Dr Mike MacDonald


High-density lipoprotein (HDL) is one of the five major groups of lipoproteins. Lipoproteins are complex particles composed of multiple proteins which transport all fat molecules (lipids) around the body within the water outside cells. They are typically composed of 80-100 proteins/particle (organized by one, two or three ApoA; more as the particles enlarge picking up and carrying more fat molecules) and transporting none to hundreds fat molecules/particle. Unlike the larger lipoprotein particles which deliver fat molecules to cells, HDL particles remove fat molecules from cells which want to export fat molecules. The fats carried include cholesterol, phospholipids, and triglycerides; amounts of each quite variable. Lipoproteins, in order of molecular size, largest to smallest, are chylomicrons, very low-density lipoprotein (VLDL), intermediate-density lipoprotein (IDL), low-density lipoprotein (LDL), and HDL. Lipoprotein molecules (all particles far smaller than human cells), enable the transportation of all lipids, such as cholesterol, phospholipids, and triglycerides, within the water around cells (extracellular fluid), including the bloodstream. For perspective on particle size; see: Cell Size and Scale,.. HDL particles, unlike the larger particles, transfer fats away from cells, artery walls and tissues (around the body, body wide) through the bloodstream, back to both (a) LDL particles and (b) back to the liver for other disposition. Increasing concentrations of HDL particles are strongly associated with decreasing accumulation of atherosclerosis within the walls of arteries[4] over weeks, years, decades. This is important because atherosclerosis, eventually, results in sudden plaque ruptures triggering clots within the artery opening, narrowing/closing the opening(s), i.e. cardiovascular disease, stroke(s) and other vascular disease complications body wide. HDL particles (though vastly different from just cholesterol and other fat molecules per-se) are sometimes referred to as good cholesterol because they can transport fat molecules (including cholesterol, triglycerides, etc.) out of artery walls, reduce macrophage accumulation, and thus help prevent, even regress atherosclerosis over weeks, years, decades, thereby helping prevent cardiovascular disease, stroke(s) and other vascular disease complications body wide. In contrast, LDL particles (also far different from cholesterol per-se) are often called bad cholesterol or unhealthy cholesterol, because they deliver fat molecules to macrophages in the wall of arteries.[5]

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