2020
DOI: 10.1016/j.atherosclerosis.2020.04.015
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High density lipoprotein functionality and cardiovascular events and mortality: A systematic review and meta-analysis

Abstract: First meta-analysis on the association between a wide range of HDL functions and the risk of cardiovascular disease and all-cause mortality • Higher cholesterol efflux and antioxidant/anti-inflammatory capacities promoted by HDL are associated with lower cardiovascular disease risk.• Higher cholesterol efflux capacity and antioxidant activity are associated with lower risk of all-cause mortality • Heterogeneity between studies and evidence of publication bias warrants caution and highlights the need for larger… Show more

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Cited by 75 publications
(56 citation statements)
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“…In recent years, several clinical studies have investigated the relationship between cholesterol efflux capacity and cardiovascular risk. A recent meta-analysis of 20 articles showed that increased high-density lipoprotein cholesterol efflux capacity was associated with a lower risk of cardiovascular disease [ 17 ]. Authors stated that the heterogeneity and evidence of publication bias highlight the need for larger prospective studies.…”
Section: Discussionmentioning
confidence: 99%
“…In recent years, several clinical studies have investigated the relationship between cholesterol efflux capacity and cardiovascular risk. A recent meta-analysis of 20 articles showed that increased high-density lipoprotein cholesterol efflux capacity was associated with a lower risk of cardiovascular disease [ 17 ]. Authors stated that the heterogeneity and evidence of publication bias highlight the need for larger prospective studies.…”
Section: Discussionmentioning
confidence: 99%
“…Moreover, animal studies have shown improved macrophage efflux after supplementation with EPA and DHA, probably mediated through activation of genes involved in reverse cholesterol transport such as ABCA1, ABCG1, ABCG5, ABCG8 and SR-B1, suggesting a molecular link between increased n-3 fatty acid intake and cholesterol efflux (24) . The anti-atherosclerotic function of HDL has been ascribed to the cholesterol efflux ability, and recently, a meta-analysis showed that greater HDL efflux capacity was associated with lower risk of CVD (43) . HDL particles are under continuous remodelling in the plasma, which will influence their functionality and lead to variability in the composition of HDL particles.…”
Section: Discussionmentioning
confidence: 99%
“…Potential mechanisms for the HDL–COVID-19 hospitalisation gradient include anti-inflammatory properties of the lipoprotein which are related to lower risk of cardiovascular disease in humans (12), particularly relevant in COVID-19 complications. Further, HDL can act as a direct modulator of immunity by inhibiting haematopoeietic stem cells proliferation and affecting the activity and function of immune cells by changing the cholesterol content of the lipid rafts in immune cell membranes (8).…”
Section: Discussionmentioning
confidence: 99%