Unit of Neurosciences, Department of Medicine and Surgery, University of Parma, 43125 Parma, Italy.
Department of Food and Drug, University of Parma, 43124 Parma, Italy.
Cells. 2021 Mar 5;10(3):574. doi: 10.3390/cells10030574.
Over the years, the relationship between high-density lipoprotein (HDL) and atherosclerosis, initially highlighted by the Framingham study, has been revealed to be extremely complex, due to the multiple HDL functions involved in atheroprotection. Among them, HDL cholesterol efflux capacity (CEC), the ability of HDL to promote cell cholesterol efflux from cells, has emerged as a better predictor of cardiovascular (CV) risk compared to merely plasma HDL-cholesterol (HDL-C) levels. HDL CEC is impaired in many genetic and pathological conditions associated to high CV risk such as dyslipidemia, chronic kidney disease, diabetes, inflammatory and autoimmune diseases, endocrine disorders, etc. The present review describes the current knowledge on HDL CEC modifications in these conditions, focusing on the most recent human studies and on genetic and pathophysiologic aspects. In addition, the most relevant strategies possibly modulating HDL CEC, including lifestyle modifications, as well as nutraceutical and pharmacological interventions, will be discussed. The objective of this review is to help understanding whether, from the current evidence, HDL CEC may be considered as a valid biomarker of CV risk and a potential pharmacological target for novel therapeutic approaches.
多年来，高密度脂蛋白 (HDL) 与动脉粥样硬化之间的关系，最初由弗雷明汉研究强调，由于涉及到 HDL 保护作用的多种功能，其关系变得极其复杂。其中，HDL 胆固醇外排能力 (CEC)，即 HDL 促进细胞内胆固醇从细胞中外排的能力，与单纯的血浆 HDL-胆固醇 (HDL-C) 水平相比，更能预测心血管 (CV) 风险。在许多与高 CV 风险相关的遗传和病理条件下，如血脂异常、慢性肾脏病、糖尿病、炎症和自身免疫性疾病、内分泌紊乱等，HDL CEC 受损。本综述描述了目前在这些情况下对 HDL CEC 改变的认识，重点介绍了最近的人类研究和遗传及病理生理方面的研究。此外，还讨论了可能调节 HDL CEC 的最相关策略，包括生活方式的改变，以及营养和药物干预。本综述的目的是帮助了解从目前的证据来看，HDL CEC 是否可以被认为是 CV 风险的有效生物标志物，以及是否可能成为新的治疗方法的潜在药物靶点。
