English 
Italian CASI CLINICI – Case Reports
Volume:
Biochimica Clinica 2012; 36(1) 46-65
Pubblicato on-line:
DOI:
HDL: metodi di misura, eterogeneità delle particelle, proposta di nomenclatura e relazione con gli eventi cardiovascolari aterosclerotici
AUTORI
1Mount Sinai Heart, Mount Sinai School of Medicine, New York, NY, USA
2MedStar Research Institute, Washington DC, USA
3INSERM Unit 939, UPMC Paris 6, Hôpital de la Pitié, Paris, France
4Vanderbilt University, Nashville, TN, USA
5SUNY Downstate Medical Center, Brooklyn, NY, USA
6Children's Hospital Oakland Research Institute, University of California, Berkeley, CA, USA
7University of California, San Francisco, CA, USA
8Liposcience, Raleigh, NC, USA
9Lipoprotein Metabolism Section, Pulmonary and Vascular Medicine Branch, National Heart, Lung and Blood Institute, National Institutes of Health, Bethesda, MD, USA
10Lipid Metabolism Laboratory, Tufts University, Boston, MA, USA
Traduzione a cura di Maria Stella Graziani e Ferruccio Ceriotti
ABSTRACT
HDL Measures, Particle Heterogeneity, Proposed Nomenclature, and Relation to Atherosclerotic Cardiovascular Events
A growing body of evidence from epidemiological data, animal studies, and clinical trials supports HDL as the next target to reduce residual cardiovascular risk in statin-treated, high-risk patients. For more than 3 decades, HDL cholesterol has been employed as the principal clinical measure of HDL and cardiovascular risk associated with low HDL-cholesterol concentrations. The physicochemical and functional heterogeneity of HDL present important challenges to investigators in the cardiovascular field who are seeking to identify more effective laboratory and clinical methods to develop a measurement method to quantify HDL that has predictive value in assessing cardiovascular risk. In this report, we critically evaluate the diverse physical and chemical methods that have been employed to characterize plasma HDL. To facilitate future characterization of HDL subfractions, we propose the development of a new nomenclature based on physical properties for the subfractions of HDL that includes very large HDL particles (VL-HDL), large HDL particles (L-HDL), medium HDL particles (M-HDL), small HDL particles (S-HDL), and very-small HDL particles (VS-HDL). This nomenclature also includes an entry for the pre-beta-1 HDL subclass that participates in macrophage cholesterol efflux. We anticipate that adoption of a uniform nomenclature system for HDL subfractions that integrates terminology from several methods will enhance our ability not only to compare findings with different approaches for HDL fractionation, but also to assess the clinical effects of different agents that modulate HDL particle structure, metabolism, and function, and in turn, cardiovascular risk prediction within these HDL subfractions.