Lipids & ApoB
HDL cholesterolHDL-C
Cholesterol carried in HDL particles; an inverse risk marker but not a treatment target.
Sample
Serum
Clinical reference range
40 to 60 mg/dL
Adult
Conv: 40–60 mg/dL
Biology
What it measures
HDL mediates reverse cholesterol transport. HDL function (efflux capacity) matters more than concentration.
Clinical use
Why we order it
ASCVD risk stratification (low HDL is an enhancer); component of metabolic syndrome.
Lens · Clinical
Interpretation by lens
Clinical interpretation
Don't pharmacologically target HDL — niacin and CETP inhibitor trials failed to reduce events. Treat the underlying metabolic disease.
Differential
Causes of abnormal values
Causes of HIGH
- ↑Genetic (CETP variants)
- ↑Estrogen
- ↑Moderate alcohol
- ↑Aerobic exercise
Causes of LOW
- ↓Insulin resistance
- ↓Smoking
- ↓Sedentary lifestyle
- ↓Anabolic steroids
Evidence-graded claims
What the data says
F
Raising HDL-C with niacin reduces ASCVD events
AIM-HIGH and HPS2-THRIVE were neutral or harmful.
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