Re-understanding the relationship of high-density lipoprotein with atherosclerosis vascular disease / 中华检验医学杂志

ABSTRACT

While several lines of evidence prove that elevated concentrations of low-density lipoproteins (LDL) usually contribute to the development of atherosclerosis and its clinical consequences, high-density lipoproteins (HDL) are widely believed to exert atheroprotective effects. Hence, HDL cholesterol (HDL-C) is in general still considered as good cholesterol. Recent researches, however, suggest that this might not always be the case and that a fundamental reassessment of the clinical significance of HDL-C is warranted. The main function of HDL is to transfer the cholesterol outside the liver into the liver for catabolism.The liver′s cholesterol metabolism and other biological effects are dependent on the number of HDL particles and its proteins and lipid contents. These functions are difficult to be described simply with the HDL-C concentration. If the components of HDL particles change, they may have adverse effects on the blood vessels. Thus, high concentrations of HDL-C in plasma are not always protective factors, and some clinical trials improving HDL-C concentrations have failed to confirm a protective effect. To explore the complex relationship and pathological mechanism between HDL and atherosclerotic diseases, it is instructive for clinical application of the HDL measurement.