Cholesterol-Overloaded HDL Particles Are Independently Associated With Progression of Carotid Atherosclerosis in a Cardiovascular Disease-Free Population

Dong ZhaoProfessor of Epidemiology, Capital Medical University

“Our findings suggested that cholesterol-overload HDL particles may predict of atherosclerotic risk despite high HDL-C levels and might explain why high plasma HDL-C levels have failed to avoid ischemic events in some clinical trials. Furthermore, it is strongly advised that consideration of the combination of cholesterol content and HDL particle number, rather than either parameter alone, may help direct future efforts to reduce atherogenesis by lowering the cholesterol content of HDL particles.”

“Although the HDL-C/HDL-P ratio may provide a poor and indirect metric for reverse cholesterol transport (RCT), it is important to emphasize that it does not reflect HDL functionality. HDL-C/HDL-P ratio is a dynamic parameter, which is determined primarily by the HDL-P turnover, especially in a cardiovascular disease–free population. High plasma HDL-P may thus be the major factor predicting atherosclerotic risk, irrespective of plasma HDL-C.”

“We think that the HDL-C/HDL-P ratio may be an integrated indicator of a profile of HDL-C and number of HDL-P and a better biomarker for RCT than the single metric of either HDL-C or HDL-P. A lower ratio may also reflect more numbers of small size HDL-P available, which may be important to facilitate the efflux of cholesterol from the cells of the vessel wall.”