Relationship between high-density lipoprotein cholesterol levels and endothelial function in women: a cross-sectional study

BMJ Open. 2020 Jul 7;10(7):e038121. doi: 10.1136/bmjopen-2020-038121.


Objectives: The purpose of this study was to evaluate the relationship between high-density lipoprotein cholesterol (HDL-C) levels and endothelial function in women.

Design: Cross-sectional study.

Setting: 22 university hospitals and affiliated clinics in Japan.

Participants: 1719 Japanese women aged 17-90 years who were not receiving lipid-lowering therapy.

Measures: We evaluated flow-mediated vasodilation (FMD) and serum levels of HDL-C. All participants were divided into four groups by HDL-C level: low HDL-C (<40 mg/dL), moderate HDL-C (40-59 mg/dL), high HDL-C (60-79 md/dL) and extremely high HDL-C (≥80 mg/dL).

Results: Univariate regression analysis revealed a significant relationship between FMD and HDL-C (r=0.12, p<0.001). FMD values were significantly smaller in the low HDL-C group (5.2%±3.8%) and moderate HDL-C group (5.2%±3.8%) than in the extremely high HDL-C group (6.7%±3.4%) (p=0.024 and p=0.003, respectively), while there was no significant difference in FMD between the high HDL-C group and the extremely high HDL-C group. Multiple logistic regression analysis did not show a significant association between HDL-C levels and FMD.

Conclusions: Endothelial function increased in relation to HDL-C levels. However, there was no association of HDL-C levels with endothelial function after adjustment of traditional cardiovascular risk factors in women.

Trial registration number: UMIN000012950; Results.

Keywords: cardiology; lipid disorders; vascular medicine.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Brachial Artery*
  • Cholesterol, HDL
  • Cross-Sectional Studies
  • Endothelium, Vascular
  • Female
  • Humans
  • Japan
  • Middle Aged
  • Triglycerides
  • Vasodilation*
  • Young Adult


  • Cholesterol, HDL
  • Triglycerides

Associated data

  • UMIN-CTR/UMIN000012950