You go to the doctor for an annual checkup, right, Tanya?
你每年都會去看醫生，對吧，坦尼婭?
Sure. As any good health editor would!
當然。任何優秀的健康編輯都會這么做!
Me too. You get asked a bunch of personal questions, a cold stethoscope on your skin, and the doctor draws some blood for standard lab tests. Among those tests, when you get them back, are two cholesterol numbers.
我也是。醫生會問你一堆私人問題，把冰冷的聽診器放在你的皮膚上，然后抽血進行檢查。當你拿回來體檢報告時，有兩個膽固醇指數。
Right. One is your level of low-density lipoprotein cholesterol, or LDL. It’s supposed to stay under 130 milligrams per deciliter—the lower the better.
是的。一個是你的低密度脂蛋白膽固醇水平，或LDL。它應該保持在每分升130毫克以下，越低越好。
The other one is high-density lipoprotein, or HDL. And that’s supposed to stay above 40 milligrams per deciliter. The higher it is, the better, we’re told.
另一種是高密度脂蛋白，簡稱HDL。這應該保持在每分升40毫克以上。我們被告知，它越高越好。
That’s because LDL is the “bad” cholesterol, the one that leads to artery-clogging plaques, heart disease, strokes, and other nasty stuff. We want less of it.
這是因為低密度脂蛋白是一種“壞”膽固醇，它會導致動脈阻塞斑塊、心臟病、中風和其他討厭的東西。我們想要的少一些。
HDL, on the other hand, is “good” cholesterol. We want more of it.
高密度脂蛋白，相反，是“好”膽固醇。我們想要更多。
HDL has this good reputation because it binds to LDL, carrying that bad stuff to the liver. From there it gets flushed out of your body, where it can’t hurt you.
高密度脂蛋白之所以好，是因為它能與低密度脂蛋白結合，將有害物質帶到肝臟。從那里，它被排出你的身體，在那里它不會傷害你。
But … you know that old saying about having too much of a good thing? It seems to be true of good cholesterol.
但是，你知道有句俗話是“物極必反”嗎?好膽固醇似乎也是如此。
So, is it possible to have too much HDL?
那么，高密度脂蛋白有可能過多嗎?
It is totally possible. Turns out that too much HDL actually raises the chances of artery and heart disease, the very things we’re trying to avoid.
這完全有可能。事實證明，過多的高密度脂蛋白實際上會增加患動脈和心臟病的幾率，而這正是我們試圖避免的事情。
Once you get above 80 for men and 100 for women—and I’m going to stop saying milligrams per deciliter because it’s a mouthful—you’re in the danger zone. A bunch of recent studies have found this effect.
一旦男性的HDL超過80毫克/分升、女性超過100毫克/分升，就處于危險區了，這一結論來自一項最近的研究。
But generally, that’s not what doctors have told patients.
但一般來說，醫生不會這樣告訴病人。
The teaching has been up until recently, that the higher the HDL, the lower the risk. So traditionally, physicians have been using very high HDL levels as a marker of a really healthy cholesterol profile.
直到最近，人們一直認為高密度脂蛋白越高，患病風險越低。所以傳統上，醫生一直使用非常高的高密度脂蛋白水平作為健康膽固醇的標志。
That’s the researcher behind some of the newer studies.
這是一些最新研究的研究人員。
My name is Arshed Quyyumi. I'm professor of medicine in the Division of Cardiology at Emory University School of Medicine in Atlanta, Georgia.
我叫阿什德·奎米，喬治亞州亞特蘭大市埃默里大學醫學院心臟病學部的醫學教授。
He did a study of more than 400,000 people in the U.K., people without other predisposing risk factors for heart disease. For men, cardiac and other disease risks went up if their HDL levels were under 40—or over 80. For women, the risk climbed once HDL levels topped 100.
他對英國超過40萬人進行了調查，這些人沒有其他易患心臟病的風險因素。對于其中的男性來說，如果HDL水平低于40毫克/分升或超過80毫克/分升，他們的心臟和其他疾病風險就會上升;對于女性，一旦HDL水平超過100毫克/分升，風險就會攀升。
When you say “climbed,” how much of a risk are we talking about? A few small percentage points, or a much bigger increase?
你說的"攀升"指的是多大的風險?是幾個小的百分點，還是更大?
Excellent question, and I asked Quyyumi about the amount of extra risk that people faced.
問得好，我問了奎米人們面臨的額外風險有多少。
If you just took them without any other evaluation of other risk factors like LDL cholesterol, blood pressure, diabetes, etc, it's almost two fold higher compared to the lowest risk group, which would have levels between 40 to 60.
如果不對其他風險因素(如低密度脂蛋白膽固醇、血壓、糖尿病等)進行任何評估，只是單純地與最低風險組做比較，高出的風險幾乎是兩倍，低風險組指的是HDL水平在40~60毫克/分升之間的人。
Even when he and his team took into account those other factors, those with very high HDL had a risk that was 80 percent higher than normal.
即使他和他的團隊將其他因素考慮在內，高密度脂蛋白水平非常高的人的風險也比正常人高出80%。
Other studies back this up. One of them looked at more than 11,000 people with high blood pressure. It found a much higher rate of cardiovascular problems in people with HDL levels both under 40 and over 80.
其他研究也支持這一觀點。其中一項研究調查了1.1萬多名高血壓患者。研究發現，在40歲以下和80歲以上的人群中，高密度脂蛋白水平高的人患心血管疾病的幾率要高得多。
OK, let me run through the numbers. HDL is bad if it’s under 40. It’s good if its 40 to 60. Possibly a risk in the 60 to 80 range. And a pretty big risk if its above 80 for men and 100 for women.
好吧，讓我算一下。如果HDL水平低于40毫克/分升，就是不好的;如果是40~60毫克/分升，就很健康;在60~80毫克/分升的范圍內可能有風險;如果男性超過80毫克/分升、女性超過100毫克/分升，就會有相當大的風險。
Yep. “Good cholesterol” is really bad cholesterol over 80 or over 100, depending on your sex, and under 40. The middle zone is the safe zone.
是的。“好膽固醇”變壞指的是超過80或100、低于40的膽固醇，這取決于你的性別。中間值是安全區域。
Now it’s a bit of a mystery why HDL should turn bad when it goes really high. Why should a molecule help you at level 45, for instance, but hurt you at level 85? It’s possible that the shape of the molecules change. So they don’t latch on tightly to circulating cholesterol and help ferry it out of the body.
為什么高密度脂蛋白在很高的時候會變壞，這有點神秘。為什么一個分子水平在45時幫你，但在85時卻會害你?分子的結構可能會改變。因此，它們不會緊緊抓住循環中的膽固醇，并幫助將其運送出體外。
Interesting. I want to go back to something intriguing you mentioned: There’s a difference between where men and women enter the HDL danger zone. You said it was over 80 for men, but over 100 for women. Why is that?
有趣。我想回到你提到的一些有趣的事情:男性和女性進入高密度脂蛋白危險區域的程度是不同的。你說男性超過80，但女性超過100。為什么呢?
You’re right. There was a 20 point difference between men and women. And honestly, neither Quyyumi’s team nor anyone else really knows why.
你是對的。男性和女性之間的差距為20分。說實話，奎米的團隊和其他人都不知道原因。
Part of it is thought to be just sex hormone differences, you know, estrogen, testosterone differences…. between men and women. There are some genetic reasons for that as well. It’s not really well worked out.
部分原因被認為是性激素的差異，你知道，雌激素，睪丸激素的差異....男人和女人之間。也有一些遺傳上的原因。這不是很好解決了。
I’ve read that estrogen can increase HDL in women, and that it can be protective. But once women reach menopause, their estrogen levels drop, and HDL becomes less protective.
我讀到過雌激素可以增加女性體內的高密度脂蛋白，這是有保護作用的。但一旦女性進入更年期，她們的雌激素水平就會下降，高密度脂蛋白的保護作用就會減弱。
In any event, it sounds like women shouldn’t freak out if their HDL is slightly over 80, according to these studies. Though men in that range should be aware they are at risk.
無論如何，根據這些研究，如果女性的高密度脂蛋白略高于80，她們也不應該驚慌失措。但在這個范圍內的男性應該意識到自己處于危險之中。
Yeah. And there shouldn’t be a huge number of people freaking out, period. Overall, the research shows that about 7 percent of the general population reaches these scary high HDL levels.
是的。不應該有很多人被嚇到，就這樣?？偟膩碚f，研究表明，大約7%的普通人群達到了這種可怕的高密度脂蛋白水平。
But still, that’s nothing to ignore. If a doctor sees 100 patients in a week, 7 of them will be in this HDL danger zone.
但是，這個問題仍然不容忽視。如果一名醫生一周看100個病人，其中就有7個將處于高密度脂蛋白危險區域。
If people are in the danger zone, what should they do?
如果人們處于危險區域，他們應該怎么做?
I asked Quyyumi about that one, too. Drinking a lot of alcohol drives HDL up, so he’d tell patients guzzling one or two glasses of wine or booze daily to cut it out.
我也問過奎米這個問題。大量飲酒會導致高密度脂蛋白升高，所以他會告訴病人改掉每天喝一兩杯葡萄酒或豪飲的習慣。
There aren’t drugs that bring down high HDL. So the big thing he’d do is focus on treating LDL.
沒有藥物可以降低高密度脂蛋白。所以醫生要做的一件大事就是專注于治療低密度脂蛋白。
Statins, for instance, are very effective at lowering LDL levels, and he’d use those.
例如，他汀類藥物在降低低密度脂蛋白水平方面非常有效，他會使用這些藥物。
And baby aspirin, used carefully, can reduce blood clots that lead to heart attacks. Check with your doctor on that one—aspirin can have side effects.
小心使用的嬰兒阿司匹林可以減少導致心臟病發作的血凝塊。向你的醫生咨詢一下阿司匹林是否有副作用。
And there’s one more thing…
還有一件事……
If they're sedentary, they should be encouraged to exercise. Exercise is helpful for everything.
如果他們久坐不動，應該鼓勵他們鍛煉。鍛煉對一切都有幫助。
I guess I’m going to keep going for my morning runs. And I’ll try to keep my “bad” cholesterol low and “good” cholesterol in that happy middle zone.
我想我還是繼續晨跑吧。我會盡量把我的“壞”膽固醇保持在低水平，把“好”膽固醇保持在快樂的中間區域。
Our colleague Lydia Denworth calls it the Goldilocks zone: not too low or too high, but just right. You can read her new Science of Health column on HDL in the middle of May, on sciam.com.
我們的同事莉迪亞·登沃斯(Lydia Denworth)稱其為“黃金區域”:既不太低也不太高，剛剛好。你可以在5月中旬的sciam.com上閱讀她關于高密度脂蛋白的健康科學專欄。
And now I’m going to call my doctor to schedule my yearly checkup.
現在我要打電話給我的醫生安排我的年度檢查。
You go to the doctor for an annual checkup, right, Tanya?
Sure. As any good health editor would!
Me too. You get asked a bunch of personal questions, a cold stethoscope on your skin, and the doctor draws some blood for standard lab tests. Among those tests, when you get them back, are two cholesterol numbers.
Right. One is your level of low-density lipoprotein cholesterol, or LDL. It’s supposed to stay under 130 milligrams per deciliter—the lower the better.
The other one is high-density lipoprotein, or HDL. And that’s supposed to stay above 40 milligrams per deciliter. The higher it is, the better, we’re told.
That’s because LDL is the “bad” cholesterol, the one that leads to artery-clogging plaques, heart disease, strokes, and other nasty stuff. We want less of it.
HDL, on the other hand, is “good” cholesterol. We want more of it.
HDL has this good reputation because it binds to LDL, carrying that bad stuff to the liver. From there it gets flushed out of your body, where it can’t hurt you.
But … you know that old saying about having too much of a good thing? It seems to be true of good cholesterol.
So, is it possible to have too much HDL?
It is totally possible. Turns out that too much HDL actually raises the chances of artery and heart disease, the very things we’re trying to avoid.
Once you get above 80 for men and 100 for women—and I’m going to stop saying milligrams per deciliter because it’s a mouthful—you’re in the danger zone. A bunch of recent studies have found this effect.
But generally, that’s not what doctors have told patients.
The teaching has been up until recently, that the higher the HDL, the lower the risk. So traditionally, physicians have been using very high HDL levels as a marker of a really healthy cholesterol profile.
That’s the researcher behind some of the newer studies.
My name is Arshed Quyyumi. I'm professor of medicine in the Division of Cardiology at Emory University School of Medicine in Atlanta, Georgia.
He did a study of more than 400,000 people in the U.K., people without other predisposing risk factors for heart disease. For men, cardiac and other disease risks went up if their HDL levels were under 40—or over 80. For women, the risk climbed once HDL levels topped 100.
When you say “climbed,” how much of a risk are we talking about? A few small percentage points, or a much bigger increase?
Excellent question, and I asked Quyyumi about the amount of extra risk that people faced.
If you just took them without any other evaluation of other risk factors like LDL cholesterol, blood pressure, diabetes, etc, it's almost two fold higher compared to the lowest risk group, which would have levels between 40 to 60.
Even when he and his team took into account those other factors, those with very high HDL had a risk that was 80 percent higher than normal.
Other studies back this up. One of them looked at more than 11,000 people with high blood pressure. It found a much higher rate of cardiovascular problems in people with HDL levels both under 40 and over 80.
OK, let me run through the numbers. HDL is bad if it’s under 40. It’s good if its 40 to 60. Possibly a risk in the 60 to 80 range. And a pretty big risk if its above 80 for men and 100 for women.
Yep. “Good cholesterol” is really bad cholesterol over 80 or over 100, depending on your sex, and under 40. The middle zone is the safe zone.
Now it’s a bit of a mystery why HDL should turn bad when it goes really high. Why should a molecule help you at level 45, for instance, but hurt you at level 85? It’s possible that the shape of the molecules change. So they don’t latch on tightly to circulating cholesterol and help ferry it out of the body.
Interesting. I want to go back to something intriguing you mentioned: There’s a difference between where men and women enter the HDL danger zone. You said it was over 80 for men, but over 100 for women. Why is that?
You’re right. There was a 20 point difference between men and women. And honestly, neither Quyyumi’s team nor anyone else really knows why.
Part of it is thought to be just sex hormone differences, you know, estrogen, testosterone differences…. between men and women. There are some genetic reasons for that as well. It’s not really well worked out.
I’ve read that estrogen can increase HDL in women, and that it can be protective. But once women reach menopause, their estrogen levels drop, and HDL becomes less protective.
In any event, it sounds like women shouldn’t freak out if their HDL is slightly over 80, according to these studies. Though men in that range should be aware they are at risk.
Yeah. And there shouldn’t be a huge number of people freaking out, period. Overall, the research shows that about 7 percent of the general population reaches these scary high HDL levels.
But still, that’s nothing to ignore. If a doctor sees 100 patients in a week, 7 of them will be in this HDL danger zone.
If people are in the danger zone, what should they do?
I asked Quyyumi about that one, too. Drinking a lot of alcohol drives HDL up, so he’d tell patients guzzling one or two glasses of wine or booze daily to cut it out.
There aren’t drugs that bring down high HDL. So the big thing he’d do is focus on treating LDL.
Statins, for instance, are very effective at lowering LDL levels, and he’d use those.
And baby aspirin, used carefully, can reduce blood clots that lead to heart attacks. Check with your doctor on that one—aspirin can have side effects.
And there’s one more thing…
If they're sedentary, they should be encouraged to exercise. Exercise is helpful for everything.
I guess I’m going to keep going for my morning runs. And I’ll try to keep my “bad” cholesterol low and “good” cholesterol in that happy middle zone.
Our colleague Lydia Denworth calls it the Goldilocks zone: not too low or too high, but just right. You can read her new Science of Health column on HDL in the middle of May, on sciam.com.
And now I’m going to call my doctor to schedule my yearly checkup.
內容來自 VOA英語學習網：http://www.yolenny.com/show-8837-243666-1.html
