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Atherosclerosis is a progressive disorder characterized by the buildup of plaques on the arterial inner wall, causing them to narrow and harden over time. These plaques comprise lipids, calcium, blood components, carbohydrates, and fibrous tissue. The process primarily affects the intima of large and medium-sized arteries, reducing blood flow in any artery.Etiology and risk factorsThe cause of atherosclerosis is multifactorial, involving a complex interplay among endothelial injury, lipid...
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Although not a source of energy, cholesterol plays a significant role as a foundational structure for bile salts, steroid hormones, and vitamin D, as well as being a crucial component of plasma membranes. Approximately 15% of blood cholesterol is derived from our diet, with the remainder synthesized from acetyl CoA by the liver and intestines. Cholesterol is eliminated from the body through its conversion into bile salts, which are eventually discarded in the feces.
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Understanding serum lipids is crucial for maintaining cardiovascular health and preventing heart disease and stroke.
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Related Experiment Video

Updated: Sep 19, 2025

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High Density Lipoprotein Particle Composition, Functionality, Deficiency, and Atherosclerotic Cardiovascular Disease

Ernst J Schaefer1,2, Bela F Asztalos3, Tomas Vaisar4

  • 1Boston Heart Diagnostics, Framingham, MA, 01702, USA. ernst.schaefer@bostonheart.eurofinsus.com.

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PubMed
Summary

Low levels of large HDL particles and high levels of small HDL particles are linked to increased atherosclerotic cardiovascular disease risk. Optimizing other risk factors is key for managing low HDL-C.

Keywords:
Atherosclerotic cardiovascular disease (ASCVD)Cellular cholesterol efflux (CEC)High density lipoproteins (HDL)Proteomics

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Area of Science:

  • Cardiovascular Science
  • Lipid Metabolism
  • Atherosclerosis Research

Background:

  • Decreased high-density-lipoprotein-cholesterol (HDL-C), HDL particles, and cholesterol efflux capacity correlate with elevated atherosclerotic cardiovascular disease (ASCVD) risk.
  • HDL particles are the most abundant lipoproteins, containing numerous proteins crucial for lipid metabolism and immune function.

Purpose of the Study:

  • To review recent findings on HDL particles, their composition, function, metabolism, and association with ASCVD risk.
  • To explore potential therapeutic strategies for ASCVD risk reduction in individuals with low HDL-C.

Main Methods:

  • Characterization of apolipoprotein (apo) A1 containing HDL particles using two-dimensional gel electrophoresis and apoA1 immunoblotting.
  • Review of recent research on HDL particle subtypes (preβ-1, α-4, α-3, α-2, α-1) and their functional roles in cholesterol transport.

Main Results:

  • HDL particles vary in size, from very small preβ-1 to very large α-1, with distinct roles in cholesterol uptake and transport.
  • Very small preβ-1 HDL are efficient cholesterol acceptors, while large α-HDL particles are involved in cholesterol delivery to the liver and exchange with triglyceride-rich lipoproteins.
  • Low levels of large α-HDL and high levels of very small preβ-1 HDL are associated with increased ASCVD risk.

Conclusions:

  • The size distribution of HDL particles is a critical determinant of ASCVD risk.
  • Optimizing modifiable ASCVD risk factors, such as LDL-C, blood pressure, and glucose levels, alongside smoking cessation, is the primary therapeutic approach for patients with low HDL-C.