Penn Med researchers gauge risk of heart disease with new cholesterol metric

People who are watching their cholesterol may soon need to look at things another way.

Penn researchers have recently found that “good cholesterol,” or high density lipoprotein (HDL), may not be the most direct measure associated with a reduced risk of cardiovascular disease. Instead, it is suggested that a new metric, called the cholesterol efflux capacity, is more closely associated with the risk of heart disease.

School of Medicine research assistant and professor Marina Cuchel defined cholesterol efflux capacity as how efficiently an individual’s HDL can remove cholesterol from white blood cells, in which they can accumulate and cause arterial blockages and subsequent heart attacks.

Cuchel explained that the study was conducted in two separate groups. One group involved healthy volunteers with varying levels of cholesterol, while the other consisted of those who previously had a blockage in the coronary artery and were considered to have heart disease.

Blood was taken from each patient, and the components of the sample were separated until all that remained was the individual’s HDL. These samples of HDL were then added to cholesterol-filled white blood cells in culture and studied to measure how well HDL could remove cholesterol from the blood cells, according to Cuchel.

“The relevance of this finding is in its concept,” Cuchel said. In terms of future research and development, “all the effort [may] now on drugs that will promote the cholesterol efflux capacity rather than increasing pure HDL levels in the blood,” she added.

Cuchel said the next step in their research is to develop a way to measure cholesterol efflux capacity in vivo, or living, organisms, as opposed to studying HDL activity in cell culture.

“The most challenging aspect of this study was trying to adapt a method to measure a [large] number of [blood] samples,” she said. Cuchel explained that since it is more difficult to measure cholesterol efflux capacity than pure HDL levels in the blood, more time and effort will be needed to administer this study on a larger scale.

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