HDL and Reverse Cholesterol Transport Biomarkers

Area of Science:

• Cardiovascular Medicine
• Lipid Metabolism
• Biochemistry

Background:

• High-density lipoprotein (HDL) is traditionally measured by cholesterol concentration (HDL-C).
• Recent research questions the simple inverse relationship between HDL-C and cardiovascular events, proposing a U-shaped association.
• This necessitates exploring alternative HDL metrics and functions.

Purpose of the Study:

• To review the evolving understanding of HDL-C's association with cardiovascular events.
• To examine novel HDL measures, including HDL particle number (HDL-P) and cholesterol efflux.
• To discuss interventions targeting HDL metabolism and function.

Main Methods:

• Literature review of recent observational studies and clinical trials.
• Analysis of emerging data on HDL particle number and cholesterol efflux.
• Synthesis of research on interventions affecting HDL function.

Main Results:

• Evidence suggests a U-shaped, not purely inverse, association between HDL-C and cardiovascular risk.
• HDL particle number (HDL-P) and cholesterol efflux capacity are inversely linked to cardiovascular events.
• Interventions show varying effects on cholesterol efflux, with novel approaches emerging.

Conclusions:

• HDL-C may not be a universally reliable marker for cardiovascular risk.
• HDL particle number and cholesterol efflux represent promising biomarkers and therapeutic targets.
• Further research is warranted to optimize interventions based on HDL function.