High-Density Lipoprotein Function Measurement in Human Studies: Focus on Cholesterol Efflux Capacity

Area of Science:

• Cardiovascular Science
• Biomarker Discovery
• Lipid Metabolism

Background:

• Low high-density lipoprotein cholesterol (HDL-C) is a risk factor for atherosclerotic cardiovascular disease (ASCVD).
• Cholesterol content alone is insufficient to assess HDL function.
• Clinical trials show increased HDL-C does not always improve ASCVD outcomes.

Purpose of the Study:

• To review methodologies for measuring cholesterol efflux capacity (CEC) ex vivo.
• To summarize current findings linking CEC to human diseases.
• To highlight CEC as a potential biomarker for ASCVD and metabolic diseases.

Main Methods:

• Measurement of CEC using stored human blood samples.
• Assessment of cholesterol efflux from macrophages to plasma/serum.
• Ex vivo analysis of HDL's reverse cholesterol transport function.

Main Results:

• CEC can be reliably measured from stored human samples.
• CEC is a potent marker of ASCVD risk.
• CEC may serve as a promising biomarker for atherosclerotic and metabolic diseases.

Conclusions:

• Cholesterol efflux capacity (CEC) is a key function of HDL and a reliable biomarker.
• Further standardization of CEC measurements is needed.
• CEC holds potential for predicting disease risk and treatment response.