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Monitoring of HDL-cholesterol in serum is of clinical importance since an inverse correlation exists between serum HDL-cholesterol concentrations and the risk of atherosclerotic disease. Elevated HDL-cholesterol concentrations are protective against coronary heart disease, while reduced HDL-cholesterol concentrations, particularly in conjunction with elevated triglycerides, increase the cardiovascular risk.2,3 Strategies have emerged for treating cardiovascular disease by increasing HDL-cholesterol levels.4,5
Total cholesterol and triglycerides are required as well for determination of lipid risk factors for coronary artery disease. These tests with HDL-C and LDL-C are the usual lipid profile. HDL-C is especially apt to be low in male subjects who are obese and sedentary, in those who smoke cigarettes, and in those who have diabetes mellitus. Uremia is also associated with lower HDL-C. Exercise, appropriate diet and moderate ethanol intake increase HDL-C.
HDL-C is useful with cholesterol in forecasting protection against coronary artery disease in the industrialized countries, possible because of ingestion of high fat diets.
Those at least risk for development of coronary arterial disease have low cholesterol, low triglycerides, and high HDL-C.
Factors contributing to decreased HDL-C include:
• Genetic factors: primary hypoalphalipoproteinemia6
• Cigarette smoking7
• Obesity7
• Hypertriglyceridemia7
• Lack of exercise
• Steroids − androgens, progestogens, anabolic
• Thiazides
• Beta-adrenergic blockers
• Probucol
• Neomycin
1. LabCorp internal studies.
2. Nauck M, Wiebe D, Warnick G. Measurement of high-density-lipoprotein. In: Rifai N, Warnick CR, Dominiczak MH, eds. Handbook of Lipoprotein Testing. 2nd ed. Washington, DC: AACC Press; 2001: 221-224.
3. Dominiczak M, McNamara J. The system of cardiovascular prevention. In: Rifai N, Warnick CR, Dominiczak MH, eds.Handbook of Lipoprotein Testing 2nd ed. Washington, DC: AACC Press; 2001:103-125.
4. Linsel-Nitschke P, Tall AR. HDL as a target in the treatment of atherosclerotic cardiovascular disease. Nat Rev Drug Discov. 2005 Mar; 4(3):193-205. PubMed 15738977
5. Ng DS. Treating low HDL-from bench to bedside. Clin Biochem. 2004 Aug; 37(8):649-659. PubMed 15302606
6. Third Report of the National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III) Final Report. Circulation. 2002 Dec 17; 106(25):3143-3421. PubMed 12485966
7. Frohlich JJ, Pritchard PH. The clinical significance of serum high density lipoproteins. Clin Biochem. 1989 Dec; 22(16):417-423. PubMed 2692872
