HDL colesterol, protector de enfermedad cardiovascular: calidad vs. cantidad


  • Agustín Iza Universidad Norbert Wiener. Lima, Perú.



Palabras clave:

HDL cholesterol, CETP (Cholesteryl ester transfer protein), coronary morbidity and mortality, reverse transport of cholesterol, number of particles HDL, HDL particles Size


Los estudios pioneros de Framingham mostraron una relación inversa entre los niveles bajos de HDL Colesterol y la morbilidad coronaria. Los ensayos con modificaciones en el estilo de vida han mostrado un muy discreto incremento en las cifras de HDL-C, y la intervención farmacológica con fibratos o acido nicotínico (niacina) no ha mostrado tampoco disminución de la mortalidad. Tratar a pacientes con medicamentos que afectan el transporte reverso de colesterol y que aumentan considerablemente la cifra de HDL tampoco ha logrado disminuir la morbilidad. La asociación inversa de cifras altas de HDL y mortalidad coronaria está siendo cuestionada en los últimos años y se ha comenzado a investigar la calidad del HDL o la de sus subfracciones como explicación a su actividad antiaterosclerótica.


Cargando métricas ...


Stroes E. Statins and LDL cholesterol lowering: an overview. Curr Med Res Opin 2005;21 Suppl 6:: S9-S16 .doi.org/10.1185/0300799005X59102

Kannel WB, High-density lipoproteins: Epidemiologic profile and risks of coronary artery disease Amer J Cardiol 1983;52(4):B9–B12. doi. org/10.1016/0002-9149(83)90649-5.

Castelli WP et al. Incidence of coronary heart disease and lipoprotein cholesterol levels. The Framingham Heart Study. JAMA 1986;266:2835-2838.

Wong N. Nature Reviews Cardiology 2014;11:276–289 doi:10.1038/nrcardio.2014.26.

Assmann G et al. Simple Scoring Scheme for Calculating the Risk of Acute Coronary Events Based on the10-Year Follow-Up of the Prospective Cardiovascular Münster (PROCAM) Study. Circulation. 2002;105:310-315. doi: 10.1161/ hc0302.102575.

Stone NJ et al. F. 2013 ACC/AHA guideline on the treatment of blood cholesterol to reduce atherosclerotic cardiovascular risk in adults: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines. Circulation. 2014; 129: S1–S45. https://doi.org/10.1161/01. cir.0000437738.63853.7a.

Capano A et al. 2016 ESC/EAS Guidelines for the Management of Dyslipidaemias. The Task Force for the Management of Dyslipidaemias of the European Society of Cardiology (ESC) and European Atherosclerosis Society (EAS). Developed with the special contribution of the European Association for Cardiovascular Prevention & Rehabilitation (EACPR) Atherosclerosis 2016; 253: 281–344. http:// dx.doi.org/10.1016/j.atherosclerosis.2016.08.018.

Sarwar N et al. Triglyceride-mediated pathways and coronary disease: collaborative analysis of 101 studies. Triglyceride Coronary Disease Genetics, Consortium and Emerging Risk Factors Collaboration. Lancet. 2010; 375: 1634–1639.

Holmes MV et al. Mendelian randomization of blood lipids for coronary heart disease. Eur Heart J. 2015; 36: 539–550

Harrison SC et al. Mendelian randomisation, lipids, and cardiovascular disease. Lancet. 2012;380:543–545

Tu JV et al. The Cardiovascular Health in Ambulatory Care Research Team (CANHEART): using big data to measure and improve cardiovascular health and healthcare services. Circ Cardiovasc Qual Outcomes. 2015; 8(2):20412. doi: 10.1161/CIRCOUTCOMES.114.001416.

Russell JC. Of mice and men, rats and atherosclerosis Cardiovasc Res 2003; 59(4): 810 – 811. DOI: http://dx.doi. org/10.1016/S0008-6363(03)00530-3 810-811.

Calkin AC et al. Gemfibrozil decreases atherosclerosis in experimental diabetes in association with a reduction in oxidative stress and inflammation. Diabetologia (2006) 49: 766–774 doi 10.1007/ s00125-005-0102-6.

The AIM-HIGH Investigators. Niacin in Patients with Low HDL Cholesterol Levels Receiving Intensive Statin Therapy. N Engl J Med 2011;365:2255-2267 . doi: 10.1056/NEJMoa1107579.

Armitage J et al. The Heart Protection Study 2-Treatment of HDL to Reduce the Incidence of Vascular Events (HPS2 THRIVE ), The HPS2-THRIVE Collaborative Group*. N Engl J Med 2014; 371:203-212 DOI: 10.1056/ NEJMoa1300955.

Highpassand M. et al. Monocyte/macrophage expression of ABCA1 has minimal contribution to plasma HDL levels. J Clin Invest. 2001, 108(9):1315-1320.

Timmins JM. Targeted inactivation of hepatic Abca1 cuases profound hypoalphalipoproteinemia and kidney hypercatabolism of apoA1. J Clin Invest. 2005:115(5):1333-1342.

Rye KA, Clay MA, Barter PJ. Remodelling of high density lipoproteins by plasma factors. Atherosclerosis.1999; 145: 227–238.

Blanche PJ, Gong EL, Forte T. M, Nichols AV. Characterization of human high-density lipoproteins by gradient gel electrophoresis. Biochim. Biophys. Acta.1981;665: 408–419.

Davidson WS et al. Proteomic Analysis of Defined HDL Subpopulations Reveals Particle-Specific Protein Clusters. Relevance to Antioxidative Function. Arterioscler Thromb Vasc Biol 2009; 26(6):870-876.

Rye KA, Barter PJ. Cardioprotective functions of HDLs. J Lipid Res. 2014; 55: 168–179.

Khera AV, Cuchel M, De la Llera-Moya M et al. Cholesterol efflux capacity, high-density lipoprotein function, and atherosclerosis. N Engl J Med, 2011,364:. 127–135.

Annema W et al. Regulation of reverse cholesterol transport-a comprehensive appraisal of available animal studies. Nutrition & Metabolism 2012; 9:25 DOI: 10.1186/1743-7075-9-25©.

Lewis GF, Rader DJ: New insights into the regulation of HDL metabolism and reverse cholesterol transport. Circulation Research.2005; 96: 1221-1232. doi: 10.1161/01. RES.0000170946.56981.5c.

Nissen SE et al. Illustrate Investigators. Effect of Torcetrapib on the Progression of Coronary Atherosclerosis. N Engl J Med 2007; 356:1304-1316 DOI: 10.1056/NEJMoa070635.

Barter PJ et al. Illuminate Investigators. Effects of torcetrapib in patients at high risk for coronary events. N Engl J Med. 2007;357(21):2109-22.

Schwartz GG et al. For the dal-Outcomes Investigators* Effects of Dalcetrapib in Patients with a Recent Acute Coronary Syndrome. N Engl J Med 2012; 367:20892099 DOI: 10.1056/NEJMoa1206797.

Cannon C et al. "Safety of Anacetrapib in Patients with or at High Risk for Coronary Heart Disease". The New England Journal of Medicine 2010 363 (25): 2406–2415. doi:10.1056/NEJMoa1009744.

Nicholls S et al. A Study of Evacetrapib in High-Risk Vascular Disease (ACCELERATE) 65th Annual Scientific Sesion 2016 del American College of Cardiology Chicago 2-4 abril 2016. https:// accscientificsession.acc.org/ accesado 15 mayo 2016.

Kerry-Anne Ryea, Kwok Leung Onga. HDL function as a predictor of coronary heart disease events: time to re-assess the HDL hypothesis? Lancet: Diabetes&Endocrinology 2015;3(7):488– 489 http://dx.doi.org/10.1016/S22138587(15)00205-3.

Rohatgi A et al. HDL cholesterol efflux capacity and incident cardiovascular events. Dallas Heart Study. N Engl J Med. 2014,;371(25):2383-93. doi: 10.1056/NEJMoa1409065.

Arsenault BJ et al. HDL particle size and the risk of coronary heart disease in apparently healthy men and women: the EPIC-Norfolk prospective population study.Atherosclerosis2009;206:276281. doi:10.1016/j. atherosclerosis.2009.01.044.

El Harchaoui et al. High-density lipoprotein particle size and concentration and coronary risk. Ann. Intern. Med.2009; 150, 84–93. doi:10.7326/0003-4819150-2-200901200-00006.

Voight BF et al. Plasma HDL cholesterol and risk of myocardial infarction: a mendelian randomisation study. Lancet. 2012;380(9841):572-80. doi: 10.1016/S0140-6736(12)60312-2.

Zanoni P, et al. Rare variant in scavenger receptor BI raises HDL cholesterol and increases risk of coronary heart disease. CHD Exome+ Consortium; CARDIoGRAM Exome Consortium; Global Lipids Genetics Consortium. Science. 2016;351(6278):1166-1171. doi: 10.1126/science.aad3517. PMID: 26965621.

Kontush A. HDL particle number and size as predictors of cardiovascular disease. Front. Pharmacol, 2015; 6:.218-224. doi 10.3389/fphar.2015.00218>. .

Mackey E et al. High-Density Lipoprotein Cholesterol and Particle Concentrations, Carotid Atherosclerosis, and Coronary Events. MESA (Multi-Ethnic Study of Atherosclerosis) J Am Coll Cardiol. 2012;60(6):508-516. doi:10.1016/j.jacc.2012.03.060.

Matyus SP et al. HDL particle number measured on the Vantera(R), the first clinical NMR analyzer. Clin. Biochem. 2014;48: 148–155. doi:10.1016/j.clinbiochem.2014.11.017

Shah AS et al. Proteomic diversity of high density lipoproteins: our emerging understanding of its importance in lipid transport and beyond. J. Lipid Res.2013; 54, 2575–2585. doi: 10.1194/jlr.R035725.

Rosenson RS et al. HDL Measures, Particle Heterogeneity, Proposed. Nomenclature, and Relation to Atherosclerotic Cardiovascular Events. Clin. Chem. 2011; 57, 392–410. doi: 10.1373/clinchem.2010.155333),

Gary FL et al. New Insights Into the Regulation of HDL Metabolism and Reverse Cholesterol Transport. Circ Res. 2005;96:1221-1232 doi: 10.1161/.




Cómo citar

Iza, A. (2019). HDL colesterol, protector de enfermedad cardiovascular: calidad vs. cantidad. Revista De Investigación De La Universidad Norbert Wiener, 5(1), 95–108. https://doi.org/10.37768/unw.rinv.05.01.011