Division of Evidence-based Laboratory Medicine, Kobe University Graduate School of Medicine.
J Atheroscler Thromb. 2019 Feb 1;26(2):111-120. doi: 10.5551/jat.RV17028. Epub 2018 Dec 12.
While there is a controversy regarding the causal relationship between high-density lipoprotein cholesterol (HDL-C) and cardiovascular disease (CVD), recent studies have demonstrated that the cholesterol efflux capacity (CEC) of HDL is associated with the incidence of CVD. However, there are several limitations to current assays of CEC. First, CEC measurements are not instantly applicable in clinical settings, because CEC assay methods require radiolabeled cholesterol and cultured cells, and these procedures are time consuming. Second, techniques to measure CEC are not standardized. Third, the condition of endogenous cholesterol donors would not be accounted for in the CEC assays. Recently, we established a simple, high-throughput, cell-free assay system to evaluate the capacity of HDL to accept additional cholesterol, which is herein referred to as "cholesterol uptake capacity (CUC)". We demonstrated that CUC represents a residual cardiovascular risk in patients with optimal low-density lipoprotein cholesterol control independently of traditional risk factors, including HDL-C. Establishing reproducible approaches for the cholesterol removal capacity of HDL is required to validate the impact of dysfunctional HDL on cardiovascular risk stratification in the "real world".
虽然高密度脂蛋白胆固醇（HDL-C）与心血管疾病（CVD）之间的因果关系存在争议，但最近的研究表明，HDL 的胆固醇外排能力（CEC）与 CVD 的发生有关。然而，目前的 CEC 检测存在一些局限性。首先，CEC 测量在临床环境中不能立即应用，因为 CEC 测定方法需要放射性标记的胆固醇和培养细胞，这些程序耗时较长。其次，CEC 的测量技术尚未标准化。第三，CEC 测定中未考虑内源性胆固醇供体的情况。最近，我们建立了一种简单、高通量、无细胞的测定系统，用于评估 HDL 接受额外胆固醇的能力，我们将其称为“胆固醇摄取能力（CUC）”。我们证明，CUC 代表了 LDL-C 控制达到最佳水平的患者的残余心血管风险，独立于传统风险因素，包括 HDL-C。建立 HDL 胆固醇清除能力的可重复方法对于验证功能失调的 HDL 对“真实世界”中心血管风险分层的影响是必要的。
