Antiatherogenic functionality of high density lipoprotein: how much versus how good

Area of Science:

• Cardiovascular Science
• Lipid Metabolism
• Atherosclerosis Research

Background:

• Plasma high density lipoprotein (HDL) concentration is a recognized negative risk factor for cardiovascular disease (CVD).
• However, HDL's concentration alone does not fully represent its atheroprotective capabilities.
• HDL functionality, its ability to perform protective functions, is increasingly recognized as critical.

Purpose of the Study:

• To highlight the importance of HDL functionality beyond its plasma concentration.
• To explore factors influencing HDL functionality.
• To discuss the assessment of HDL's atheroprotective capacity.

Main Methods:

• Review of experimental and clinical evidence on HDL function.
• Analysis of conditions affecting HDL functionality (e.g., CAD, diabetes, inflammation).
• Examination of structural modifications impacting HDL functionality (e.g., glycation, oxidation, particle composition).

Main Results:

• HDL functionality is partly independent of HDL concentration and crucial for atheroprotection.
• Various conditions and interventions significantly alter HDL functionality.
• Structural modifications like protein/lipid changes and particle size affect HDL function.

Conclusions:

• HDL functionality is a critical determinant of atheroprotective capacity, potentially more so than concentration.
• Understanding the link between HDL structure and function is an emerging area.
• Direct measurement of individual HDL functions may be necessary to fully assess atheroprotective potential.