Información del artículo
Se ha asociado la hiperlipemia posprandial a componentes del síndrome metabólico y mayor riesgo de enfermedad cardiovascular. Se define como una elevación de las concentraciones plasmáticas de triglicéridos tras la ingestión de grasa.
Se ha descrito la relación del síndrome metabólico con el estrés oxidativo. Por un lado, en sujetos obesos se observa un incremento de la producción de especies reactivas de oxígeno que deteriora la secreción de insulina y conduce a un aumento de la producción de adipocinas. Y por otro lado, se ha visto que el papel antioxidante de las concentraciones plasmáticas de lipoproteínas de alta densidad está mermado en circunstancias de hipertrigliceridemia, hiperinsulinemia y resistencia a la insulina.
Este incremento del estrés oxidativo y la producción de citocinas es más patente durante el estado posprandial. También se observa un aumento de las moléculas de adhesión celular, y todo esto lleva a daño vascular y disfunción endotelial.
En todo este maremágnum de sucesos, ¿qué papel tiene la hiperuricemia? ¿Las cifras elevadas de ácido úrico son un marcador de riesgo cardiovascular o un factor de riesgo cardiovascular? Por un lado está la producción de radicales superóxidos, por otro lado está el efecto antioxidante del propio ácido úrico. Esta paradoja ha motivado que aparezcan trabajos donde se demuestra que la administración de alopurinol, que es hipouricemiante, reduce las especies reactivas de oxígeno, y otros donde se observa que la elevación de las cifras de ácido úrico incrementa la capacidad antioxidante del plasma.
Palabras clave:
Hiperlipemia posprandial
Estrés oxidativo
Síndrome metabólico
Ácido úrico
Hiperuricemia
Postprandial hyperlipidemia has been associated with components of the metabolic syndrome and an increased risk of cardiovascular disease. It is defined as an elevation of plasma triglyceride levels after fat intake.
An association between the metabolic syndrome and oxidative stress has been described. On the one hand, obese subjects showed increased production of reactive oxygen species, reducing insulin secretion and leading to increased adipokine production. On the other hand, the antioxidant role of plasma high-density lipoprotein levels is reduced in situations of hypertriglyceridemia, hyperinsulinemia and insulin resistance.
This increase of oxidative stress and cytokine production is more evident during postprandial states. Moreover, an increase in cell adhesion molecules has also been observed, all of which leads to vascular injury and endothelial dysfunction.
What is the role of hyperuricemia among all these events? Are elevated uric acid levels a marker for cardiovascular risk or a cardiovascular risk factor? On the one hand, there is superoxide radical production and on the other, the antioxidant effect of uric acid. This paradox has led to the publication of some studies that demonstrate that allopurinol administration, which lowers uric acid levels, reduces reactive oxygen species and to others that show that elevation of uric acid levels increases the antioxidant ability of plasma
Key words:
Postprandial hyperlipidemia
Oxidative stress
Metabolic syndrome
Uric acid
Hyperuricemia
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