Wednesday , April 14 2021

Not all “good” cholesterol is healthy



cholesterol

Cholesterol molecule space filling model. Credit: RedAndr / Wikipedia

HDL (high density lipoprotein cholesterol) or “good cholesterol” is associated with a reduced risk of cardiovascular disease as it carries cholesterol that has been deposited in the arteries of the liver for elimination. This is in contrast to the so-called “bad cholesterol”, LDL (low density lipoprotein cholesterol), which causes cholesterol to build up in the arteries and increases cardiovascular risk. Although drugs that lower LDL cholesterol reduce cardiovascular risk, those that increase good cholesterol have not been shown to be effective in reducing the risk of heart disease. This paradox has challenged the link between good cholesterol and cardiovascular risk, and researchers are now studying the characteristics of these HDL or good cholesterol particles.

A study led by the Del Mar Hospital Medical Research Institute (IMIM), published in the journal Metabolism, Clinical and Experimental, has now proven that not all good cholesterol is healthy. Researchers from CIBER for Cardiovascular Diseases (CIBERCV), CIBER for Obesity and Nutrition (CIBEROBN) and CIBER for Epidemiology and Public Health (CIBERESP), and others from Hospital Cl Hospitalnic-IDIBAPS, IDIBELL, Hospital de la Santa The Creu i Sant Pau Research Institute and the Clínico Universitario Hospital in Zaragoza also participated in this study.

In the study, researchers analyzed genetic traits that determine the size of good cholesterol and then studied their relationship to the risk of myocardial infarction. The conclusion is that the genetic traits associated with the formation of large particles of good cholesterol are directly related to a higher risk of heart attack, while traits associated with the formation of small particles of good cholesterol are associated with a lower risk of heart attack.

“There is a positive causal relationship between HDL cholesterol particle size and the risk of heart attack, so although we need to increase the levels of good cholesterol in the blood, it should always be small particles,” explains the study’s lead researcher, Dr. Robert Elosua, researcher at the Hospital del Mar-IMIM, CIBERCV and the Vic-Central University of Catalonia (UVic-UCC).

Good cholesterol particles are more efficient at transporting cholesterol to the liver so that it can be eliminated. “If we have to do anything about HDL, it is to increase the number of small particles, which are the ones that adequately perform the function of eliminating cholesterol, those that actually carry it to the liver for removal and do not allow it to accumulate. in the arteries and cause cardiovascular disease, “says Dr. varlvaro Hernáez, a researcher at IDIBAPS and CIBEROBN.

There are currently no drugs that increase good cholesterol levels and reduce the risk of cardiovascular disease. “This study highlights new and potential therapeutic targets in the field of cardiovascular disease, including several genes related to the qualitative aspects of HDL particles, which may contribute to cardiovascular prevention,” concludes Dr. Albert Prats, a researcher in Epidemiology and the Cardiovascular Genetics Research Team at the del Mar-IMIM Hospital and the first author of the study.


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More information:
Albert Prats-Uribe et al, Characteristics of High Density Lipoproteins and Coronary Heart Disease: a Mendelian Randomization Study, Metabolism (2020). DOI: 10.1016 / j.metabol.2020.154351

Provided by IMIM (Del Mar Hospital Medical Research Institute)

Reference: Not all “good” cholesterol (2021, February 26) was retrieved on February 26, 2021 from https://medicalxpress.com/news/2021-02-good-cholesterol-healthy.html

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