Related Experiment Video
Updated: Aug 12, 2026
Technique of Porcine Liver Procurement and Orthotopic Transplantation using an Active Porto-Caval Shunt
Published on: May 7, 2015
HDL particle concentration, but not HDL cholesterol, is inversely associated with mortality after liver
Mateo Chvatal-Medina1, Setor K Kunutsor2, Yakun Li1
1Department of Gastroenterology and Hepatology, University Medical Center Groningen, University of Groningen, P.O. Box 30.001, 9700 RB Groningen, the Netherlands (Chvatal-Medina, Li, van Vilsteren, and Moshage).
Insights
High-density lipoprotein particle concentration (HDL-P), not cholesterol (HDL-C), is linked to mortality in liver transplant recipients. Higher HDL-P indicates lower mortality risk, suggesting HDL-P is a better biomarker for long-term survival.
Area of Science:
- Cardiovascular Medicine
- Transplantation Immunology
- Biomarker Discovery
Background:
- Liver transplant recipients (LTRs) face elevated mortality risks from cardiometabolic issues.
- Traditional lipid measures like HDL-C may not fully represent HDL's function.
- Nuclear magnetic resonance (NMR) spectroscopy quantifies HDL particle concentration (HDL-P), subclasses, and size, offering a more comprehensive view.
Purpose of the Study:
- To determine if HDL-P concentration predicts mortality in LTRs compared to HDL-C.
- To investigate the association between HDL subclasses, size, and mortality in LTRs.
Main Methods:
- Prospective cohort study of 367 LTRs.
- Quantification of HDL-P, subclasses, size, and HDL-C using NMR spectroscopy.
- All-cause mortality as the primary outcome, analyzed with Cox regression models.
Main Results:
- 78 deaths occurred over a median 7.8-year follow-up.
- Higher total and small HDL-P were independently associated with lower mortality.
- Large HDL-P and HDL size were associated with increased mortality, while HDL-C showed no association.
Conclusions:
- NMR-derived HDL-P, not HDL-C, is an independent predictor of all-cause mortality in LTRs.
- HDL subclasses have opposing associations with mortality, highlighting HDL-P's distinct prognostic value.
- HDL-P may serve as a crucial mortality biomarker in liver transplant recipients.
Background:
Liver transplant recipients (LTRs) are at increased risk of long-term mortality in part due to cardiometabolic complications. Dyslipidemia is common after transplantation, but conventional lipid measurements, such as high-density lipoprotein cholesterol (HDL-C), may capture different aspects of HDL compared with its particle concentration and size. Nuclear magnetic resonance (NMR) spectroscopy allows quantification of HDL particle concentration (HDL-P), subclasses (small, medium, and large), and size, which might better reflect the impact of HDL on morbidity and mortality.
Objective:
To assess whether the HDL-P concentration is associated with mortality in LTRs in comparison with HDL-C.
Methods:
We conducted a prospective cohort study within the TransplantLines biobank at the University Medical Center Groningen (NCT03272841). A total of 367 LTRs were included. Total HDL-P, subclasses, size, and HDL-C were quantified by NMR spectroscopy. The primary outcome was all-cause mortality. Associations between HDL markers and mortality were assessed using Cox proportional hazards regression models with adjustment for demographic, metabolic, inflammatory, and transplant-related factors.
Results:
Over a median follow-up of 7.8 years (2530 person-years), 78 deaths occurred. Total and small HDL-P were inversely and independently associated with all-cause mortality; whereas large HDL-P and HDL size were positively associated with mortality. HDL-C was not associated with mortality. The inverse association of total HDL-P remained after adjustment for HDL-C.
Conclusion:
NMR-derived total HDL particle concentration, rather than HDL-C, is independently associated with all-cause mortality in LTRs. The opposing directionalities across HDL subclasses suggest that HDL-P captures dimensions of HDL not reflected by HDL-C itself and, hence, could represent a potentially important mortality biomarker in LTRs.
More Related Videos
10:56A Familial Hypercholesterolemia Human Liver Chimeric Mouse Model Using Induced Pluripotent Stem Cell-derived Hepatocytes
Published on: September 15, 2018
11:13Enrichment of Native Lipoprotein Particles with microRNA and Subsequent Determination of Their Absolute/Relative microRNA Content and Their Cellular Transfer Rate
Published on: May 9, 2019