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Novel Insights From Human Studies on the Role of High-Density Lipoprotein in Mortality and Noncardiovascular Disease

Journal

ARTERIOSCLEROSIS THROMBOSIS AND VASCULAR BIOLOGY
Volume 41, Issue 1, Pages 128-140

Publisher

LIPPINCOTT WILLIAMS & WILKINS
DOI: 10.1161/ATVBAHA.120.314050

Keywords

atherosclerosis; cardiovascular diseases; lipids; lipoproteins; mortality

Funding

  1. Novo Nordisk Foundation, Denmark
  2. Herlev and Gentofte Hospital, Copenhagen University Hospital, Denmark
  3. Chief Physician Johan Boserup and Lise Boserup's Fund, Denmark
  4. Danish Heart Foundation
  5. Danish Medical Research Council
  6. Copenhagen County Foundation
  7. Herlev and Gentofte Hospital, Copenhagen University Hospital

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Recent studies have suggested that extremely high levels of HDL cholesterol are associated with increased mortality, indicating that HDL may have harmful effects in some instances. Furthermore, observational and genetic studies have shown that HDL might be linked to the development of major noncardiovascular diseases.
The vast majority of research about HDL (high-density lipoprotein) has for decades revolved around the possible role of HDL in atherosclerosis and its therapeutic potential within cardiovascular disease prevention; however, failures with therapies aimed at increasing HDL cholesterol has left questions as to what the role and function of HDL in human health and disease is. Recent observational studies have further shown that extreme high HDL cholesterol is associated with high mortality leading to speculations that HDL could in some instances be harmful. In addition, evidence from observational, and to a lesser extent genetic studies has emerged indicating that HDL might be associated with the development of other major noncardiovascular diseases, such as infectious disease, autoimmune disease, cancer, type 2 diabetes, kidney disease, and lung disease. In this review, we discuss (1) the association between extreme high HDL cholesterol and mortality and (2) the emerging human evidence linking HDL to several major diseases outside the realm of cardiovascular disease.

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