Is High-Density Lipoprotein Functionality Useful as a Residual Risk Marker for Familial Hypercholesterolemia?

CAD prevention.In this issue of the Journal, Tada et al measured cholesterol uptake capacity (CUC), one of the HDL functions, in 108 clinically diagnosed FH patients and found it more useful than HDL cholesterol levels as a predictive marker of CAD. 9 My group also previously reported that cholesterol efflux capacity (CEC), an HDL function, is a more useful predictive marker of CAD than the serum HDL cholesterol level in patients with FH on statin therapy.10 Of the HDL functions, CEC is the one with the most potential for clinical testing, 11 but there are several issues with the conventional methods, including the use of radiolabeled cholesterol for the measurement, the use of cultured cells, and the need to correct measurements using pooled plasma/serum from each facility.12 In other words, the conventional method is difficult to perform in hospital due to the complexity of operation, safety, and facilities.To overcome these issues, researchers in Japan have pioneered the improvement of methods for measuring CEC (Table ).For example, Shimizu et al developed a nonradioactive method to quantify the CEC by mass spectrometry using the stable isotope ([d7]-cholesterol) instead of radioactive cholesterol.13 Horiuchi et al developed a cell-free, nonradioactive method to evaluate CEC by fluorescence intensity using gel beads coated with liposomes Article p ????The opinions expressed in this article are not necessarily those of the editors or of the Japanese Circulation Society.