Is HDL-cholesterol bad?


Many thanks to Dr Mariela Glandt, from Israel, for this week’s topic. Mariela is an endocrinologist who has been running a clinic for obesity and diabetes for the last seven years, using the ketogenic diet as the main tool (Ref 1). Mariela spotted a paper called “Association between High-Density Lipoprotein Cholesterol levels and adverse cardiovascular outcomes in high-risk populations” written by Liu et al (Ref 2). It concluded that “Results of this cohort study suggest that very high HDL-C levels are paradoxically associated with higher mortality risk in individuals with CAD [coronary artery disease].” The word paradoxically was used because it is assumed that HDL-cholesterol is good, and this study concluded that it is bad when “very high” and in “individuals with coronary artery disease.”

It was a really interesting paper, but we need to start with some background on cholesterol and lipoproteins generally and HDL-cholesterol specifically – targets, contents, and measurements.

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