The structure, function and metabolism of high-density lipoproteins: A status report

Case-control and prospective epidemiologic studies have found a striking, consistently negative association between high-density lipoprotein (HDL) levels and coronary vascular events. As a result, the genetic and environmental determinants of HDL levels are being studied intensively. These investigations and their potential clinical applications require a fundamental understanding of the structure, function and metabolism of HDL and its components. Of special interest are the means by which HDL exerts its apparently protective effect. In this report we characterize the structure of HDL and describe its components, particularly the protein component. We discuss HDL metabolism in light of the relationship of HDL to the other lipoprotein classes, and relate what little is known of the functions of HDL. We also review the biochemical mechanisms by which HDL may protect against cardiovascular disease and discuss further biochemical research that will be necessary for a better understanding of HDL.