High density lipoprotein functionality and cardiovascular events and mortality: A systematic review and meta-analysis

Soria-Florido, María Trinidad; Schröder, Helmut; Grau, María; Fitó, Montserrat; Lassale, Camille

doi:10.1016/j.atherosclerosis.2020.04.015

Cited by 70 publications

(56 citation statements)

References 66 publications

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“…In recent years, several clinical studies have investigated the relationship between cholesterol efflux capacity and cardiovascular risk. A recent meta-analysis of 20 articles showed that increased high-density lipoprotein cholesterol efflux capacity was associated with a lower risk of cardiovascular disease [ 17 ]. Authors stated that the heterogeneity and evidence of publication bias highlight the need for larger prospective studies.…”

Section: Discussionmentioning

confidence: 99%

Cholesterol Efflux Capacity and Cardiovascular Disease: The Ludwigshafen Risk and Cardiovascular Health (LURIC) Study

et al. 2020

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(1) Background and Aims: Efforts to reduce coronary artery disease (CAD) by raising high-density lipoprotein (HDL) cholesterol (HDL-C) have not been uniformly successful. A more important factor than HDL-C may be cellular cholesterol efflux mediated by HDL, which has been shown to be associated with CAD. In this report, we analyzed the influence of cardiovascular biomarkers and risk factors on cholesterol efflux in a prospective observational study of patients referred to coronary angiography. (2) Methods: HDL-mediated efflux capacity was determined for 2468 participants of the Ludwigshafen Risk and Cardiovascular Health (LURIC) study who were referred to coronary angiography at baseline between 1997 and 2000. Median follow-up time was 9.9 years. Primary and secondary endpoints were cardiovascular and all-cause mortality, respectively. (3) Results: Cholesterol efflux strongly correlated with HDL-related markers including HDL cholesterol, HDL phospholipids, and apolipoproteins AI and AII, as well as HDL particle concentration, which was not seen for low density lipoprotein (LDL) markers including LDL cholesterol and apoB. Cholesterol efflux was associated negatively with C-reactive protein (CRP), fibrinogen, interleukin-6 (IL-6), and serum amyloid A. Cardiovascular mortality was higher in patients in the lowest cholesterol efflux quartile. This association was weakened, but not fully abolished, after adjustment for HDL cholesterol. (4) Conclusions: We demonstrate that cholesterol efflux was associated with HDL-composition as well as inflammatory burden in patients referred for coronary angiography, and that this inversely predicts cardiovascular mortality independently of HDL cholesterol.

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Section: Discussionmentioning

confidence: 99%

Cholesterol Efflux Capacity and Cardiovascular Disease: The Ludwigshafen Risk and Cardiovascular Health (LURIC) Study

et al. 2020

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“…Moreover, animal studies have shown improved macrophage efflux after supplementation with EPA and DHA, probably mediated through activation of genes involved in reverse cholesterol transport such as ABCA1, ABCG1, ABCG5, ABCG8 and SR-B1, suggesting a molecular link between increased n-3 fatty acid intake and cholesterol efflux (24) . The anti-atherosclerotic function of HDL has been ascribed to the cholesterol efflux ability, and recently, a meta-analysis showed that greater HDL efflux capacity was associated with lower risk of CVD (43) . HDL particles are under continuous remodelling in the plasma, which will influence their functionality and lead to variability in the composition of HDL particles.…”

Section: Discussionmentioning

confidence: 99%

Comprehensive lipid and metabolite profiling in healthy adults with low and high consumption of fatty fish: a cross-sectional study

et al. 2020

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Fish consumption is associated with reduced risk of cardiovascular disease (CVD), which may be partly mediated by alterations in plasma lipids, such as high-density lipoprotein cholesterol (HDL-C). However, comprehensive analyses of associations between fatty fish consumption and lipoprotein subclass profile are limited and show inconsistent results. Therefore, the aim of the present exploratory study was to investigate the association between fatty fish consumption and lipoprotein subclass particle concentrations and composition, with emphasis on HDL. We performed a comprehensive plasma metabolite profiling in 517 healthy adults, using a targeted high-throughput nuclear magnetic resonance spectroscopy platform. The participants were divided into tertiles based on consumption of fatty fish, reported through a validated food frequency questionnaire. We compared the concentration of metabolites between the participants in the lowest and highest tertiles of fatty fish consumption. We show that high-consumers of fatty fish (>223 g/week, median intake 294 g/week) had higher particle concentrations and content of total lipids, and phospholipids in large and extra-large HDL particles, and higher content of total cholesterol, free cholesterol, cholesteryl esters and triglycerides in large HDL particles, than low-consumers (<107 g/week, median intake 58 g/week). Using fatty fish consumption as a continuous variable, we found that fatty fish consumption was associated with lower levels of the inflammation marker glycoprotein acetyls. In conclusion, high-consumers of fatty fish, seem to have a more favourable HDL-C-related lipoprotein profile and anti-inflammatory phenotype than low-consumers of fatty fish. Thus, these data support the current Norwegian dietary recommendations for fish consumption regarding CVD risk.

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“…Potential mechanisms for the HDL–COVID-19 hospitalisation gradient include anti-inflammatory properties of the lipoprotein which are related to lower risk of cardiovascular disease in humans (12), particularly relevant in COVID-19 complications. Further, HDL can act as a direct modulator of immunity by inhibiting haematopoeietic stem cells proliferation and affecting the activity and function of immune cells by changing the cholesterol content of the lipid rafts in immune cell membranes (8).…”

Section: Discussionmentioning

confidence: 99%

Association of pre-pandemic high-density lipoprotein cholesterol with risk of COVID-19 hospitalisation and death: the UK Biobank cohort study

Lassale

Hamer

Hernáez

et al. 2021

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IntroductionWhile unfavourable changes in High Density Lipoprotein (HDL)-cholesterol appear to be a consequence of COVID-19, the reverse has been little-studied. Our objective was to test whether HDL-cholesterol within the normal range is associated with subsequent COVID-19 hospitalisation.DesignWe examined 317,306 participants in the prospective UK Biobank study with complete data on HDL-cholesterol and covariates at baseline (2006-2010). Follow-up for COVID-19 status was via hospitalisation records in England (16th March and 31st May 2020). Death certificates for the period 1st March to 30th September 2020 with an underlying cause denoted as COVID-19 (emergency ICD-10 code U07.1) were also utilised.ResultsLower COVID-19 hospitalisation risk was apparent in people with higher level of HDL-cholesterol, adjusting for factors including health behaviours, inflammatory markers, and socio-economic status. The association appeared to be linear so that for each 0.2 mmol/L increase in HDL-cholesterol, the odds ratio for COVID-19 hospitalisation was 0.91 (95% confidence interval: 0.86, 0.96). A similar pattern of association was apparent when deaths from COVID-19 was the outcome of interest.ConclusionsAdequately high levels of HDL-cholesterol are associated with a lower risk of severe COVID-19.

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High density lipoprotein functionality and cardiovascular events and mortality: A systematic review and meta-analysis

Cited by 70 publications

References 66 publications

Cholesterol Efflux Capacity and Cardiovascular Disease: The Ludwigshafen Risk and Cardiovascular Health (LURIC) Study

Cholesterol Efflux Capacity and Cardiovascular Disease: The Ludwigshafen Risk and Cardiovascular Health (LURIC) Study

Comprehensive lipid and metabolite profiling in healthy adults with low and high consumption of fatty fish: a cross-sectional study

Association of pre-pandemic high-density lipoprotein cholesterol with risk of COVID-19 hospitalisation and death: the UK Biobank cohort study

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