ApoL1 levels in high density lipoprotein and cardiovascular event presentation in patients with familial hypercholesterolemia

J Lipid Res. 2016 Jun;57(6):1059-73. doi: 10.1194/jlr.P061598. Epub 2016 Apr 25.


HDL composition rather than HDL-cholesterol (HDL-C) levels seems to be a key determinant of HDL-induced atheroprotection. Heterozygous familial hypercholesterolemia (FH) patients, with lifelong exposure to high LDL levels, show a high prevalence of premature coronary artery disease. We hypothesized that HDL of FH patients might have a modified protein composition and investigated the proteomic signature of HDL obtained from FH patients and their unaffected relatives. HDLs were characterized by 2D electrophoresis/MS in 10 families from the SAFEHEART cohort (3 individuals/family: 2 with genetic FH diagnosis and 1 non-FH relative) clinically characterized and treated as per guidelines. FH patients had lower apoA-I levels and a differential HDL distribution profile of apoL1 and apoA-IV. ELISA validation revealed decreased apoL1 serum levels in FH patients. ApoL1 levels were able to predict presentation of an ischemic cardiac event, and apoL1/HDL-C ratio was associated with the survival rate after the event. FH patients who died because of a fatal cardiac event had lower apoL1 and LCAT content in HDL3 an average of 3.5 years before the event than those who survived. Changes in HDL protein composition could affect patients' prognosis. The proteomic profile of apoL1 is modified in HDLs of high cardiovascular risk patients, and apoL1 plasma levels are significantly lower in serum and in HDL3 of patients that will suffer an adverse cardiac event within 3 years.

Keywords: apolipoprotein L1; biomarkers; mortality; prognosis; proteomics.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Apolipoprotein L1
  • Apolipoproteins / blood*
  • Apolipoproteins / genetics
  • Apolipoproteins A / blood
  • Coronary Artery Disease / blood*
  • Coronary Artery Disease / genetics
  • Coronary Artery Disease / mortality
  • Coronary Artery Disease / pathology
  • Female
  • Humans
  • Hyperlipoproteinemia Type II / blood*
  • Hyperlipoproteinemia Type II / genetics
  • Hyperlipoproteinemia Type II / mortality
  • Hyperlipoproteinemia Type II / pathology
  • Lipoproteins, HDL / blood*
  • Lipoproteins, HDL / genetics
  • Male
  • Middle Aged
  • Proteomics
  • Risk Factors


  • APOL1 protein, human
  • Apolipoprotein L1
  • Apolipoproteins
  • Apolipoproteins A
  • Lipoproteins, HDL
  • apolipoprotein A-IV