Dysfunctional HDL: a novel important diagnostic and therapeutic target in cardiovascular disease?

Prog Lipid Res. 2012 Oct;51(4):314-24. doi: 10.1016/j.plipres.2012.03.003. Epub 2012 May 15.


High density lipoprotein (HDL) has many properties, which contribute to its atheroprotective role. However, some recent clinical trials have identified subjects with the progression of atherosclerosis despite normal levels of HDL cholesterol. This raises the question if all subfractions of HDL have the same properties. Moreover, recent investigations have shown that both acute and chronic inflammation may lead to structural and functional changes of HDL, which render the particles proinflammatory. Although therapeutic agents that increase HDL levels are now quite well established it is not clear whether they influence HDL quality. We review the current state of knowledge on the properties of HDL and factors/therapeutic agents which may restrain the transformation of normal HDL into dysfunctional HDL.

Publication types

  • Review

MeSH terms

  • Animals
  • Apolipoproteins / antagonists & inhibitors
  • Apolipoproteins / metabolism
  • Azetidines / therapeutic use
  • Cardiovascular Diseases / diagnosis*
  • Cardiovascular Diseases / drug therapy
  • Cardiovascular Diseases / metabolism
  • Cholesterol Ester Transfer Proteins / antagonists & inhibitors
  • Cholesterol Ester Transfer Proteins / metabolism
  • Cholesterol, HDL / metabolism*
  • Ezetimibe
  • Fibric Acids / therapeutic use
  • Humans
  • Hydroxymethylglutaryl-CoA Reductase Inhibitors / therapeutic use
  • Niacin / therapeutic use
  • Peroxidase / antagonists & inhibitors
  • Peroxidase / metabolism
  • Thiazolidinediones / therapeutic use


  • Apolipoproteins
  • Azetidines
  • Cholesterol Ester Transfer Proteins
  • Cholesterol, HDL
  • Fibric Acids
  • Hydroxymethylglutaryl-CoA Reductase Inhibitors
  • Thiazolidinediones
  • Niacin
  • Peroxidase
  • Ezetimibe