How Good is 'Good Cholesterol?'
At first we thought all cholesterol was bad. Then, some time ago, there was this idea of “good cholesterol” -- the kind that protects the heart by removing the bad stuff from our arteries, and carrying it back to the liver, where it’s broken down and passed from the body.
Low-density lipoprotein (LDL) (the bad cholesterol) is found in high levels in 33.5% of American adults, according to the Centers for Disease Control and Prevention (CDC). High levels of high density lipoprotein (HDL) (the good cholesterol) are believed to provide anti-inflammatory protection in the arteries.
But now research presented at the American College of Cardiology 2016 Scientific Sessions in Chicago suggests that high levels of that "good cholesterol" are unlikely to protect people from heart disease if their bloodstream also contains high levels of a newly identified biomarker of inflammation in the arteries.
Inflammation of the artery walls raises the risk of a heart attack or stroke because it increases the chance of plaque on the arterial walls rupturing.
Researchers used a test called NMR spectroscopy to measure lipoprotein particles and glycoprotein acetylation, or GlycA, in 2,848 patients. Participants were average age 63; 66% were male, and 65% had coronary artery disease.
Findings revealed a higher risk of heart attack or stroke among those with high levels of the biomarker GlycA. These results indicate that an interaction may occur between GlycA and small HDL particles, restricting the capacity of HDL to act as an anti-inflammatory, and increasing the chance of a heart attack or stroke.
So good cholesterol is still good, but its effectiveness can be compromised by GlycA levels – which may now become a more reliable predictor of life-threatening adverse events.