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Published on: October 12, 2017
Protein-based HDL subspecies: Rationale and association with cardiovascular disease, diabetes, stroke, and dementia
F M Sacks1, J D Furtado2, M K Jensen3
1Nutrition Department, Harvard T.H. Chan School of Public Health, 665 Huntington Ave, Boston 02115, USA.
Insights
High-density lipoprotein (HDL) cholesterol subspecies have varying impacts on cardiovascular disease risk. Specific HDL proteins like apoC3 and apoE influence health outcomes differently, affecting conditions from diabetes to dementia.
Area of Science:
- Cardiovascular Science
- Metabolic Disease Research
- Neuroscience
Background:
- High-density lipoprotein (HDL) cholesterol is a key factor in cardiovascular disease (CVD) risk stratification.
- HDL comprises diverse protein-defined subspecies, each with distinct roles and associations with disease risk.
- Subspecies containing apolipoprotein C3 (apoC3) are linked to increased CVD risk, while those with apolipoprotein E (apoE) are associated with reduced risk.
Purpose of the Study:
- To elucidate the differential roles of HDL subspecies in relation to various chronic diseases.
- To understand the opposing effects of apoC3 and apoE within HDL on cholesterol transport and disease risk.
- To explore the associations of specific HDL subspecies with coronary heart disease, type 2 diabetes, dementia, and other neurological conditions.
Main Methods:
- Analysis of HDL subspecies composition.
- Correlation of specific HDL subspecies (e.g., containing apoC3, apoE, C3, alpha-2 macroglobulin, plasminogen, haptoglobin, apoC1) with clinical outcomes.
- Epidemiological and biochemical assessments of HDL's role in disease pathogenesis.
Main Results:
- HDL subspecies containing apoC3 are associated with higher risks of coronary heart disease, type 2 diabetes, insulin resistance, ischemic stroke, and dementia.
- HDL subspecies containing apoE, and apoE itself, are linked to a lower risk of dementia.
- Other HDL subspecies, such as those with complement C3 or alpha-2 macroglobulin, are associated with increased coronary heart disease risk, while HDL with apoC1 is linked to lower risk.
Conclusions:
- The composition of HDL subspecies significantly influences the risk of major chronic lifestyle diseases.
- Understanding the specific functions of HDL subspecies provides a more nuanced view of cardiovascular and metabolic health.
- Targeting specific HDL subspecies may offer novel therapeutic strategies for prevalent chronic diseases.
Abstract:
HDL-cholesterol is associated with reduced risk of cardiovascular disease, and is used in clinical practice for risk stratification. HDL is composed of many protein-defined subspecies that each comprises just a few percent of the total, some associated with lower and some with higher risk of CVD. HDL that contains apoC3 or apoE are subspecies that have opposing actions on HDL reverse cholesterol transport and opposing associations with risk of future CVD, apoC3 adverse and apoE beneficial. In addition to coronary heart disease, HDL that contains apoC3 is associated with risk of future type 2 diabetes and insulin resistance; ischemic stroke and cerebral infarction; dementia and the deposition of beta-amyloid in the brain. HDL that contains apoE and apoE itself are associated with lower risk of dementia. Other HDL subspecies that contain complement C3, alpha-2 macroglobulin, plasminogen, or haptoglobin are associated with higher future risk of coronary heart disease, whereas others such as HDL that contains apoC1 are associated with lower risk. At this time, these findings provide improved understanding of the multifaceted HDL system to better determine risk and targeting of therapy for the most prevalent chronic lifestyle diseases in our society.
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