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Where next with HDL assays?
Katrin Niisuke1, Katalin V Horvath, Bela F Asztalos
1Cardiovascular Nutrition Laboratory, Human Nutrition Research Center on Aging at Tufts University, Boston, Massachusetts, USA.
Insights
High-density lipoprotein cholesterol (HDL-C) levels don't always predict cardiovascular disease (CVD) risk. New research focuses on HDL particle concentration, composition, and function for better CVD risk assessment.
Area of Science:
- Cardiovascular Research
- Lipid Metabolism
- Biomarker Discovery
Background:
- The inverse relationship between HDL cholesterol (HDL-C) and cardiovascular disease (CVD) is well-established.
- However, interventions targeting HDL-C have not consistently reduced CVD risk, suggesting limitations in using HDL-C alone.
- HDL (high-density lipoprotein) is a complex particle, and its function, composition, and particle concentration may be more indicative of CVD risk than HDL-C levels.
Purpose of the Study:
- To review recent findings on HDL composition, particle concentrations, and cholesterol efflux capacity in relation to CVD.
- To highlight the need for improved understanding of HDL's role in CVD beyond HDL-C.
- To identify potential novel biomarkers and therapeutic targets for CVD prevention and treatment.
Main Methods:
- Review of recent scientific literature on HDL and CVD.
- Analysis of studies examining HDL composition, particle concentrations, and functional assays (e.g., cholesterol efflux capacity).
- Identification of trends and discrepancies in HDL research related to CVD.
Main Results:
- Recent research emphasizes HDL composition, particle concentrations, and cholesterol efflux capacity as key determinants of CVD risk.
- Functional aspects and subpopulations of HDL particles are increasingly recognized as crucial in understanding HDL's role in CVD.
- Discrepancies exist among studies due to a lack of standardization in HDL assays.
Conclusions:
- HDL-C alone is insufficient for accurately assessing CVD risk.
- HDL particle characteristics and functionality offer more reliable insights into CVD.
- Standardized assays are urgently needed to advance HDL research and its clinical application in CVD.
Purpose Of Review:
The inverse association between HDL cholesterol (HDL-C) and cardiovascular disease (CVD) has been unequivocally proven in the past several decades. However, some interventions aiming to increase HDL-C failed to reduce CVD risk. HDL is structurally and functionally complex and HDL-associated metrics other than HDL-C, such as the concentration, composition, and functionality of HDL particles, have been considered as better determinants of CVD risk. A large body of recent research has addressed changes in HDL functions and HDL subpopulations in CVD with the goal of discovering novel and reliable biomarkers and targets for the treatment or prevention of CVD.
Recent Findings:
We have reviewed recent findings on HDL composition, HDL particle concentrations, and cell-cholesterol efflux capacity that have lately contributed to our understanding of HDL's role in CVD.
Summary:
We point out that a major problem in HDL research is the lack of standardization of HDL assays that has led to discrepancies among studies. Therefore, there is a need for new standardized assays that capture the complexities of key HDL parameters.
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