A new test may help aid in the diagnosis and treatment of heart disease by measuring how a patient’s HDL cholesterol (HDL-C) removes arterial cholesterol, according to Japanese researchers. 

One of the main functions of HDL-C is to mediate the removal of cholesterol from blood vessel walls. According to recent studies, cholesterol efflux capacity, the ability to HDL-C to perform this function, is thought to be a better indicator of cardiovascular disease development than HDL-C levels on their own. Current procedures to measure cholesterol efflux capacity, however, require radioisotope-labeled cholesterol and cultured macrophages, which are too complex for use in patient testing. 

The team, led by Amane Harada, PhD, of Sysmex Corporation, and Ryuji Toh, MD, PhD, of Kobe University Graduate School of Medicine, designed a test for HDL-C function that can determine cholesterol uptake capacity, which is easier to measure and correlates with cholesterol efflux capacity, in less than 6 hours.  

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The new assay was evaluated in 156 patients who had undergone revascularization (such as stent or bypass) due to coronary artery disease and who had subsequently decreased their LDL-C to <100mg/dL. The data showed low cholesterol uptake capacity post-treatment was significantly associated with the recurrence of coronary lesions. Combining cholesterol uptake capacity with known cardiovascular disease risk factors also significantly improved the power of those factors to predict patients who would re-develop heart disease. 

Overall, the assay demonstrated high reproducibility (CV <10%) with a short processing time of under 6 hours. Future validation of the test may allow clinicians to utilize cholesterol uptake capacity with HDL-C levels to better predict who is at risk for cardiovascular disease onset or recurrence. 

“A more efficient enhancement of the atheroprotective functions of HDL may decrease the risk of atherosclerosis and [cardiovascular disease], although it has been difficult to develop therapeutic drugs with the expected effects,” wrote Harada and Toh in their paper. “We consider that this can be explained in part by the lack of a convenient assay system to evaluate HDL functionality without complicated or time-consuming procedures. In this respect, our cholesterol uptake assay provides a concise, accurate, and robust system for high-throughput analysis at low cost.” 

For more information visit jalm.aaccjnls.org.