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Subject: Cholesterol, High-Density Lipoprotein (HDL)
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HDL, also known as HDL-C, is produced by the liver and consists of mostly cholesterol, protein, and phospholipid. It carries cholesterol in the bloodstream from the tissues to the liver (reverse cholesterol transport). HDL is termed the “good cholesterol,” because its levels are inversely related to CHD, and it is an independent risk factor.
Normal range: see Table 16.19.
Assessment of risk of heart disease and atherosclerosis
Ordered in combination with total cholesterol, LDL, and triglycerides as a lipid profile
Regular physical activity or exercise
Chronic liver disease
Chronic renal failure, nephrosis, uremia
Familial hyper-α-lipoproteinemia (Tangier disease)
Deficiency of apo A-I and apo C-III
HDL is increased due to moderate ethanol consumption, estrogens, and insulin.
HDL is decreased due to starvation; stress and recent illness; smoking; obesity and lack of exercise; drugs such as steroids, thiazide diuretics, and beta blockers; hypertriglyceridemia (>1,700 mg/dL); and elevated serum immunoglobulin levels.
Other factors that may also increase cholesterol include cigarette smoking, age, hypertension, family history of premature heart disease, preexisting heart disease, and DM.
Low levels of HDL-C (with or without associated co-lipid abnormalities) are seen in Asians than in non-Asians. This is a distinct phenotype associated with increased risk for CHD.