Determinants of cholesterol efflux capacity in humans

Charlotte Talbot*, Jogchum Plat*, Andreas Ritsch*, Ronald Mensink*

*Corresponding author for this work

Research output: Contribution to journalReview articlepeer-review


High-density lipoproteins (HDL) play an important role in the reverse cholesterol transport (RCT) pathway, contributing to the efflux of excess cellular cholesterol. However, the classic hypothesis that raising HDL-cholesterol (HDL-C) concentrations reduces cardiovascular disease (CVD) risk has been challenged by recent intervention studies. Nowadays, improving cholesterol efflux capacity of HDL particles is considered to be a better target for the prevention of CVD. We will first briefly summarize assays that have been developed in order to
quantify HDL-mediated cholesterol efflux from macrophages. However, the main purpose of this review is to discuss factors and ABC-transporters that are associated with HDL-mediated cholesterol efflux, such as HDL
particle characteristics (i.e. HDL size and composition), subjects' characteristics (i.e. gender, BMI and age), HDLC raising drugs, lifestyle, genetic background, as well as acute and low-grade systemic inflammation.

suggested that factors associated with small HDL particles efficiently promote cholesterol efflux via the ABCA1 transporter. This appears to contradict findings from epidemiological studies suggesting that in particular large HDL2 particles are related to a reduced CVD risk. It is therefore essential not only to understand targets to increase cholesterol efflux capacity, but also to prove causality between cholesterol efflux capacity and the prevention of CVD risk.
Original languageEnglish
Pages (from-to)21-32
JournalProgress in Lipid Research
Publication statusPublished - 2018

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