title: [Clinical importance of HDL cholesterol].
abstract: BACKGROUND
  Each year 16-17 million determinations of high-density lipoprotein cholesterol (HDL-C) are conducted and interpreted in Germany. Recently acquired data have led to a fundamental reassessment of the clinical significance of HDL-C.
  
  
  METHODS
  This review article is based on a selective literature search.
  
  
  RESULTS
  Low HDL‑C levels usually indicate an increased cardiovascular risk, particularly in primary prevention but the epidemiological relationship between HDL‑C and the risk is complex. The HDL plays a role in the back transport and excretion of cholesterol; however, the biological functions of HDL are dependent on the protein and lipid composition, which is not reflected by the HDL‑C concentration. If the composition of HDL is pathologically altered it can also exert negative vascular effects.
  
  
  CONCLUSIONS
  Compared with low-density lipoprotein cholesterol (LDL-C), HDL‑C is of secondary importance for cardiovascular risk stratification and the calculation of the LDL-C:HDL‑C ratio is not useful for all patients. Low HDL‑C levels should prompt a search for additional metabolic and inflammatory pathologies. An increase in HDL‑C through lifestyle changes (e.g. smoking cessation and physical exercise) has positive effects and is recommended; however, HDL‑C is currently not a valid target for drug therapy.
authors.affiliation: Medizinische Klinik V (Nephrologie, Hypertensiologie, Rheumatologie, Endokrinologie, Diabetologie), Medizinische Fakultät Mannheim der Universität Heidelberg, Heidelberg, Deutschland.|Klinisches Institut für Medizinische und Chemische Labordiagnostik, Medizinische Universität Graz, Graz, Österreich.|Synlab Akademie, synlab Holding Deutschland GmbH, Mannheim und Augsburg, Deutschland.
authors.forename: W
authors.initials: W
authors.lastname: März
authors.affiliation: Medizinische Klinik V (Nephrologie, Hypertensiologie, Rheumatologie, Endokrinologie, Diabetologie), Medizinische Fakultät Mannheim der Universität Heidelberg, Heidelberg, Deutschland.|Institut für Ernährungswissenschaften, Friedrich-Schiller-Universität Jena, Jena, Deutschland.
authors.forename: M E
authors.initials: ME
authors.lastname: Kleber
authors.affiliation: Klinisches Institut für Medizinische und Chemische Labordiagnostik, Medizinische Universität Graz, Graz, Österreich.
authors.forename: H
authors.initials: H
authors.lastname: Scharnagl
authors.affiliation: Klinik für Innere Medizin IV, Nieren- und Hochdruckkrankheiten, Universitätsklinikum des Saarlandes, 66421, Homburg/Saar, Deutschland.
authors.forename: T
authors.initials: T
authors.lastname: Speer
authors.affiliation: Klinik für Innere Medizin IV, Nieren- und Hochdruckkrankheiten, Universitätsklinikum des Saarlandes, 66421, Homburg/Saar, Deutschland.
authors.forename: S
authors.initials: S
authors.lastname: Zewinger
authors.affiliation: Klinik für Innere Medizin, Medizinische Universität Innsbruck, Innsbruck, Österreich.
authors.forename: A
authors.initials: A
authors.lastname: Ritsch
authors.affiliation: Medizinische Klinik II, Klinikum der Universität München, 81377, München, Deutschland.
authors.forename: K G
authors.initials: KG
authors.lastname: Parhofer
authors.affiliation: Institut für Klinische Chemie, Universitätsspital, 8091, Zürich, Schweiz.
authors.forename: A
authors.initials: A
authors.lastname: von Eckardstein
authors.affiliation: Klinik für Kardiologie, Charité, Berlin, Deutschland.
authors.forename: U
authors.initials: U
authors.lastname: Landmesser
authors.affiliation: Klinik für Innere Medizin III, Kardiologie, Angiologie und Internistische Intensivmedizin (IMED), Universitätsklinikum des Saarlandes, 66421, Homburg/Saar, Deutschland. ulrich.laufs@uks.eu.
authors.forename: U
authors.initials: U
authors.lastname: Laufs
mesh_terms: D015415:Biomarkers / Q000097:blood; D002318:Cardiovascular Diseases / Q000097:blood* / Q000175:diagnosis / Q000401:mortality*; D008076:Cholesterol, HDL / Q000097:blood*; D008078:Cholesterol, LDL / Q000097:blood*; D019317:Evidence-Based Medicine; D006801:Humans; D015995:Prevalence; D015203:Reproducibility of Results; D012307:Risk Factors; D012680:Sensitivity and Specificity
chemical_list: D015415:Biomarkers; D008076:Cholesterol, HDL; D008078:Cholesterol, LDL
keywords: Cardiovascular risk; Cholesterol; High-density lipoprotein; Low-density lipoprotein; Review