HDL cholesterol
lipoproteinHDL removes cholesterol and phospholipid hydroperoxides from lesions, opposing atherosclerotic lipid accumulation.
Pathway placement
Cascade stepLipid retention & oxidation
Confidencehigh
RationaleCardioprotective lipoprotein opposing LDL atherogenesis.
Druggability
Not assessed (no mapped human gene target).
Type I vs Type II discrimination
ScoresIndeterminate
R — rupture / Type-I33
C — confounder / Type-II33
A — assay feasibility84
E — evidence strength57
T1DI (composite)24
Specificity differential (R−C)0
Confounder panel (Type-II drivers)
1sepsis / systemic inflammationmag 1
2anemia / acute blood lossn/a
3hypovolemia / dehydrationn/a
4tachyarrhythmiamag 1
5hypoxemia / respiratory failuremag 1
6hypertensive emergencyn/a
7high-demand / peri-operative stressn/a
Coverage: 3/7 confounders with evidence
Tier: deep-scored (abstract-extracted) · 5 supporting references. See the discrimination table for all markers.
Assay & specimen
Validated clinical assay
Specimen
Serum or plasma
Collection tube
Serum separator (gold/red-top, SST) · Lithium heparin (green-top)
Method / principle
Direct enzymatic (homogeneous)
Reagent / substrate
Selective detergent + cholesterol esterase/oxidase/peroxidase Trinder
Platform
Automated analyzer
Turnaround · availability
Routine · Universal
Literature evidence(16)
- Association between Intestinal Flora Metabolites and Coronary Artery Vulnerable Plaque Characteristics in Coronary Heart Disease.British journal of hospital medicine (London, England : 2005) · 2025 · PMID 40135300 · doi
- Association between the atherogenic index of plasma and major adverse cardiovascular events in patients with premature coronary artery disease.European journal of medical research · 2025 · PMID 40551214 · doi
- Association between adjusted atherogenic index of plasma and major adverse cardiovascular events after percutaneous coronary intervention in patients with STEMI: a prospective observational study in China.BMJ open · 2025 · PMID 40840987 · doi
- Effect of biological sex on human circulating lipidome: An overview of the literature.Atherosclerosis · 2023 · PMID 37743161 · doi
- Lipidomic Approaches to Study HDL Metabolism in Patients with Central Obesity Diagnosed with Metabolic Syndrome.International journal of molecular sciences · 2022 · PMID 35743227 · doi
- Which one of LDL-C /HDL-C ratio and non-HDL-C can better predict the severity of coronary artery disease in STEMI patients.BMC cardiovascular disorders · 2022 · PMID 35843962 · doi
- Atherogenic Lipoproteins for the Statin Residual Cardiovascular Disease Risk.International journal of molecular sciences · 2022 · PMID 36362288 · doi
- Association between lipid profiles and presence of carotid plaque.Scientific reports · 2019 · PMID 31784590 · doi
- Mendelian randomization: Its impact on cardiovascular disease.Journal of cardiology · 2018 · PMID 29801689 · doi
- Genome-wide enrichment of mA-associated single-nucleotide polymorphisms in the lipid loci.The pharmacogenomics journal · 2018 · PMID 30262821 · doi
- Epidemiology: disease associations and modulators of HDL-related biomarkers.Handbook of experimental pharmacology · 2015 · PMID 25522991 · doi
- Role of HDL in those with diabetes.Current cardiology reports · 2014 · PMID 25199216
- High-density lipoprotein cholesterol and intracoronary thrombosis burden.Coronary artery disease · 2013 · PMID 23111583 · doi
- Extended-release niacin/laropiprant improves endothelial function in patients after myocardial infarction.Heart and vessels · 2013 · PMID 23712600 · doi
- Plasma lipoprotein abnormalities in hemodialysis patients--clinical implications and therapeutic guidelines.Therapeutic apheresis and dialysis : official peer-reviewed journal of the International Society for Apheresis, the Japanese Society for Apheresis, the Japanese Society for Dialysis Therapy · 2006 · PMID 16911182 · doi
- Pharmacologic augmentation of high-density lipoproteins: mechanisms of currently available and emerging therapies.Current opinion in cardiology · 2005 · PMID 15956828 · doi
Clinical trials(1)
- A Randomized Trial of the Long-term Clinical Effects of Raising HDL Cholesterol With Extended Release Niacin/LaropiprantNCT00461630 · PHASE3 · COMPLETED · ER niacin/laropiprant, simvastatin, ezetimibe/simvastatin