高密度脂蛋白之影響因素－飲食、體能及荷爾蒙（下篇：體能及荷爾蒙）

Abstract

高密度脂蛋白(HDL)受飲食影響因素（除酒精外）相對於低密度脂蛋白 (LDL)較小，但體能及荷爾蒙因素對高密度脂蛋白卻可能影響較大。本文將體能分為三部份來探討與高密度脂蛋白膽固醇(HDL-C)的關係：第一、肥胖程度多與血液中HDL-C呈負相關；第二、中廣型肥胖或上身肥胖的體型也與HDL-C呈負相關；第三、運動量與HDL-C有顯著之正相關性。就荷爾蒙之影響而言，女性血中HDL-C的濃度比男性顯著高許多(約25%) ，這極可能與性荷爾蒙影響有關。停經後婦女其HDL-C比停經前是否會下降或上升並無一致性。停經後所使用的女性荷爾蒙，動情激素(estrogen)可降低LDL-C及提高HDL-C及三酸甘油酯的濃度，而黃體激素(progesterone)可降低HDL-C和三酸甘油酯，提高LDL-C。停經後所使用的女性荷爾蒙對HDL-C的影響並無定論。提高HDL-C的最好生活型態選擇為持續規律的運動，避免肥胖。

Dietary influence (except alcohol) on high density lipoprotein cholesterol (HDL-C) concentration was less significant than on the low density lipoprotein (LDL). However, physical fitness and sex hormones may exert more influences on HDL-C level than dietary factors. We discuss the relationships between HDL-C and physical fitness in three areas. First, obesity index such as body mass index (BMI) is negatively correlated with HDL-C level. Second, body fat distribution, represented by waist hip ratio (WHR), is also negatively correlated with HDL-C independent from BMI. Third, various forms of exercise increase HDL-C significantly with a benefit of losing body fatness. Even though females tend to have higher HDL-C than males by an average of 25 percent, the metabolic roles of sex hormones such as estrogen, progesterone and testosterone affecting on blood lipids are still unknown. Whether the postmenopausal women have lower or higher HDL-C levels than the premenopausal women remains controversial. Improve physical fitness to increase HDL-C is the best lifestyle recommendation until today.