Should You Receive Treatment for Very Low HDL Levels?

Lisa Nelson Health Pro
  • Lisa Nelson RD #5: Should individuals with low HDL levels receive treatment even if all other levels are normal?


    Dr. Shelby-Lane: According to ScienceDaily (May 29, 2005) - High circulating levels of the "good cholesterol" HDL are associated with decreased risk of cardiovascular disease. HDL helps the liver excrete extra cholesterol by binding to a receptor in the liver called scavenger receptor-BI (SR-BI). However, the signaling events between HDL and SR-BI that afforded heart healthy benefits were not known.


    In a study appearing online on March 24, 2005, in advance of the April 1, 2005 print edition of the Journal of Clinical Investigation, Philip Shaul and colleagues from the University of Texas Southwestern Medical Center examine the following pathway:

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    The authors show that HDL activates an enzyme called eNOS and sets off a cellular signal that depends on cholesterol efflux and two intact domains of SR-BI -- the transmembrane domain and its cytoplasmic tail. These regions of SR-BI may serve as "cholesterol sensors" which set into motion cellular events to activate eNOS. This may be the mechanism responsible for the ability of HDL to reduce cardiovascular disease risk.


    Lisa Nelson RD: Again, let's clarify.  If an individual has low HDL levels they should seek treatment even if all other cholesterol levels are normal.  Correct?


    Dr. Shelby-Lane: Again, a low HDL is an isolated risk factor and should be included in the overall health picture, and can be modified with diet, nutrition, and some newer drugs. 


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Published On: February 25, 2009