HDL cholesterol is actually the cholesterol “cargo” carried in the HDL particles, and an emerging concept is that perhaps HDL cholesterol is not our best biomarker for the activity of HDL. The concept of other HDL biomarkers as a predictor of atherosclerosis and CVD events was explored recently in the Multi-Ethnic Study of Atherosclerosis (MESA).[46] In this trial, individuals of different ethnicities, races, and both genders, men and women, were evaluated for changes in carotid intimal medial thickness (cIMT) and changes in incident cardiovascular events. The study found that in individuals with highest levels of serum HDL cholesterol, the risk of CVD events was unrelated to serum LDL cholesterol levels, indicating that serum HDL and LDL cholesterol levels are separate and unrelated as biomarkers with regards to risk. On the other hand, there was an inverse relationship between HDL cholesterol and LDL particle concentration.
J Clin Lipidol. 2011; 5(6).[46]Mackey RH, Greenland P, Goff DC, et al. The relationship of HDL cholesterol and HDL particles to carotid atherosclerosis and incident cardiovascular events: The Multi- Ethnic Study of Atherosclerosis. Abstracts from the American Heart Association Joint Conference: Nutrition, Physical Activity and Metabolism and Metabolism and CVD Epidemiology and Prevention 2011 Scientific Sessions. 2011;331. Abstract P410
