January 12th, 2011
Researchers Shed New Light on HDL Cholesterol
Larry Husten, PHD
Two papers published in the New England Journal of Medicine shed new light on the important but often mysterious role of HDL cholesterol in cardiovascular disease.
In the first paper, researchers at the University of Pennsylvania studied 1,000 healthy volunteers and patients with coronary artery disease and observed a strong inverse relationship between cholesterol efflux from macrophages (a key element in reverse cholesterol transport, which is thought to have a protective effect against atherosclerosis) and carotid intima-media thickness.
The investigators also found that cholesterol efflux was independent of HDL level. In an accompanying editorial, Jay Heinecke writes that the study provides evidence to support the view that “HDL efflux capacity is a measure of HDL function that is relevant to the pathogenesis of atherosclerosis.” Further, he writes, the study also supports “the proposal that dysfunctional HDL contributes to the risk of coronary disease.”
In the second paper, researchers in the Netherlands report finding a family with a functional mutation in SR-B1, an HDL receptor that may play a key role in reverse cholesterol transport. The authors report that family members with the mutation had increased HDL levels but reduced cholesterol efflux from macrophages. Although no increase in atherosclerosis was observed in the small group of patients with the mutation, the researchers observed an alteration in platelet function and a decrease in adrenal steroidogenesis.
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