Effects of dysfunctional HDL on coronary artery disease

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High-density lipoprotein cholesterol (HDL-C) is a negative risk factor for CAD. HDL exhibits a variety of anti-atherogenic functions including anti-inflammatory and anti-oxidative as well as promoting reverse cholesterol transport. However, it has been reported that HDL may lose its anti-atherogenic properties and become pro-atherogenic (dysfunctional) under conditions such as inflammation, diabetes, and oxidative stress. In this study, we evaluated HDL function in Japanese patients, and investigated effects of dysfunctional HDL on coronary artery disease (CAD).1) Granular leukocyte-derived myeloperoxidase (MPO) promotes oxidation of lipoproteins, while paraoxonase 1 (PON1) has antioxidant properties for high-density lipoprotein (HDL). We found that serum MPO/PON1 ratio reflect anti-inflammatory properties of HDL. Furthermore, MPO/PON1 ratio was significantly associated with the prevalence of coronary lesions in Japanese patients.2) Pitavastatin has a function of increasing plasma HDL-C levels as well as decreasing low-density lipoprotein cholesterol levels. We demonstrated that pitavastatin also enhances cholesterol efflux capacity and antioxidative properties of HDL.