Functional diversity of high-density lipoproteins: finding the golden mean

Abstract

The review is devoted to the analysis of the relationship between blood levels of high-density lipoprotein cholesterol (HDL-С) and atherosclerosis-related diseases. The review considers the clinical significance of extremely high HDL-C levels in connection with atheroprotective roles of HDL. While scientific discussions regarding the role of HDL-C level in determining the risk of atherosclerosisrelated diseases are still ongoing, the review presents and analyzes the arguments of leading experts both «pro» and «contra» new views on HDL. Significant attention is paid to the analysis of possible causes and mechanisms of HDL proatherogenic effects found in subjects with very high HDL-C levels, which are studied using proteomics and metabolomics methods. The question of whether all HDL subpopulations have the same anti- or proatherogenic potential, and to what extent the biological activity of HDL is determined by variations in their subfractional spectrum, is discussed. The principles of developing an accessible method for assessing the functional activity of HDL are considered.

Keywords

• high density lipoproteins (hdl)
• hdl cholesterol
• reverse cholesterol transport
• cardiovascular diseases
• atherosclerosis
• hdl functionality
• mendelian randomization