You go to the doctor for an annual checkup, right, Tanya?
你每年都会去看医生，对吧，坦尼娅?
Sure. As any good health editor would!
当然。任何优秀的健康编辑都会这么做!
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。医生会问你一堆私人问题，把冰冷的听诊器放在你的皮肤上，然后抽血进行检查。当你拿回来体检报告时，有两个胆固醇指数。
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。一个是你的低密度脂蛋白胆固醇水平，或LDL。它应该保持在每分升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.
另一种是高密度脂蛋白，简称HDL。这应该保持在每分升40毫克以上。我们被告知，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.
这是因为低密度脂蛋白是一种“坏”胆固醇，它会导致动脉阻塞斑块、心脏病、中风和其他讨厌的东西。我们想要的少一些。
HDL, on the other hand, is “good” cholesterol. We want more of it.
高密度脂蛋白，相反，是“好”胆固醇。我们想要更多。
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，是因为它能与低密度脂蛋白结合，将有害物质带到肝脏。从那里，它被排出你的身体，在那里它不会伤害你。
But … you know that old saying about having too much of a good thing? It seems to be true of good cholesterol.
但是，你知道有句俗话是“物极必反”吗?好胆固醇似乎也是如此。
So, is it possible to have too much HDL?
那么，高密度脂蛋白有可能过多吗?
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.
这完全有可能。事实证明，过多的高密度脂蛋白实际上会增加患动脉和心脏病的几率，而这正是我们试图避免的事情。
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超过80毫克/分升、女性超过100毫克/分升，就处于危险区了，这一结论来自一项最近的研究。
But generally, that’s not what doctors have told patients.
但一般来说，医生不会这样告诉病人。
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，人们一直认为高密度脂蛋白越高，患病风险越低。所以传统上，医生一直使用非常高的高密度脂蛋白水平作为健康胆固醇的标志。
That’s the researcher behind some of the newer studies.
这是一些最新研究的研究人员。
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，乔治亚州亚特兰大市埃默里大学医学院心脏病学部的医学教授。
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.
他对英国超过40万人进行了调查，这些人没有其他易患心脏病的风险因素。对于其中的男性来说，如果HDL水平低于40毫克/分升或超过80毫克/分升，他们的心脏和其他疾病风险就会上升;对于女性，一旦HDL水平超过100毫克/分升，风险就会攀升。
When you say “climbed,” how much of a risk are we talking about? A few small percentage points, or a much bigger increase?
你说的"攀升"指的是多大的风险?是几个小的百分点，还是更大?
Excellent question, and I asked Quyyumi about the amount of extra risk that people faced.
问得好，我问了奎米人们面临的额外风险有多少。
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.
如果不对其他风险因素(如低密度脂蛋白胆固醇、血压、糖尿病等)进行任何评估，只是单纯地与最低风险组做比较，高出的风险几乎是两倍，低风险组指的是HDL水平在40~60毫克/分升之间的人。
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.
即使他和他的团队将其他因素考虑在内，高密度脂蛋白水平非常高的人的风险也比正常人高出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.
其他研究也支持这一观点。其中一项研究调查了1.1万多名高血压患者。研究发现，在40岁以下和80岁以上的人群中，高密度脂蛋白水平高的人患心血管疾病的几率要高得多。
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，让我算一下。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/分升的范围内可能有风险;如果男性超过80毫克/分升、女性超过100毫克/分升，就会有相当大的风险。
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。“好胆固醇”变坏指的是超过80或100、低于40的胆固醇，这取决于你的性别。中间值是安全区域。
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.
为什么高密度脂蛋白在很高的时候会变坏，这有点神秘。为什么一个分子水平在45时帮你，但在85时却会害你?分子的结构可能会改变。因此，它们不会紧紧抓住循环中的胆固醇，并帮助将其运送出体外。
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:男性和女性进入高密度脂蛋白危险区域的程度是不同的。你说男性超过80，但女性超过100。为什么呢?
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.
你是对的。男性和女性之间的差距为20分。说实话，奎米的团队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.
部分原因被认为是性激素的差异，你知道，雌激素，睾丸激素的差异....男人和女人之间。也有一些遗传上的原因。这不是很好解决了。
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.
我读到过雌激素可以增加女性体内的高密度脂蛋白，这是有保护作用的。但一旦女性进入更年期，她们的雌激素水平就会下降，高密度脂蛋白的保护作用就会减弱。
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.
无论如何，根据这些研究，如果女性的高密度脂蛋白略高于80，她们也不应该惊慌失措。但在这个范围内的男性应该意识到自己处于危险之中。
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。不应该有很多人被吓到，就这样。总的来说，研究表明，大约7%的普通人群达到了这种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，这个问题仍然不容忽视。如果一名医生一周看100个病人，其中就有7个将处于高密度脂蛋白危险区域。
If people are in the danger zone, what should they do?
如果人们处于危险区域，他们应该怎么做?
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.
我也问过奎米这个问题。大量饮酒会导致高密度脂蛋白升高，所以他会告诉病人改掉每天喝一两杯葡萄酒或豪饮的习惯。
There aren’t drugs that bring down high HDL. So the big thing he’d do is focus on treating LDL.
没有药物可以降低高密度脂蛋白。所以医生要做的一件大事就是专注于治疗低密度脂蛋白。
Statins, for instance, are very effective at lowering LDL levels, and he’d use those.
例如，他汀类药物在降低低密度脂蛋白水平方面非常有效，他会使用这些药物。
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.
小心使用的婴儿阿司匹林可以减少导致心脏病发作的血凝块。向你的医生咨询一下阿司匹林是否有副作用。
And there’s one more thing…
还有一件事……
If they're sedentary, they should be encouraged to exercise. Exercise is helpful for everything.
如果他们久坐不动，应该鼓励他们锻炼。锻炼对一切都有帮助。
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.
我想我还是继续晨跑吧。我会尽量把我的“坏”胆固醇保持在低水平，把“好”胆固醇保持在快乐的中间区域。
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.
我们的同事莉迪亚·登沃斯(Lydia Denworth)称其为“黄金区域”:既不太低也不太高，刚刚好。你可以在5月中旬的sciam.com上阅读她关于高密度脂蛋白的健康科学专栏。
And now I’m going to call my doctor to schedule my yearly checkup.
现在我要打电话给我的医生安排我的年度检查。
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.
内容来自 VOA英语学习网：https://www.chinavoa.com/show-8837-243666-1.html
