UNIVERSIDAD PRIVADA SAN JUAN BAUTISTA EL COLESTEROL
“AÑO DE LA DIVERSIFICACION DIVERSIFICACION PRODUCTIVA PRODUCTIVA Y DEL FORTALECIMIENTO FORTALECIMIENTO DE LA EDUCACION” EDUCACION”
UNIVERSIDAD PRIVADA
“SAN JUAN BAUTISTA” FACULTAD DE DERECHO ESCUELA PROFESIONAL DE DERECHO Tema:
PUBLICIDAD, OBLIGATO OBLIGATORIEDAD RIEDAD DE LOS PROCEDIMIENTOS PROCEDIMIENTOS ESTABLECIDOS ESTABLECIDOS EN LA LEY Cur!:
Te!r"a Ge#era$ %e$ Pr!&e! D!&e#'e:
Hur'a%! Bu! Re#a'! A$um#!:
A#'()a#a Larrea'e*u( Le!#e$a C!#'rera A$ar&+# A%r(# Fa$&!#" Ur(-e Emer!# G(ra! Ra.e$$! J!ue$ Gu'(/rre) Be#a.(%e Cr('(a# Or/ Ur(-e 0($!# C(&$! 1 Tur#!: II 2 N!&3e
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UNIVERSIDAD PRIVADA SAN JUAN BAUTISTA EL COLESTEROL
De"#ca$%r#a A D#%&, por brindarme la dicha de la salud y bienestar físico y espiritual. espiritual.
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2
UNIVERSIDAD PRIVADA SAN JUAN BAUTISTA EL COLESTEROL
De"#ca$%r#a A D#%&, por brindarme la dicha de la salud y bienestar físico y espiritual. espiritual.
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como agradecimiento a su esfuerzo, amor amor y apoy apoyo o Inco Incond ndic icio iona nal, l, dura durant nte e mi for formaci mación ón tant tanto o personal como profesional. por brindarme su guía y sabiduría en el desarrollo de este trabajo.
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UNIVERSIDAD PRIVADA SAN JUAN BAUTISTA EL COLESTEROL
ÍNDICE PÁG. INTRODUCCIÓN
04
CAPÍTULO I: GENERALIDADES 1.1. EL COLESTEROL
07
1.2. FUNCIONES DEL COLESTEROL
08
1.3. OTRAS FUNCIONES METABÓLICAS DEL COLESTEROL
08
1.4. TRANSPORTE DEL COLESTEROL – LIPOPROTEÍNAS
12
1.5. ATEROSCLEROSIS Y DAÑO UE !ACE EL COLESTEROL
13
CAPÍTULO II: SÍNTESIS METABÓLICA METABÓLICA DE COLESTEROL 2.1.
RE"ULACIÓN DE LA SÍNTESIS DE COLESTEROL
18
2.2.
RE"U "UL LACIÓN DE DE LA LA ACTI# TI#IDAD DE DE LA LA EN$IMA IMA !M" RE REDUCTASA
18
2.3.
CONTROL DE LA SÍNTESIS POR EL COLESTEROL DE LA DIETA
1%
2.4. 2.4.
CONT CO NTRO ROL L POS POSITI ITI#O #O DE DE LA SÍNT SÍNTES ESIS IS DE DE COLE COLEST STER EROL OL Y RE"ULACIÓN DE LA SÍNTESIS DE LAS EN$IMAS
2.5. 2.5.
21
FUEN FUENTES TES DEL DEL CO COLE LEST STER EROL OL ENDÓ ENDÓ"E "ENO NO – EFE EFECT CTO O DE DIETAS RICAS EN !IDRATOS DE CARBONO
24
CONCLUSIÓN
28
ANEXOS
29
3
UNIVERSIDAD PRIVADA SAN JUAN BAUTISTA EL COLESTEROL
INTRODUCCIÓ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
UNIVERSIDAD PRIVADA SAN JUAN BAUTISTA EL COLESTEROL
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UNIVERSIDAD PRIVADA SAN JUAN BAUTISTA EL COLESTEROL
CAPÍTULO I
GENERALIDADES
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sin modificar su conocimiento. S'&' >9'* +&-( '/)*' &+( -/'()-,+*'(6 (+9*' )+,+ /,+ / /'+ *'(&),+ +9&- 9-* / *,-6 '*+ '()+ /+ > (-,+ (? '/ '& (+ ,'& +&'()'*+&. P*)-'/)' /+ > >9-,+ *'(&),+( ' +,-;-'/ &+ ' (' -9 +/+-'/,+ ,'(,' '& *-/--+. E( -+*)/)' *'(&)* & +-/-,'/- ,' +/&(-+/'( ,'*-,( ,' '(),-+( )/ ,-()/)'( ++ ''*-'/)+( ,' B-+?-
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UNIVERSIDAD PRIVADA SAN JUAN BAUTISTA EL COLESTEROL
*'('/)+( / -/;+*- ,+'/), ,'& ')9+&-(+ ,'& +&'()'*+& : ,' & &-'/)- +**') ' (' ,'9' ('-* * '-)* ( ''(+. 1.1.
EL COLESTEROL E& +&'()'*+& '( /+ ,' &+( *+,)+( ( 9/,/)'( ,' & ++(-- ,'& '*+ >/+ : ,' &+( /-&'(6 : /+ ,' &+( *+,)+( ( /''(*-+( * '& ')9+&-(+ : * &( '()*)*( '&&*'(. U/ '*(+/ ,' 70 ,' '(+ )-'/' '/ ( '*+ /+*&'/)' 100 ,' +&'()'*+&6 '/ ( :+* *)' ++ ++/'/)' '()*)*& ,' &( '9*/( '&&*'(6 : (<&+ / ''K *)' =10@ -*&/,+ +* & (/*'. E& +&'()'*+& '( / *+,)+ 9(-'/)' /-&. L+( '')&'( /+ )-'/'/ +&'()'*+&6 /' )-'/'/ +)*+( '()'*+&'( '/ (( '9*/(6 '/ > '/+* /)-,,6 : ' ( '('&')+ *-/-& '() ;+*,+ +* '&&+(. E& +&'()'*+& '( / ++/'/)' >9-)& ,' & ,-')6 : (' '/'/)* '/ *)-'/)' )+,+( &+( &-'/)+( ,' +*-'/ /-&6 ++ >'+(6 &'>'6 */'6 '(,+6 : *-(+(Q '*+6 ++ '&-+( ( 9+6 /' /+ (' ,'9' 9(* ,' &-'/)+( : *-+( '/ +&'()'*+& '/ & ,-')6 )++ ,'9'/ '-)*(' &+( &-'/)+( ' &+ +/)-'/'/6 : ' '& +&'()'*+& ,' & ,-') '( -*'(-/,-9&' * '-)* ( ''(+.
Fig!" #. E()*)* ?- ,'& +&'()'*+& &-9*' : '()'*-;-,+6 ++ +&'()'*+&(&;)+ + ++ ()'* ,' / -,+ *(+.
1.2.
FUNCIONES DEL COLESTEROL "
UNIVERSIDAD PRIVADA SAN JUAN BAUTISTA EL COLESTEROL
E& $%&'()'!%& +/()-):' '& '&''/)+ '()*)*& 9(-+ ,'& '('&')+ ,' &( '9*/( '&&*'(. S-/ ( *';'*+ &( '9*/( (' >*?/ ')*','/)' ;&-,( : '*,'*?/ ( +/(-()'/-. E& +&'()'*+& '() '/ &( '9*/( '()'*-;-,( '/ ( *+ >-,*+-&+ =O!@J +/ -,+( *(+(6 *-/-&'/)' oleico : linoleico6 + ++ colesterol-sulfato. E& *+ +&* ,'& +&'()'*+&(&;)+ (' ,-(+/' '/ / ,' &( *( ,' & '9*/ -/)'*-+//,+ +/ +)*+( *+( +&*'( ,' '( +/6 -'/)*( ' ( 9&), +*- >-,*+;<9- ', '9'9-, '/)*' &( *)'( +&*'( ,' &+( &?-,+( ;+*/,+ '& '('&')+ ,' & '9*/6 : &-'/,+ >( +)*( ;/-+/'(6 '/)*' &( ' ,'()/ & *',- ,' & '*'9-&-,, ,' &+( *+)+/'( : ,' &+( -+/'( ,' (+,-+6 : ( *)--- '/ & )*/(-(- ,' ('K&'(. E& +&'()'*+& )9-/ '( -*'(-/,-9&' '/ &+( *+'(+( ,' ;+-)+(-( ' ';')/ &( &&( * )** >+( /)*-'/)'(6 : '/ '/'*&6 * & ;/- ,' &--' ,' *'(-,+( +*/-+( ' >'/ &+( *<;+(. L( '9*/( ,'9'/ )'/'* / '()*)* ;&-, * ' &( *+)'?/( -/)'*,( '/ '&& (' ',/ +'* '/ >+*-+/)& * -/)'*-+/* +/ (( &-/,+( : +/ +)*( *+)'?/(. L ;&-,' & , & *( -/()*,. C+/ ''(+ ,' *( ()*, &( '9*/( (' >'/ *?-,(6 '*+ (<&+ +/ & *( -/()*, /''(*- &( '9*/( (+/ ')*','/)' ;&-,(6 : : ('/(-9&'( 9-+( ,' )''*)*. E& +&'()'*+& '()9-&- & '()*)* ,' &( '9*/(Q * ' )'// & '()*)* +**') ,'9'/ )'/'* &( *++*-+/'( ,',( ,' *( ()*,6 -/()*, : +&'()'*+&. L( '9*/( *+,-,( '/ '& &9+*)+*-+ (-/ +&'()'*+& (+/ -/'()9&'( 9-+( ,' )''*)* +,-;-/,+ ,*)-'/)' ( ;&-,' ;*'/)' &+( 9-+( ''K+( ,' )''*)* ' +**'/ '/ '& */+ ;-(-+&<-+. 1.3.
OTRAS FUNCIONES METABÓLICAS DEL COLESTEROL A,'( ,' (( ;/-+/'( '/ &( '9*/( '&&*'(6 '& +&'()'*+& '( / -+*)/)' *+,)+ ' '& ')9+&-(+ ( ++ )'*- *- * ;9*-* +)*+( +'()+(J
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UNIVERSIDAD PRIVADA SAN JUAN BAUTISTA EL COLESTEROL
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UNIVERSIDAD PRIVADA SAN JUAN BAUTISTA EL COLESTEROL
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UNIVERSIDAD PRIVADA SAN JUAN BAUTISTA EL COLESTEROL
Fig!" 4. P*-/-&'( >+*+/( ,' & +*)' ,' &( &/,&( ,*'/&'( =+*)-+-,'(@. M-/'*&++*)-+-,' =&,+()'*+/@6 : &++*)-+-,'( =+*)-(+/ : +*)-(+&@.
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UNIVERSIDAD PRIVADA SAN JUAN BAUTISTA EL COLESTEROL
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*+99&''/)' (' ,'9' ' '& >'(+ /''(-) *'/+* '& ,'<(-)+ ,' &-+ * *''* : *''/'**('6 : & -)-/ D +/)*-9:' '()' *+'(+ '/)/,+ '& )*;-+ ,' &-+ '/ & (/*' =-/&-,( & 9(+*- -/)'()-/& : & *'9(+*- *'/&@6 '*+ '( : -+*)/)' )'/'* '/ '/) '6 ,,+ '& '& *'&,+* ,' '() -)-/6 : ' '( *'*(+* ,' / >+*+/6 )+*& ++ (&''/)+ &-'/)*-+ ,'9' >'*(' +/ > *'- : (-'*' 9+ --&/- ,- ,'& '(),+ ,' &-;-- ,'& >'(+6 : ' / ,+(-( ,'(-,+ &) *+,-* / ,'(&-;-- ''(- ,' &+( >'(+(. E& '(,+ *(+ : >+( +)*+( &-'/)+( +/)-'/'/ (;--'/)' -)-/ D * 9*-* &( /''(-,,'( /+*&'(Q /(' &( ('-+/'( A&-'/)- : ,-')6 : O()'++*+(-( : +()'+'/-. 1.4.
TRANSPORTE DEL COLESTEROL < LIPOPROTEÍNAS L+( /)*-'/)'( (+&9&'( ,' & ,-'()- =-/+-,+(6 *'( : -)-/( (+&9&'(@ -/ ,'(,' '& -/)'()-/+ & >?,+ +* & '/ +*). A,'(6 '& >?,+ *'-9' +* & *)'*- >')- +?'/+6 >+*+/(6 : /)*-'/)'( (-()-+(6 *'-9-'/,+ -/;+*- ,'& +/)'/-,+ (+&9&' ,' & ,-') : ,' & (-)- '/'*& ,'& +*/-(+Q *'++/' &+( /)*-'/)'( 9(+*9-,+( ,' '*,+ +/ &( /''(-,,'( (-()-(6 : >' &( +/'*(-+/'(
'*)-/'/)'(.
U/
&
,-')
&'
>'
)*9*
''(-'/)'Q *)' ,' &+( *+9&'( ,-'()-+( ' ', +(-+/*6 '& >?,+ '( -'/ *-/-&'/)' (;*' &+( ';')+( ,' / & ,-'). E& )*/(+*)' ,' &+( &?-,+(6 +&'()'*+& : -)-/( &-+(+&9&'( '( >+ ( +&'+ : ' & /+ ('* (+&9&'( /+ ','/ ('* '/-,+( & '/ +*) +*' &&? *+,-*?/ *-,'/)' ,'<(-)+( ,' *(6 : ,'9'/ ('* '/-,+( +* +)*+ -/+. E() +)* ? '( '& (-()' &-/;)-+. E/)*' &( ;/-+/'( ,'& (-()' &-/;)-+ >: ' ,'()* ,+(J ( '& '/)*& '/ '& (-()' -//' ='* ,')&&'( '/ & ('- S-()' -//'@6 : ( '& '/ '& )*/(+*)' ,' &+( &?-,+( : ,'& +&'()'*+& ,' & ,-'). 12
UNIVERSIDAD PRIVADA SAN JUAN BAUTISTA EL COLESTEROL
A& ('* : -/(+&9&'6 '& +&'()'*+& (' )*/(+*) +* & (/*' &-,+ &-+*+)'?/( &()-(6 *+)'?/( -/)*'&&*'(6 : * & '*'- 9-&-* : & 9(+*- -/)'()-/& + '/ ,-(+&-+/'( -'&*'(. L :+* *)' ,'& +&'()'*+& - '()'*-;-,+ '/ ( *+ >-,*+-&+ +* / -,+ *(+ =*-/-&'/)' +&'-+ + &-/+&'-+@ + ++ +&'()'*+& (&;)+. L( &&( )/ '& +&'()'*+& ,' &( &-+*+)'?/( *+-'/,+ '& '/&' ()'*6 : &+ *''()'*-;-/ * -/)'**&+ '/ (( '9*/(6 '( '& +&'()'*+& &-9*' /+ &' ,'9-,'/)' ( ;/- '()*)*&. 1.5.
ATEROSCLEROSIS = DA>O ?UE +ACE EL COLESTEROL A '(* ,' & ';-- ,' &( &-+*+)'?/(6 /+ (-'*' (' ',' '-)* ' / -'*) ;*- ,' +&'()'*+& *'--)' (+9*' &( *','( &( *)'*-( &+ ' &&' )'*+(&'*+(-(6 : ' *'--)' '/ &+( +/,)+( 9-&-*'( *+,-'/,+ &&+( 9-&-*'(. E& ''(+ ,' +&'()'*+& ;+*'' & ;+*- ,' '()+( ,'<(-)+(.
Li@%@!%)'-"( L( &-+*+)'?/( )*/(+*)/ &+( *+,)+( >-,*+;<9-+( -/(+&9&'( '/ =&?-,+(6 +&'()'*+&6 -)-/( &-+(+&9&'(6 ')@ +* & (/*'6 : (' &(-;-/ +* ( ,'/(-,,. C++ &+( &?-,+( )-'/'/ '/+* ,'/(-,, ' &( *+)'?/(6 /) :+* *++*- ,' &?-,+( )'/ / &-+*+)'?/ '/+* ('* ( ,'/(-,,. D' '*,+ +/ '()' *-)'*-+6 &( &-+*+)'?/( (' &(-;-/ '/ &+( *+( ,'(*-)+( '/ & T9& 1.
T!"-(@%!)' 3'& $%&'()'!%& 3' &" 3i')" < ?i&%,i$!%-'( CM E& +&'()'*+& ' (' 9(+*9' ,' & ,-') (' )*/(+*) +* '& (-()' &-/;)-+ ,'(,' &( &&( ,' & +( ,'& -/)'()-/+ ='/)'*+-)+(@ '/ &+( -&+-*+/'( =CM@6 ' (+/ &( &-+*+)'?/( ,' '/+* ,'/(-,,6 ;9*-,( +* &+( *+-+( '/)'*+-)+(. D'& -/)'()-/+ (&'/ +/,)+( &-/;)-+( ' &&'/ &+( CM +/ &+( *+,)+( &-?,-+( *+','/)'( ,' & 9(+*- -/)'()-/&.
13
UNIVERSIDAD PRIVADA SAN JUAN BAUTISTA EL COLESTEROL
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
Li@%@!%)'-"( ;'@1)i$"( L( &-+*+)'?/( ,' 9 ,'/(-,,6 + LDL =L+H D'/(-): L-+*+)'-/(@ (+/ *'/'/)'( ,' IDL =&-+*+)'?/( ,' ,'/(-,, -/)'*',-@6 &( &'( (+/ ( ' *'/'/)'( ,' #LDL =&-+*+)'?/( ,' : 9 ,'/(-,,@. L( #LDL (' ;9*-/ '/ '& >?,+. E& >?,+ ;9*- +&'()'*+& : -,+( *(+(6 *-/-&'/)' *)-* ,' >-,*)+( ,' *9+/+Q +/ &+( -,+( *(+( ;9*- )*-&-*-,+( :
14
UNIVERSIDAD PRIVADA SAN JUAN BAUTISTA EL COLESTEROL
;+(;+&?-,+(6 : '+*) )+,+( '()+( *+,)+(6 '/ ( :+* *)' '/ &( &-+*+)'?/( #LDL6 ' +/)-'/'/ *-/-&'/)' &+( )*-&-*-,+( '/,<'/+( =555@6 +&'()'*+& =20@ : ;+(;+&?-,+( =15@6 (-'/,+ ( ;*- *+)'- (<&+ '& 510. D*/)' ( *'+**-,+ +* & (/*' ( +/)'/-,+ &-?,-+ : &+ ,' +&'()'*+& (' )*/(;-'*'/ &+( )'-,+( =: '/ *)' )9-/ &( &-+*+)'?/( !DL@. A(? &( #LDL '/)/ ( ,'/(-,,6 : (' +/-'*)'/ *+*'(-'/)' '/ IDL : LDL. E/ '() ,'/ ,' +/'*(- & *++*- ,' +&'()'*+& '/)/,+ >() &&'* 456 -'/)*( ' '& *'()+ ,' & ;*- &-?,- / ,-(-/:'/,+ >() 10 ,' )*-&-*-,+( : 20 ,' ;+(;+&?-,+(Q & -(+ )-'+ & ;*- *+)'- '/)/,+ >() ('* 25 '/ &( LDL. L( LDL ','/ ,' ( +&'()'*+& : (( &?-,+( &+( )'-,+(6 : & ;*- *+)'- ' ', '( ,'()*-, +* &+( *<;+(.
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
C%&'()'!%& *'-% ,"&% L( !DL )-'/'/ ( ;-/-,, +* '& +&'()'*+& ' &( LDL6 : &+ ')*'/ ,' &+( )'-,+(6 : ,' &( &( )'*+(&'*<)-( +/,-/,+&+ & >?,+ * '&--/*&+. P+* '& +/)**-+ &( LDL )-'/'/ ( ;-/-,, +* &( *+)'?/( ,'& )'-,+ +/')-+ ,' &( *','( ,' &( *)'*-(6 : ','/ ,'(*'/,'* &&? ( +&'()'*+& *++-'/,+ & ;+*- ,' &(. E()( *+-',,'( (+/ '& +)-+ ,' ' (' &&' +&'()'*+& &+ & (+-,+ 1
UNIVERSIDAD PRIVADA SAN JUAN BAUTISTA EL COLESTEROL
LDL6 +*' '( / -/,-)-+ ,' ( '/)+ '/ '& '*+6 : ,' & *+'/(- ;+** &( )'*+(&'*<)-(6 : +&'()'*+& 9'/+ & (+-,+ !DL6 +*' '( '& ' - * '&--/*('.
"&%!'( -%!,"&'( 3' $%&'()'!%& )!ig&i$!i3%( '- ("-g!' C+&'()'*+& )+)&J I/;'*-+* 200 ,L. N+*&&)+J '/)*' 200 : 240 ,L. A&)+J ('*-+* 240 ,L. C+&'()'*+& LDLJ N+*&J -/;'*-+* 100 L. N+*&&)+J '/)*' 100 : 10 ,L. A&)+J ('*-+* 10 ,L. C+&'()'*+& !DLJ N+*& =>+9*'@J ('*-+* 35 ,LQ '*J ('*-+* 40 ,L. T*-&-*-,+(J N+*&J -/;'*-+* 150 ,L. N+*&&)+J '/)*' 150 : 200 ,L. A&)+J ('*-+* 200 ,L.
1!
UNIVERSIDAD PRIVADA SAN JUAN BAUTISTA EL COLESTEROL
CAPÍTULO II
SÍNTESIS METABÓLICA DE COLESTEROL L :+* *)' ,'& +&'()'*+& ' )'/'+( '/ '& '*+ /+ *+',' ,' & ,-') (-/+ ,' ( (?/)'(-( '/,<'/. E& ')9+&-(+ >/+6 ++ '& ,' )+,+( &+( /-&'( (-/)')- +&'()'*+&. U/ '*(+/ /+*& =/+ +9'( /- ,-9)-@ (-/)')- ,-*-'/)' '/)*' % : 13 +* ,' ( +*+*&. A(? / '*(+/ ,' 70 (-/)')- '/)*' 30 : %00 ,' +&'()'*+& ,-*-'/)'. E() (?/)'(-( (' >' '/ *-+( <*/+( : )'-,+(6 '*+ '& *-/-& '( '& >?,+ ' , '/) ,'& 5075 ,' & *+,-( '/-( : *+)'?/( ,-;'*'/)'( =;-* @6 : &)-), ,' *+'(+( *'&,+*'( : )*/(+*)' ,' *+,)+( +* '& -)+&(6 +* &( '9*/( -/)'*/( ,' & && : +* &+( +*)-'/)+( -/)*'&&*'( =*')?&+ '/,+&(-+ : *)+ ,' "+&-@.
Fig!" . P*)' ,'& ')9<&-+ +/ & *) ,' & (?/)'(-( ,' +&'()'*+& : +)*+( ,'*-,+( ,'(,' ')-&C+A. E& *+'(+ +&')+ )-'/' ( ,' '-/)' (+( : '() *'&,+ '/ *-+( /)+(6 *-/-&'/)' '/ & '/- !M" *',)( =!M"R@6 & *-'* ,' ( *) '('?;- =-/,-, +/ / ;&'> -+&')6 **-9 & --'*,.
1"
UNIVERSIDAD PRIVADA SAN JUAN BAUTISTA EL COLESTEROL
2.1.
REGULACIÓN DE LA SÍNTESIS DE COLESTEROL E()' '( '& /)+ ( -+*)/)' ' ,'9'+( +/(-,'** ?6 : ' & :+* *)' ,'& +&'()'*+& ' )'/'+( '/ '& '*+: & ( ,' ( ''(+/+ *+',' ,'& +&'()'*+& ,' & ,-') (-/+ ,' ( (?/)'(-( '/,<'/. P+* )/)+6 & '+* ;+* ,' '-)* '& ''(+ ,' +&'()'*+& '( +*'/,'* 9-'/ &+( '/-(+( *'&,+*'( ' +'*/ (+9*' ( (?/)'(-(6 '('-&'/)' '/ '& >?,+6 * )* (+9*' '&&+(.
2.2.
REGULACIÓN DE LA ACTIIDAD DE LA ENIMA +MG REDUCTASA L (?/)'(-( ')9<&- ,' & :+* *)' ,' &+( *+,)+( (' *'& ',-/)'
/
'/-(+
-9'*/)-+
,'
+/)*+&
/')-+
+
*')*+&-'/)- =;'',9@6 (--&* & ' *+,' '& ;&+),+* ,' / ,'<(-)+ ,' 6 ' & &/* / -'*)+ /-'& -'** '& +/,)+ ,' &-'/)-( *)( ')9<&-( '& *+,)+ ;-/& -/>-9' & )--,, ,' & '/- ' )&- '& *-'* (+6 ++ '()* & ;-* . E()' '/-(+ '/'*& ,' *'&- )9-/ ;/-+/6 '/ -'*)+ ('/)-,+6 '/ & (?/)'(-( ,' +&'()'*+&. S-/ '9*+6 ? '( >+ ( +&'+6 : '/ *)' : ,-;'*'/)'6 ,'9-,+ ' & *) ,' (?/)'(-( ,' +&'()'*+& +**' '/ & ;*- (+&9&' ,' & &&6 : '& +&'()'*+&6 *+,)+ ;-/&6 '( : -/(+&9&'. E()( *)'*?()-( +&-/ >+ ( *'&- : ( )*/(+*)'. E& /)+ *-/-& ,' *'&- '( & '/- !M" C+A *',)( =!M"R@6 *-'* '/- ,' & ,'/ ,' (?/)'(-(. E() '/- (' *'& ',-/)' '/-(+( ' +'*/ (+9*' ( )--,, : (+9*' ( /)-,,.
Fig!" . M'/-(+ ,' -/>-9-- ;'',9 =*')*+&-'/)-@. E& *+,)+ P ' (' (* * ,-'*(( ;/-+/'( (' *+,' ',-/)' / ,'/ ,' *'-+/'( *)-* ,'& *'*(+* )*( ,' / ,'/ ,' -/)'*',-*-+( S 16 S26Z E()' *+,)+ -/)'*-+/ +/ & *-'* '/- ,' & ,'/ =+ +/ / ,' &( *-'*(@ -/>-9-'/,+ ( )--,,. D' '() ;+* (' '-) ' (' *+, P '/ ''(+6 : (' '*-)' '& (+ ,'& *'*(+* * +)*( ;/-+/'(. E/ & (?/)'(-( ,' +&'()'*+& '()' '/-(+ )9-/ ;/-+/6 '*+ '( >+ ( +&'+6 '( '/ & -/)'*-'/' '/ :+* ',-, '& +&'()'*+& *+','/)' ,' & ,-').
1#
UNIVERSIDAD PRIVADA SAN JUAN BAUTISTA EL COLESTEROL
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
CONTROL DE LA SÍNTESIS POR EL COLESTEROL DE LA DIETA S-/ '9*+6 '& '/-(+ ,' +/)*+& /')-+ '/,<'/+6 ,'(*-)+ **-96 * ;*'/* & )--,, ,' & !M"R : '/ +/(''/-6 & (?/)'(-( ,' +&'()'*+&6 9(,+ '/ & /)-,, ,' +&'()'*+& ' (' > *+,-,+6 /+ '( ,'& )+,+ ';- '( /+ ',' ,')'/'* +* +&')+ '& *+'(+6 : /''(-) / '/-(+ ,--+/&. E()' ('/,+ '/-(+ -'/' +9'*/,+ +* '& $%&'()'!%& 3' &" 3i')" : '( >+ ( ';- ' '& *-'*+6 '( & (+&+ &&' +/)*+&* '& 100 ,'& *+'(+ . E/ ';')+6 (- (' (*-' '& +&'()'*+& ,' & ,-') & (?/)'(-( ,' +&'()'*+& +/)-/ ,'(+/)*+&, : (' (-' *+,-'/,+ +&'()'*+& >() /-'&'( &)+(6 -'/)*( ' (- & ,-') )-'/' (;--'/)' +&'()'*+& =065 ,' ( ++(--
)+)&@ ( (?/)'(-(
,'
,')-'/'
)+)&'/)'.
#*-+(
''*-'/)+( >/ ,'+()*,+ ' '/ '& >?,+ ,' *)( &-'/),( ,*/)' 8 ,?( +/ / ,-') '/)'*'/)' *'/)' ,' +&'()'*+& (' *+,+ / (?/)'(-( ,' +&'()'*+& >+ ( &) ' '& ,' &( *)( +/)*+& &-'/),( +/ / ,-') 9 '/ +&'()'*+&6 -'/)*( ' +/ / +/)'/-,+ '/ & ,-') ,' 065 ,' +&'()'*+& ,*/)' +>+ ,?(6 & (?/)'(-( (' ,')+ +* +&')+. L+( )+*'( ,' '()' )*9+ >'/ /+)* ' (( *'(&),+( *';)/ '& +/('+ ,' '-)* '& +&'()'*+& '/ & ,-') =(+/ *'(&),+( 9&-,+( '/ 1%536 : *'-)'*,'/)' +*+9,+( +/ 1$
UNIVERSIDAD PRIVADA SAN JUAN BAUTISTA EL COLESTEROL
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
UNIVERSIDAD PRIVADA SAN JUAN BAUTISTA EL COLESTEROL
-/)'*-+/* +/ & !M"R ' -/>-9-*&. P+* )/)+6 '& -/>-9-,+* ( +)'/)' ,' & (?/)'(-( ,' +&'()'*+& '( '& ' (' )*/(+*) +* &+( CMR6 )+,+ '& & *+',' ,' & ,-'). L +/&(- '/'*& ,' '()+( '/-(+( '( ' '& +&'()'*+& ,' & ,-') '( '& *-/-& *'&,+* ,' & (?/)'(-( '/,<'/ ,' +&'()'*+&6 : & ;+* ( ';- =)+,+ +/ +,'*-@ ,' '-)* ( ''(+. E()' ';')+ (' > ,'+()*,+ ,-*')'/)' '/ '& &9+*)+*-+ +/ *'/'/)'( ,' -&+-*+/'( =CMR@ *'*,+( & ';')+. 2.4.
CONTROL POSITIO DE LA SÍNTESIS DE COLESTEROL = REGULACIÓN DE LA SÍNTESIS DE LAS ENIMAS C++ +**' '/ >+( +)*+( *+'(+( ')9<&-+(6 ,'( ,'& +/)*+& /')-+ ' ;*'/ & (?/)'(-( ,' +&'()'*+& -/>-9-'/,+ & )--,, ,' & !M"R6 )9-/ >: / +/)*+& (+9*' & /)-,, ,' & '/- ,-(+/-9&'. E()' +/)*+& ',' ('* /')-+ =;*'//,+ & (?/)'(-( ,' & '/-@ + +(-)-+ =)-/,+&@. !:6 & '/+(6 ,+( )-+( ,' '/-(+( ' +'*/ '/ '()' ('/)-,+J /,+ &+( /-'&'( ,' +&'()'*+& (+/ 9+( & *+)'?/ *'&,+* SREBP6 '/ &* ,' -/)'*-+/* +/ & '/- !M"R * ;*'/* ( )--,,6 -* & /&'+ ' -/)'*-+/ +/ '& DNA =+ ADN@ : '()-& & )--,, ,' &+( '/'( ' +,-;-/ &( '/-( * & 9-+(?/)'(-( ,' +&'()'*+&6 -/&-, & (?/)'(-( ,' &( &-+*+)'?/( ' &+ / '+*)* =LDL : #LDL@.
R'g&"$i- ;%!,%-"& T9-/ >: / +/)*+& +(-)-+ *'&,+ +* & >-<;-(-(J L( *)( &( ' (' > ')-*,+ & >-<;-(-( -'*,'/ *)-'/)' )+, & -,, ,' (-/)')-* +&'()'*+&. S-/ '9*+6 '(* ,' ( '-,'/)' -/)'*(6 '()' '/-(+6 ,'(9-'*)+ >' (- ('('/) K+(6 : ',-,+6 (-/ ,,6 +* >+*+/( >-+;-(*-(6 '/( (' > '(),-,+ +/ +()'*-+*-,,6 /- * +/;-**&+ /- * *'9)-*&+. L -/(&-/ )9-/ *'' -/)'*'/-* '/ '() *'&-6 '*+ /+ (' > &*,+ ( ;/- '/ '()' ('/)-,+.
21
UNIVERSIDAD PRIVADA SAN JUAN BAUTISTA EL COLESTEROL
L (?/)'(-( ,' &( '/-( *'(+/(9&'( ,' & (?/)'(-( ,' -,+( *(+( =&-+/'(-(@ : ,' & (?/)'(-( ,' +&'()'*+& '() +/)*+&, +* &( *+)'?/( *'&,+*( SREBPJ L SREBP1 )- & )*/(*-- ,' &+( '/'( &-+/-+(6 *'(+/(9&'( ,' &( '/-( ' (-/)')-/ &+( -,+( *(+( =*-/-&'/)' '/ '& >?,+@Q & SREBP2 )- &+( '/'( ,' & (?/)'(-( ,' +&'()'*+&Q : '& ;)+* SREBP1 )- &+( ,+( )-+(. L+( -,+( *(+( +&--/()*,+( ,' & ,-') =H3@ : =H@6 *','/ & SREBP1 : '&'*/ & ,'*,- ,' &+( RNA +**'(+/,-'/)'( =&( +&&( ' &&'/ '& '/(' '/)-+ * & (?/)'(-( ,' &( '/-(@. E()' ';')+ /+ &+ >'/ &+( -,+( *(+( ()*,+( /- &+( -/()*,+( =H%@. P+* +)* *)'6 & -/(&-/ : &+( *9+>-,*)+( )9-/ )-/ & )--,, ,' '()+( '/'( \13]6 ,' /'* ' / ,-') *- '/ *9+>-,*)+( =' )- & ('*'- ,' -/(&-/@ '/) & (?/)'(-( ,' +&'()'*+&. #'*'+( ( ,')&&'( ,' '()' ';')+ ( 9+.
E/'$)% (%*!' '& $%-)!%& 3' &" (-)'(i( 3' $%&'()'!%& @%! &%( 1$i3%( g!"(%( 3' &" 3i')". L%( 1$i3%( g!"(%( @%&ii-(")!"3%( !'3$'- &" (-)'(i( &" "*(%!$i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
UNIVERSIDAD PRIVADA SAN JUAN BAUTISTA EL COLESTEROL
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
UNIVERSIDAD PRIVADA SAN JUAN BAUTISTA EL COLESTEROL
2..
FUENTES DEL COLESTEROL ENDÓGENO < EFECTO DE DIETAS RICAS EN +IDRATOS DE CARBONO L (?/)'(-( ,' +&'()'*+&6 -& ' & ,' -,+( *(+(6 +**' '/ '& -)+&( '&&*6 *)-* ,'& -/)'*',-*-+ ')9<&-+ ')-&C+A. E& ')-&C+A *+',' *-/-&'/)' ,' & ,'*,- ,' >-,*)+( ,' *9+/+ : ,' -,+( *(+(6 : (' *+,' '/ &( -)++/,*-( ,+/,' (' +/('
++
*-/-&
-/)'*',-*-+
'/'*)-+.
P'*+
'()'
-/)'*',-*-+ /+ (' ',' +/(-* -/,''/,-'/)''/)' (-/+ ' * '&&+ (' )-'/' ' +9-/* +/ +)*+J +&'))+. E& +&'))+ (' *''/'* '/ & *) ,' +/(+ ,' ')-&C+A +*--//,+ / *) ?&-J '& -&+ ,' ^*'9(6 ' '( & *) '/)*& ,'& ')9+&-(+ '/'*)-+. S-/ '9*+6 /+ )+,+ '& +&'))+ ' '/)* '/ '& -&+ (' *''* +*' &/+( *+,)+( -/)'*',-+( ,' '() *) (' (/ * +)*+( *+<(-)+( =(?/)'(-( ,' -/+-,+(6 >'+&+9-/6 -)+*++( : +)*+(@. E()' ,*'/' '*,- & *''/'*- ,'& +&'))+ '*/,+ & -,, ,'& -&+.
Fig!" . C')%g-'(i(: (?/)'(-( ,' '*+( ')-+( /,+ '& -&+ ,' ^*'9( /+ ',' ,* '/) ,' )+,+ '& ')-&C+A *+,-,+ '/ & +-,- ,' -,+( *(+(6 +* >9'* '((' ,' +&)-+ ,'9-,+ & ;&) ,' *'*(+*'( /&'*<)-+(. E& -,+ (*)-+ *-/--+ )-+ ,' /'()*+ *+,)+ A(*9+&- *'('&' '()' *+9&' ++ ;'/)' /&'*<)-.
24
UNIVERSIDAD PRIVADA SAN JUAN BAUTISTA EL COLESTEROL
E()' ,*'/' (' +'/( +/ *-( *)( ')9<&-( ' *+,'/ +&'))+ ,-*')'/)'Q '()' *+'(+ ,' *''*- (' ,'/+-/ /&'*+(-( + '9,* =,'& *-'+ *'&&'/* + '9*@. P* ' '& -&+ ,' ^*'9( ;/-+/' +**')'/)' )-'/'/ ' '()* ;/-+//,+ : 9-'/ &( *)( /&'*<)-( ;-/ ,' +'/(* ( ,*'/'. C/,+ ()( /+ ;/-+// 9-'/6 /+*&'/)' +* '((' ,' *'*(+*'( ')9<&-+( ,' +&'))+6 & *+,- ,' ')-&C+A '( ('*-+* & -,, * +/(-*&+6 : '& ')9+&-(+ ,' (-()'( ,' &--,'*+ ,' ')-&C+A * '-)* ' (' &' '()' -/)'*',-*-+6 +/-*)-/,+&+ '/ +)*+( *+,)+( ' (' '+*)/ +)*+( )'-,+( ' ',/ +/(-*&+(.
S-)'(i( 3' $'!@%( $')-i$%(: C')%g-'(i(. S- *+',' ,' & ,'*,- ,' -,+( *(+(6 '& ''(+ ,' ')-&C+A (' +/-'*)' '/ &( -)++/,*-( '/ '*+( ')-+( =')+'))+6 9– >-,*+-9)-*)+ : ')+/@. E& >?,+ '( '& *-/-&*+,)+* ,' '*+( ')-+( : (- '()' *+9&' '( ,+ ',' +(-+/* ')+(-( =;-* 7@.
S-)'(i( 3' $%&'()'!%&. S- *+',' ,' & ,'*,- ,' >-,*)+( ,' *9+/+6 '& ''(+ ,' ')-&C+A (' ( ,' & -)++/,*- & -)+&( ,+/,' (' +/-'*)' '/ -,+( *(+( : '/ +&'()'*+& =;-* 8@. E/ '& -)+&(6 & (?/)'(-( ,' +&'()'*+& ) ++ &--,'*+ ,' ')-&C+A6 : (?6 - ,%)i% 3' &" (-)'(i( i-)'-(i" 3' $%&'()'!%& '( - '$'(%
3' ;i3!")%( 3' $"!*%-% '- &" 3i')". E()' ';')+ '&- ' '/ >+( (+( & +9'(-,, *+,-, +* ''(+ ,' (?/)'(-( ,' -,+( *(+( : +K, ,'& ''(+ ,' +&'()'*+&. A,'(6 & (?/)'(-( ,' +&'()'*+& ++ &--,'*+ ,'& ')-&C+A -)+&(-+ (' +*'9 '/ &+( ,-9)-+(6 ,+/,' & >9'* / ,-(-/- ,' & (?/)'(-( ,' -,+( *(+( ,'9-, & ,';--'/)' ';')+ ,' & -/(&-/6 '/) & (?/)'(-( ,' +&'()'*+& & ,'(-* '& (+ ,'& ')-&C+A +* '( *). E& >?,+ ,'9' ;9*-* +&'()'*+& '/ ( () ',-,6 : * '() ;/- '& -)+&( ,'/,* '& ')-&C+A ' /''(-)'6 '*+ >: ' '-)* ( (?/)'(-( (-6 * &+ & /+ >: ' ;+** ( (&-, ,' 2
UNIVERSIDAD PRIVADA SAN JUAN BAUTISTA EL COLESTEROL
&( -)++/,*-( & -)+&(6 &+ & (' *+,' -/'-)9&''/)' /,+ >: ''(+ ,' >-,*)+( ,' *9+/+ '/ & ,-'). P+* )/)+6 / ( -+*)/)' ,'& ''(+ ,' +&'()'*+& '( & 9/,/- ,' >-,*)+( ,' *9+/+ ,' & ,-')6 : / ;+* ,' '-)*&+ '( *',-*&+(.
Fig!" 8. S?/)'(-( ,' -,+( *(+( : +&'()'*+& /,+ '& -&+ ,' ^*'9( /+ ',' 9(+*9'* )+,+ '& ')-&C+A *+','/)' ,' & ,'*,- ,' >-,*)+( ,' *9+/+.
F'-)'( 3' !)"( "-"@&'!)i$"( < A(@"!*%&i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
2!
UNIVERSIDAD PRIVADA SAN JUAN BAUTISTA EL COLESTEROL
,' *( /+ (' ,'9' & +/)'/-,+ &<*-+ ,' & ,-')6 (-/+ ' & &+( /+ '( / 9'/ *'*(+* /&'*<)-+ +* ,+( +)-+(J 1. L -/(&-/6 : ('*'- (' '()-& +/ / ,-') *- '/ *9+>-,*)+(6 *',' ;'*)''/)' & )--,, ,' &-*)+ *9+-&(6 '/- /&'*<)- *)-* ,' -*)+ '/ '& >?,+6 & 9&+'* & '*'(- ,'& '/ ' +,-;- ( (?/)'(-(. A,'(6 & -/(&-/ : & &+( )9-/ *+''/ & &-+/'(-( =(?/)'(-( ,' -,+( *(+(@6 ' '( & ( *-*- ,' & +9'(-,, : ,'& (?/,*+' ')9<&-+. 2. L '/- -*)+ *9+-&(6 ' (' >9? ('()+ ( *-/-& *) /&'*<)- = *)-* ,' & &+(@ )-'/' + )--,, '/ '& +* : : + + /-// '/ '& (&+ =*-/-&'( +/(-,+*'( ,' -,+( *(+( ++ +9()-9&'( '/'*)-+(6 +* &+ ' /+ ',' )'/,'* '() /''(-,,. P+* '& +/)**-+6 *-+( '(),-+( '/ &+( K+( 1%01%70 >9?/ ('*-,+ ' '& -,+ (*)-+ =/+ ,' &+( '-/)' -/+-,+( +/()-):'/)'( ,' &( *+)'?/(6 :6 ( '6 / -+*)/)' -/)'*',-*-+ ')9<&-+ * & (?/)'(-( ,' +)*+( *+,)+(@ +,*? ('* / -+*)/)' *'*(+* /&'*<)-+ '/ (&+ : +*9? -/(-()-,+ '/ ,'+()** '()' ';')+. C++ )/)( +)*( ''(6 '&&+( *'(&),+( *'?/ >9'*(' ',,+ '/ '& +&-,+6 '( & -/'()-- (+9*' & +9'(-,,6 '& ''(+ ,' +&'()'*+& :6 '/ '/'*&6 '& (?/,*+' ')9<&-+6 9(9/ +)*( ((.
2"
UNIVERSIDAD PRIVADA SAN JUAN BAUTISTA EL COLESTEROL
CONCLUSIÓN
E& +&'()'*+& '( / (()/- *( ' '() *'('/)' '/ )+,( &( &&( ,' ( '*+. E( /''(*-+ &+ ,' +&'()'*+& * ' ( +*/-(+ ', ;/-+/*. S >?,+ *+,' (;--'/)' +&'()'*+& * ( '*+. C-'*)+( &-'/)+( *++*-+// /)-,,'( ,--+/&'( ,' +&'()'*+&6 ' ','/ ('* :+*'( ' &( ' ( +*/-(+ /''(-). A/' &+ ,' +&'()'*+& '/ ( (/*' '( '('/-& * ( (&,6 ,'(-,+ ',' ('* /+-+. S- ( /-'& ,' +&'()'*+& '( : &)+6 ',' '/)* ( *-'(+ ,' '/;'*',, *,?. !: >( *+/'( * / /-'& &)+ ,' +&'()'*+&. I/&:'/ ,-') ' >-()+*- ;-&-*. L +9'(-,, + &/( '/;'*',,'( ++ & ,-9')'( )9-/ ','/ +/)*-9-* / /-'& &)+ ,' +&'()'*+&. C+&'()'*+& LDL. L &-+*+)'?/ ,' 9 ,'/(-,,6 + +&'()'*+& LDL6 '( +/+-, ++ V'& +&'()'*+& &+W. E& ''(+ ,' LDL (' & '/ (( *)'*-( : ',' +/,-* '/;'*',, *,?. C/)+ ( &)+ '& /-'& ,' LDL6 :+* ( *-'(+ ,' '/;'*',, *,?. R',-* '& +&'()'*+& LDL '&',+ ',' *''/-* )'( *,?+( : (&* -,(. C+&'()'*+& !DL. L &-+*+)'?/ ,' &) ,'/(-,,6 + +&'()'*+& !DL6 (' > /,+ '& +,+ ,' V'& +&'()'*+& 9'/+W. E()+ '( ,'9-,+ ' (' +/(-,'* ' *''' +&'()'*+& ,' & (/*'. A&)+( /-'&'( ,' !DL '/ ( (/*' ','/ :,* *',-* ( *-'(+ ,' '/;'*',, *,? +*+/*-. U/ /-'& 9+ ',' '/)* ( *-'(+ ,' '/;'*',, *,?. T*-&-*-,+(.L+( )*-&-*-,+( (+/ +)*+ )-+ ,' (()/- *( '/ ( +**-'/)' (/?/'. L( '*(+/( +/ / /-'& &)+ ,' )*-&-*-,+( '/ & (/*' ','/ )'/'* )9-/ LDL &)(. A&&( +/ / /-'& &)+ ,' )*-&-*-,+( (,+ / /-'& '&',+ ,' +&'()'*+& LDL ','/ '()* '/ *-'(+ ,' '/;'*',, *,? +*+/*-.
2#
UNIVERSIDAD PRIVADA SAN JUAN BAUTISTA EL COLESTEROL
ANEXOS
ORI*EN DEL COLESTEROL
2$
UNIVERSIDAD PRIVADA SAN JUAN BAUTISTA EL COLESTEROL
NIELES ALTOS DE COLESTEROL
3%
UNIVERSIDAD PRIVADA SAN JUAN BAUTISTA EL COLESTEROL
31
UNIVERSIDAD PRIVADA SAN JUAN BAUTISTA EL COLESTEROL
32