HDL measures, particle heterogeneity, proposed nomenclature, and relation to atherosclerotic cardiovascular events.
BACKGROUND
A growing body of evidence from epidemiological data, animal studies, and clinical trials supports HDL as the next target to reduce residual cardiovascular risk in statin-treated, high-risk patients. For more than 3 decades, HDL cholesterol has been employed as the principal clinical measure of HDL and cardiovascular risk associated with low HDL-cholesterol concentrations. The physicochemical and functional heterogeneity of HDL present important challenges to investigators in the cardiovascular field who are seeking to identify more effective laboratory and clinical methods to develop a measurement method to quantify HDL that has predictive value in assessing cardiovascular risk.


BACKGROUND
In this report, we critically evaluate the diverse physical and chemical methods that have been employed to characterize plasma HDL. To facilitate future characterization of HDL subfractions, we propose the development of a new nomenclature based on physical properties for the subfractions of HDL that includes very large HDL particles (VL-HDL), large HDL particles (L-HDL), medium HDL particles (M-HDL), small HDL particles (S-HDL), and very-small HDL particles (VS-HDL). This nomenclature also includes an entry for the pre-β-1 HDL subclass that participates in macrophage cholesterol efflux.


CONCLUSIONS
We anticipate that adoption of a uniform nomenclature system for HDL subfractions that integrates terminology from several methods will enhance our ability not only to compare findings with different approaches for HDL fractionation, but also to assess the clinical effects of different agents that modulate HDL particle structure, metabolism, and function, and in turn, cardiovascular risk prediction within these HDL subfractions.
Mount Sinai Heart, Mount Sinai School of Medicine, New York, NY, USA. robert.rosenson@mssm.edu
Robert S
RS
Rosenson
H Bryan
HB
Brewer
M John
MJ
Chapman
Sergio
S
Fazio
M Mahmood
MM
Hussain
Anatol
A
Kontush
Ronald M
RM
Krauss
James D
JD
Otvos
Alan T
AT
Remaley
Ernst J
EJ
Schaefer
D016632:Apolipoprotein A-I / Q000097:blood; D016633:Apolipoprotein A-II / Q000097:blood; D001055:Apolipoproteins B / Q000097:blood; D050197:Atherosclerosis / Q000097:blood*; D001774:Blood Chemical Analysis / Q000295:instrumentation / Q000379:methods / Q000592:standards; D002318:Cardiovascular Diseases / Q000097:blood; D002499:Centrifugation, Density Gradient; D015180:Electrophoresis, Gel, Two-Dimensional; D006801:Humans; D015151:Immunoblotting; D008075:Lipoproteins, HDL / Q000097:blood / Q000145:classification; D009682:Magnetic Resonance Spectroscopy; D011237:Predictive Value of Tests; D012307:Risk Factors; D012680:Sensitivity and Specificity; D009626:Terminology as Topic
D016632:Apolipoprotein A-I; D016633:Apolipoprotein A-II; D001055:Apolipoproteins B; D008075:Lipoproteins, HDL