Advertisement

How an Understanding of HDL’s Metabolism May Help us Discover New Ways to Evaluate Atherosclerosis and its Risk of Progression in the Living Patient

  • Gerd Assmann
Part of the Nato ASI Series book series (NSSA, volume 219)

Abstract

Prospective studies of recent years have demonstrated the existence of a reverse relation between plasma HDL (high density lipoproteins) concentration and the incidence of coronary artery disease (1–3) (Table 1). Also, in cohort studies patients with verified coronary artery disease present with lower mean HDL concentrations than healthy controls (Figure 1). A study group of the European Atherosclerosis Society (EAS) has, in a recent policy statement (4), agreed on 35 mg/dl HDL cholesterol as a provisional cutoff value for risk assessment. This cutoff corresponds to the 16th percentile of the HDL cholesterol distribution in adult males in West Germany (Figure 2). Plasma concentrations below this cutoff may be associated with increased risk for premature onset of atherosclerosis.

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. 1.
    T. Gordon, W. B. Kannel, W. P. Castelli, and T. R. Dawber, Lipoproteins, cardiovascular disease, and death. The Framingham Study, Arch. Intern. Med. 141:1128–1132 (1981).CrossRefGoogle Scholar
  2. 2.
    G. Assmann and H. Schulte, “PROCAM-Trial,” Panscientia Verlag, Medingen, Zurich (1986).Google Scholar
  3. 3.
    H. M. Frick. Helsinki Heart Study - primary prevention trial with gemfibrozil in middle aged men with dyslipidaemia, New Engl. J. Med. 317:1237–1245 (1987).CrossRefGoogle Scholar
  4. 4.
    Study Group, European Atherosclerosis Society, Strategies for the prevention of coronary heart disease: A policy statement of the European Atherosclerosis Society, Europ. Heart J. 8:77–88 (1987).Google Scholar
  5. 5.
    T. G. Redgrave and D. M. Small, Quantitation of the transfer of surface phospholipid of chylomicrons to the high density fraction during catabolism of chylomicrons in the rat, J. Clin. Invest. 64:162–171 (1979).CrossRefPubMedPubMedCentralGoogle Scholar
  6. 6.
    C. Koo, T. L. Innerarity, and R. W. Mahley, Obligatory role of cholesterol and apolipoprotein E in the formation of large cholesterol-enriched and receptor active high density lipoproteins. J. Biol. Chem. 260:11934–11943 (1985).Google Scholar
  7. 7.
    R. Ross and J. A. Glomset, The pathogenesis of atherosclerosis, New Engl. J. Med. 295:364–377 & 420–425 (1976).CrossRefGoogle Scholar
  8. 8.
    R. J. Havel, Role of the liver in atherosclerosis. Arteriosclerosis 5:569–580 (1985).CrossRefPubMedGoogle Scholar
  9. 9.
    J. M. Hong, S. J. Demosky Jr., S. B. Edge, R. E. Gregg, J. C. Osborne, and H. B. Brewer Jr., Characterization of a human hepatic receptor for high density lipoproteins, Arteriosclerosis 5:228–237 (1985).CrossRefGoogle Scholar
  10. 10.
    P. E. Fielding and C. J. Fielding. A cholesteryl ester transfer complex in human plasma, Proc. Natl. Acad. Sci. (USA) 77:3327–3330 (1980).CrossRefGoogle Scholar
  11. 11.
    G. Schmitz, R. Niemann, B. Brennhausen, R. Krause, and G. Assmann. Regulation of high density lipoprotein receptors in cultured macrophages: role of acyl-CoA: cholesterolacyltransferase, EMBOJ 4:2773–2779 (1985).Google Scholar
  12. 12.
    G. Schmitz, H. Robenek, U. Lohmann, and G. Assmann, Interaction of high density lipoproteins with cholesteryl ester-laden macrophages: biochemical and morphological characterization of cell surface receptor binding, endocytosis, and resecretion of high density lipoproteins by macrophages. EMBOJ 4:613–622 (1985).Google Scholar
  13. 13.
    G. Schmitz, G. Assmann, H. Robenek, and B. Brennhausen, Tangier disease: a disorder of intracellular membrane traffic. Proc. Natl. Acad. Sci. (USA) 82:6305–6309 (1985).CrossRefGoogle Scholar
  14. 14.
    J. P. Slotte, J. F. Oram, and E. L. Bierman, Binding of high density lipoproteins to cell receptors promotes translocation of cholesterol from intracellular membranes to the cell surface, J. Lipid Res. 26:487–494 (1985).Google Scholar
  15. 15.
    S. Eisenberg, Preferential enrichment of large-sized very low density populations with transferred cholesteryl esters, J. Lipid Res. 26:487–494 (1985).PubMedGoogle Scholar
  16. 16.
    G. Assmann and G. Schmitz, Familial HDL deficiency: Tangier disease, in: “Metabolic Basis of Inherited Disease,” McGraw-Hill, New York (1989).Google Scholar
  17. 17.
    G. Assmann, “Lipid Metabolism and Atherosclerosis,” Schattauer Verlag, Stuttgart (1982).Google Scholar
  18. 18.
    G. Assmann, ed., Fettstoffwechselstörungen und koronare Herzkrankheit. Primarprävention, Diagnostik und Therapie - Leitlinien für die Praxis, MMV Medizin Verlag, München (1988).Google Scholar

Copyright information

© Plenum Press, New York 1991

Authors and Affiliations

  • Gerd Assmann
    • 1
  1. 1.Institut für Klinische Chemie und Laboratoriumsmedizin und Institut for ArterioskleroseforschungMünsterGermany

Personalised recommendations