畛n acyl : Cholesterol TD Acyl CoA HS CoA Acyl CoA cholesterol transferase Cholesterol este
- 50. T畛ng h畛p cholesterol 畛 gan (ch畛 y畉u), v畛 th動畛ng th畉n, ru畛t, da, tinh hon NL: ch畛 y畉u t畛 Acetyl CoA (acetoacetat, alhydric acid) Coenzym c畉n thi畉t: NADPH2 G畛m: 35 f/ Enzym, chia 3 giai o畉n: - Giai o畉n 1: T/h畛p acid Mevalonic t畛 Acetyl-CoA - Giai o畉n 2: T畉o Squalen (30 C) t畛 acid Mevalonic - Giai o畉n 3: 坦ng v嘆ng Squalen (-3C) t畉o Cholesterol B狸nh th動畛ng: Cholesterol TP = 3,9 4,9 mmol/l. tu畛i v gi畛i, B畛nh l箪: /XVM
- 51. 仰I畛U HA T畛NG H畛P CHOLESTEROL HMG-CoA Mevalonat Cholesterol HMG-CoA-Reductase Cholesterol T.臓 (-) (-) Acetyl-CoA (> 5,2 mmol/l)
- 52. T畛ng h畛p vitamin D
- 53. T畛ng h畛p c叩c Acid m畉t ,mu畛i m畉t : 但y l con 動畛ng ch鱈nh 畛 ph但n gi畉i Cholesterol (tr叩nh 畛 畛ng Cholesterol) trong 畛ng v畉t, x畉y ra 畛 gan v ru畛t. 2 acid m畉t 動畛c t畉o 畛 gan l A.Cholic v Chenodeoxycholic, 2 acid deoxycholic v lithocholic 動畛c t畉o thnh 畛 ru畛t. Cholesterol Acid Cholic C叩c acid m畉t (Glycocholic ho畉c Taurocholic)
- 55. CC D畉NG LIPID TRONG MU - LIPOPROTEIN (LP ) Lipid m叩u g畛m : Acid b辿o (AB ) Phospholipid ( PL ) Triglycerid (TG ) Cholesterol ( T畛 do & Ester ) T畛ng c畛ng c叩c d畉ng Lipid tr棚n g畛i Lipid ton ph畉n ,chi畉m 1 l動畛ng l畛n trong m叩u (5 -7,5 g/L) Ph畉n di chuy畛n v h嘆a tan 動畛c trong m叩u nh畛 k畉t h畛p v畛i Protein g畛i l Lipoprotein(LP ). Ri棚ng AB k畉t h畛p v畛i Albumin th狸 ph畛c h畛p ny kh担ng g畛i l LP
- 59. 畉C I畛M C畛A CC LP Chylomicron (CM): L ch畉t v畉n chuy畛n TG ngo畉i sinh, 動畛c t畛ng h畛p 畛 ru畛t. Do LPL, TG c畛a CM b畛 th畛y ph但n, cung c畉p AB t畛 do cho m担 s畛 d畛ng. Ph畉n c嘆n l畉i l Remant CM ti畉p t畛c di chuy畛n tho叩i h坦a t畉i gan. B狸nh th動畛ng, sau khi n huy畉t 岳動董稼乙 畛c do c坦 nhi畛u CM. L炭c 坦i, huy畉t 岳動董稼乙 trong do gan 達 b畉t gi畛 h畉t CM
- 60. VLDL L ch畉t v畉n chuy畛n TG n畛i sinh t畛 gan 畉n m担 ngo畉i vi Ngoi ra c嘆n c坦 cholesterol. T畛 l畛 TG 鱈t d畉n lm cho t畛 l畛 C/VLDL tng d畉n. VLDL chuy畛n thnh IDL, r畛i thnh LD
- 61. LDL Sinh ra t畛 IDL, giu C, di chuy畛n trong m叩u 畉n b畛 m畉t t畉 bo m叩u ngo畉i vi v gan BE v b畉t gi畛 vo trong n畛i bo tho叩i h坦a, gi畉i ph坦ng aa, cung c畉p C cho t畉 bo. Khi LDL tng C tng cao g但y 畛 畛ng C thnh m畉ch: XVM C叩c LP tham gia g但y XVM nh動: VLDL, IDL
- 62. HDL HDL thu nh畉n C t畛 t畉 bo, v畉n chuy畛n v畛 gan 畛 o th畉i xu畛ng m畉t. HDL l ch畉t ch畛ng 畛 畛ng C trong t畉 bo ngo畉i vi, 動畛c coi nh動 ch畉t b畉o v畛 thnh m畉ch, ch畛ng x董 v畛a. 畛 叩nh gi叩 nguy c董 VXM trong l但m sng, ch畛 畛nh c叩c x辿t nghi畛m nh動: C, TG, HDL-C, LDL-C, t鱈nh t畛 s畛 LDL-C/HDL-C, C/HDL-C
- 63. 畉C I畛M CHUY畛N HA LIPID 畛 M畛T S畛 M Chuy畛n h坦a lipid 畛 m担 m畛
- 64. 畉nh h動畛ng c畛a hormon 畛i v畛i chuy畛n h坦a lipid t畉i m担 m畛 Insulin: Tng h畉p thu glucose vo t畉 bo, tng tho叩i h坦a glucose t畉o glycerol-P, tng t畛ng h畛p TG 畛c ch畉 ho畉t 畛ng c畛a lipase (thi畉u insulin lm G tng do kh担ng vo t畉 bo, v ABTD tng)
- 65. 畉nh h動畛ng c畛a hormon 畛i v畛i s畛 th畛y ph但n TG
- 66. CHUY畛N HA LIPID 畛 GAN T畛ng h畛p AB, 硫oxh AB x畉y ra ch畛 y畉u 畛 gan t畉o ActCoA (畛t ch叩y trong CT citric, v畉n chuy畛n d畉ng th畛 ceton t畉o nng l動畛ng) Phospholipid 動畛c t畛ng h畛p ch畛 y畉u 畛 gan v畉n chuy畛n m畛 ra kh畛i gan TG 動畛c t畛ng h畛p 畛 gan v畉n chuy畛n kh畛i gan c湛ng v畛i PL, C, CE v apoprotein d動畛i d畉ng VLDL
- 67. Nguy棚n nh但n g但y gan nhi畛m m畛: Gan trn ng畉p AB do: n qu叩 nhi畛u glucid, ch畉t b辿o Huy 畛ng AB t畛 m担 m畛 v畛 qu叩 nhi畛u (T, nghi畛nr動畛u 坦i l但u ngy )nghi畛n r動畛u, 坦i l但u ngy) T畉o kh担ng 畛 LP do: Thi畉u apo B (d湛ng kh叩ng sinh lm gi畉m t畛ng h畛p Pr..) Thi畉u PL do thi畉u AB c畉n thi畉t, thi畉u cholin, ng畛 畛c..
- 68. Chuy畛n h坦a lipid
- 69. K畉T THC