The complexity of HDL.
Plasma high-density lipoprotein cholesterol (HDL-C) levels are inversely associated with coronary artery disease risk in large epidemiologic studies. This rule, however, has many exceptions in individual patients, and evidence suggests that other facets of high-density lipoprotein particle biology not captured by measuring HDL-C levels are responsible for HDL's effects in vivo. This article reviews the evidence for the protective nature of HDL, current evidence from animal and human studies regarding HDL-based therapies, the major steps in HDL particle formation and metabolism, alterations leading to dysfunctional HDL in diabetes and inflammatory states, and potential alternatives to HDL-C to measure HDL function and predict its protective value clinically.
Francis
Gordon A
GA
Department of Medicine and UBC James Hogg Research Centre, Providence Heart and Lung Institute, 1081 Burrard St., Vancouver, British Columbia, Canada. gordon.fracis@hli.ubc.ca
D000818:Animals; D006801:Humans; D008075:Lipoproteins, HDL / Q000378:metabolism*
D008075:Lipoproteins, HDL