Related Experiment Video
Updated: May 2, 2026
Cholesterol Efflux Assay
Published on: March 6, 2012
Cholesterol efflux capacity, carotid atherosclerosis, and cerebrovascular symptomatology
1From the Departments of Experimental Medicine (R.J.D., S.S.D.) and Biochemistry (A.H.), Faculty of Medicine, McGill University, Montreal, Quebec, Canada; Department of Pathology and Laboratory Medicine, University of Ottawa, Ottawa, Ontario, Canada. (C.L., J.P.V.); and Faculty of Medicine, Centre for Innovative Medicine, McGill University Health Centre, Montreal, Quebec, Canada (J.G.).
Insights
Cholesterol efflux capacity is lower in patients with carotid atherosclerosis, inversely correlating with stenosis severity and plaque complexity. This suggests cholesterol efflux capacity may indicate the extent of carotid atherosclerotic burden.
Area of Science:
- Cardiovascular Research
- Biomarker Discovery
- Atherosclerosis Research
Background:
- Cholesterol efflux capacity (CEC) is crucial for reverse cholesterol transport.
- Reduced CEC is linked to atherosclerosis, but its role in carotid atherosclerosis is not fully understood.
Purpose of the Study:
- To investigate the association between cholesterol efflux capacity and carotid atherosclerosis severity and cerebrovascular disease.
Main Methods:
- Recruited 154 patients with carotid stenosis and 9 healthy controls.
- Assessed carotid stenosis via ultrasound and plaque morphology using AHA classification.
- Measured cholesterol efflux capacity in serum depleted of apolipoprotein B particles.
Main Results:
- Cholesterol efflux capacity was significantly lower in patients with carotid atherosclerosis compared to controls.
- Lower efflux capacity was inversely associated with higher degrees of carotid stenosis.
- Efflux capacity differed significantly across American Heart Association plaque classifications, indicating association with plaque morphology.
Conclusions:
- Cholesterol efflux capacity is inversely associated with carotid stenosis severity and advanced plaque morphology.
- CEC may serve as a biomarker for the severity of carotid atherosclerotic burden.
- Further research is needed to explore therapies targeting high-density lipoprotein quality for carotid atherosclerosis stabilization.
Objective:
To investigate the association of cholesterol efflux capacity with carotid atherosclerosis and cerebrovascular disease.
Approach And Results:
Patients with high-grade carotid stenosis (n=154) were recruited from Vascular Surgery clinics and 9 healthy controls from the McGill University Health Network, Montreal, Canada. Cerebrovascular symptomatology history was obtained. Stenosis was assessed by carotid ultrasound. Fasting blood samples were collected and depleted of apolipoprotein B particles by polyethylene glycol precipitation from serum. Cholesterol efflux was determined by incubating apolipoprotein B-depleted serum in cAMP-stimulated J774 cells for 6 hours. Carotid specimens were classified by 2 vascular pathologists using the American Heart Association atheromatous plaque classification. Differences in efflux were assessed according to (1) stenosis, (2) American Heart Association classification, and (3) cerebrovascular symptomatology. Normalized efflux was significantly lower in patients with carotid atherosclerosis compared with controls (0.97±0.16 versus 1.5±0.46; P<0.0001). Efflux was inversely associated with stenosis; the odds ratio for 80% to 99% versus 50% to 79% stenosis of tertile 1 (lowest) versus tertile 3 (highest) of efflux was 3.78 (95% confidence interval, 1.18-12.06) after adjusting for age, sex, low-density lipoprotein, and high-density lipoprotein. There were significant differences in cholesterol efflux between American Heart Association fibroatheroma (Va, 0.91±0.13), mainly calcific (Vb, 0.97±0.15), and mainly fibrotic (Vc, 1.03±0.21; P=0.05). There were no significant differences in efflux according to symptomatology.
Conclusions:
Cholesterol efflux capacity is inversely associated with increasing carotid stenosis and is associated with more advanced carotid plaque morphology, suggesting that cholesterol efflux capacity may be a biomarker for severity of carotid atherosclerotic burden. Whether therapies targeting high-density lipoprotein quality could be useful for stabilizing carotid atherosclerosis needs to be assessed.
Related Concept Videos
01:27Atherosclerosis II: Clinical Manifestations and Diagnostic Tests
01:30Atherosclerosis I: Introduction
01:29Cholesterol: Significance and Regulation
Considering cholesterol and...
01:26Atherosclerosis III: Management
01:19Blood Studies for Cardiovascular System II: CRP, Hcy, and Cardiac Natriuretic Peptide Markers
These markers indicate stress or strain on the heart muscle:
Natriuretic Peptides (BNP)
Cardiac myocytes produce these hormones in response to ventricular stretching...
01:30Coronary Artery Disease I: Introduction