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HDL modification

recent developments and their relevance to atherosclerotic cardiovascular disease

Wilkins, John T.a,b,c; Seckler, Henrique S.c,d

doi: 10.1097/MOL.0000000000000571
NUTRITION AND METABOLISM: Edited by Frank M. Sacks and Majken K. Jensen

Purpose of review In the last 2 years, significant advances in the understanding of HDL particle structure and the associations between particle structure, function, and atherosclerosis have been made. We will review and provide clinical and epidemiological context to these recent advances.

Recent findings Several recent studies have analyzed the associations between HDL particle size distribution, number, and particle function and specific environmental, behavioral, and pharmacologic exposures. Detailed phenotyping of HDL-associated protein complements, particularly apolipoproteins, strongly suggests structural subspecies of HDL exist with differential associations with HDL function and ASCVD risk.

Summary The recent data on biological and structural variation in HDL suggests the existence of relatively discrete particle species, which share a similar structure and function. We propose that the classical taxonomy that clusters HDL particles by cholesterol content is incomplete. Detailed phenotyping of HDL subspecies in clinical and epidemiological research may yield insights into new risk markers and biochemical pathways that could provide targets for atherosclerotic cardiovascular disease (ASCVD) therapy and prevention in the future.

aDepartment of Medicine (Cardiology)

bDepartment of Preventive Medicine, Feinberg School of Medicine, Northwestern University, Chicago

cDepartments of Chemistry and Molecular Biosciences and the Proteomics Center of Excellence

dChemistry of Life Processes Institute, Northwestern University, Evanston, Illinois, USA

Correspondence to John T. Wilkins, Northwestern University Feinberg School of Medicine, Chicago, IL 60611, USA. E-mail:

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