Very High ‘Good Cholesterol’ HDL Linked To Increased Risk of Infections

MedicalResearch.com Interview with:

Børge G. Nordestgaard, MD, DMSc Professor, University of Copenhagen Chief Physician, Dept. Clinical Biochemistry Herlev and Gentofte Hospital Copenhagen University Hospital, Denmark

Prof. Nordestgaard

Børge G. Nordestgaard, MD, DMSc
Professor, University of Copenhagen
Chief Physician, Dept. Clinical Biochemistry
Herlev and Gentofte Hospital
Copenhagen University Hospital, Denmark 

MedicalResearch.com: What is the background for this study?

Response: For decades research into the role and function of high-density lipoprotein (HDL) has revolved around the believe that HDL protects against atherosclerotic cardiovascular disease. However, results from large genetic studies and from large randomized clinical trials with HDL cholesterol elevating drugs have all indicated that there is no causal association between HDL cholesterol and risk of atherosclerotic cardiovascular disease.

Given the hitherto strong focus on cardiovascular disease, little is known about the possible role of HDL in other aspects of human health and disease. Preclinical evidence has indicated that HDL might be of importance for normal function of the immune system and susceptibility to infectious disease, but it had never previously been investigated if levels of HDL cholesterol is associated with the risk of infectious disease in individuals from the general population. In the present study we tested this hypothesis in more than 100.000 Danes from the population at large.

MedicalResearch.com: What are the main findings? 

Response: Our study showed for the first time that both low and very high levels of HDL cholesterol were associated with high risk of infectious disease such as pneumonia and gastroenteritis in the general population. The same U-shaped association was observed for infectious disease related death. 

MedicalResearch.com: What should readers take away from your report?

Response: Individuals with the very highest HDL cholesterol levels should no longer be considered to be those with the best prospect in life, as they have higher risk of infectious disease and mortality and as we showed previously also increased risk of death from any cause. 

MedicalResearch.com: What recommendations do you have for future research as a result of this work? 

Response: There is a need for new research focusing on aspects of HDL not directly related to cardiovascular disease, as HDL might have other important and still unknown roles in human physiology. This could for example be related to the immune system. 

MedicalResearch.com: Is there anything else you would like to add? 

Response: HDL is the most important transporter of fat in most species. Therefore, from
an evolutionary standpoint HDL must be of great importance in the human body, but new thinking about HDL is needed to further our understanding of HDL and its role in in human health and disease.

Any disclosures? Nothing to disclose.

Citations:

Eur Heart J. 2017 Dec 8. doi: 10.1093/eurheartj/ehx665. [Epub ahead of print]

U-shaped relationship of HDL and risk of infectious disease: two prospective population-based cohort studies.
Madsen CM,  Varbo A,  Tybjærg-Hansen A, Frikke-Schmidt R, Nordestgaard BG 

 

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