Hyperalphalipoproteinemia and Beyond: The Role of HDL in Cardiovascular Diseases
Antonina Giammanco,
Davide Noto,
Carlo Maria Barbagallo,
Emilio Nardi,
Rosalia Caldarella,
Marcello Ciaccio,
Maurizio Rocco Averna,
Angelo Baldassare Cefalù
Affiliations
Antonina Giammanco
Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties–University of Palermo, Via del Vespro, 129, 90127 Palermo, Italy
Davide Noto
Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties–University of Palermo, Via del Vespro, 129, 90127 Palermo, Italy
Carlo Maria Barbagallo
Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties–University of Palermo, Via del Vespro, 129, 90127 Palermo, Italy
Emilio Nardi
Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties–University of Palermo, Via del Vespro, 129, 90127 Palermo, Italy
Rosalia Caldarella
Department of Laboratory Medicine, Unit of Laboratory Medicine CoreLab, University Hospital “P. Giaccone”, 90127 Palermo, Italy
Marcello Ciaccio
Department of Laboratory Medicine, Unit of Laboratory Medicine CoreLab, University Hospital “P. Giaccone”, 90127 Palermo, Italy
Maurizio Rocco Averna
Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties–University of Palermo, Via del Vespro, 129, 90127 Palermo, Italy
Angelo Baldassare Cefalù
Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties–University of Palermo, Via del Vespro, 129, 90127 Palermo, Italy
Hyperalphalipoproteinemia (HALP) is a lipid disorder characterized by elevated plasma high-density lipoprotein cholesterol (HDL-C) levels above the 90th percentile of the distribution of HDL-C values in the general population. Secondary non-genetic factors such as drugs, pregnancy, alcohol intake, and liver diseases might induce HDL increases. Primary forms of HALP are caused by mutations in the genes coding for cholesteryl ester transfer protein (CETP), hepatic lipase (HL), apolipoprotein C-III (apo C-III), scavenger receptor class B type I (SR-BI) and endothelial lipase (EL). However, in the last decades, genome-wide association studies (GWAS) have also suggested a polygenic inheritance of hyperalphalipoproteinemia. Epidemiological studies have suggested that HDL-C is inversely correlated with cardiovascular (CV) risk, but recent Mendelian randomization data have shown a lack of atheroprotective causal effects of HDL-C. This review will focus on primary forms of HALP, the role of polygenic inheritance on HDL-C, associated risk for cardiovascular diseases and possible treatment options.
