{"id":"c633c1fb00b5","type":"article","url":"https://hartvaat.nl/2026/08/13/hdl-eiwitten-bepalen-cvd-en-ontstekingsrisico-onafhankelijk-van-hdl-c/","title":"HDL-eiwitten bepalen CVD- en ontstekingsrisico — onafhankelijk van HDL-C","title_en":"HDL-associated proteins affecting CVD and systemic inflammation.","category":"chronische nierziekte","category_label":"Nierziekte","professions":["apotheker","cardioloog","internist"],"tags":[],"journal":"Current opinion in lipidology","doi":"10.1097/MOL.0000000000001052","source_url":"https://doi.org/10.1097/MOL.0000000000001052","authors":["Samuel C Delk","Srinivasa T Reddy"],"significance":5,"published":"2026-08-20","source_date":"2026-08-13","image":"https://hartvaat.nl/global/img/0155cc89a708.webp","kennis":["https://hartvaat.nl/kennis/nierziekte/nierziekte-en-cardiovasculair-risico/","https://hartvaat.nl/kennis/cardiometabool/esc-richtlijn-diabetes-cvd-cardiometabool/"],"congress":"","summary_en":"This narrative review explains why elevated HDL-C is a poor predictor of cardiovascular protection, emphasizing that HDL function depends on its associated proteins. Key molecules like ApoM, ApoA-I, and SR-B1 modulate inflammation, LDL deposition, and endotoxin clearance, with ApoM showing a protective association in chronic kidney disease. While CETP inhibition improved survival in a murine sepsis model, clinical translation remains pending as key trials continue. The authors advocate shifting focus from HDL-cholesterol levels to HDL functionality in both research and clinical practice.","created":"2026-08-13T01:25:24Z","updated":"2026-08-13T01:25:26Z","licence":"Citeer vrij, met bronvermelding en een link naar hartvaat.nl (de url van het record). Samenvattingen zijn redactioneel werk van HartVaat; de oorspronkelijke publicaties blijven van hun uitgevers (doi). Geen medisch advies.","body_markdown":"Deze overzichtsstudie belicht waarom verhoogd HDL-cholesterol geen betrouwbare marker is voor bescherming tegen cardiovasculaire ziekte en ontsteking. Recent onderzoek wijst uit dat de functie van HDL sterk wordt bepaald door geassocieerde eiwitten zoals ApoM, ApoA-I en SR-B1, die betrokken zijn bij mitochondriale regulatie, LDL-depositie en endotoxine-afbraak. Bij chronische nierziekte wordt een verband gezien tussen ApoM en verbeterde klinische uitkomsten. Hoewel CETP-remming in muismodellen de overleving verbeterde, blijft de vertaling naar de klinische praktijk voorlopig voorbehouden. Het artikel pleit voor een functionele benadering van HDL in plaats van alleen cholesterolmetingen.","abstract_original":"PURPOSE OF REVIEW: It has become clear that elevated HDL-C is not a reliable marker of protection against inflammation and cardiovascular disease (CVD). This review summarizes recent advances in understanding how HDL function is affected by its associated proteins, demonstrating that this is a more appropriate lens through which to assess HDL's protective capacity. RECENT FINDINGS: Recent publications have demonstrated an inverse relationship between ApoM and clinical outcomes in chronic kidney disease and its concomitant cardiovascular indications. Mechanistic studies show that ApoM's regulation of mitochondrial function and autophagy are likely contributors to this effect. Additionally, ApoA-I, serum amyloid albumin (SAA), and SR-B1 have recently been highlighted as key regulators of atherogenesis through their ability to prevent LDL transcytosis and arterial entrapment by proteoglycans. Lastly, a novel mechanism is described wherein HDL-bound endotoxin is degraded through the endosome-lysosome pathway in an SR-B1-dependent manner, attenuating IL-1β activation. In the same study, inhibition of CETP (cholesterol ester transfer protein) increased HDL and improved mortality in a mouse model of sepsis, highlighting this pathway's importance and therapeutic potential of CETP inhibition, which is currently in key clinical trials. SUMMARY: HDL regulates inflammation and CVD through a variety of mechanisms independent of reverse cholesterol transport, including autophagy, LDL deposition, endotoxin clearance."}