Assessment of HDL Cholesterol Removal Capacity: Toward Clinical Application
- PMID: 30542002
- PMCID: PMC6365149
- DOI: 10.5551/jat.RV17028
Assessment of HDL Cholesterol Removal Capacity: Toward Clinical Application
Abstract
While there is a controversy regarding the causal relationship between high-density lipoprotein cholesterol (HDL-C) and cardiovascular disease (CVD), recent studies have demonstrated that the cholesterol efflux capacity (CEC) of HDL is associated with the incidence of CVD. However, there are several limitations to current assays of CEC. First, CEC measurements are not instantly applicable in clinical settings, because CEC assay methods require radiolabeled cholesterol and cultured cells, and these procedures are time consuming. Second, techniques to measure CEC are not standardized. Third, the condition of endogenous cholesterol donors would not be accounted for in the CEC assays. Recently, we established a simple, high-throughput, cell-free assay system to evaluate the capacity of HDL to accept additional cholesterol, which is herein referred to as "cholesterol uptake capacity (CUC)". We demonstrated that CUC represents a residual cardiovascular risk in patients with optimal low-density lipoprotein cholesterol control independently of traditional risk factors, including HDL-C. Establishing reproducible approaches for the cholesterol removal capacity of HDL is required to validate the impact of dysfunctional HDL on cardiovascular risk stratification in the "real world".
Keywords: Cardiovascular disease; Cholesterol efflux capacity (CEC); Cholesterol uptake capacity (CUC); HDL cholesterol (HDL-C); High-density lipoprotein (HDL).
Conflict of interest statement
The Division of Evidence-based Laboratory Medicine, Kobe University Graduate School of Medicine, was established by an endowment fund from the Sysmex Corporation.
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