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High-Density Lipoprotein and Dietary Fatty Acids—Reply
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In Reply: Dr Kim distinguishes the effects of saturated fatty acids and trans-fatty acids on lipoproteins. However, reports of the effect of trans-fatty acids on HDL-C have been variable, with a large meta-analysis finding a statistically nonsignificant effect on HDL-C.1 In addition to increasing levels of LDL-C, trans-fatty acids promote vascular inflammation and endothelial dysfunction and reduce paraoxonase activity.2 These lipid and biochemical effects act synergistically to increase cardiovascular disease risk.2
The issue is more complex than indicated by HDL-C. Saturated fat rapidly promotes proinflammatory changes in HDL without changing HDL-C level.3 Thus, as mentioned in our review, dietary intake of both saturated fatty acids and trans-fatty acids should be avoided and substituted with intake of monounsaturated and polyunsaturated fatty acids.
Financial Disclosures: Dr Ansell reported receiving speaking honoraria from AstraZeneca, Kos Pharmaceuticals, Merck, and Pfizer; receiving research medication from Merck and Pfizer in the past; . . . [Full Text of this Article]
Inder M. Singh, MD, MS
Department of Cardiovascular Medicine
Krannert Institute of Cardiology
Indiana University Medical Center
Indianapolis
Mehdi H. Shishehbor, DO, MPH
shishem@gmail.com
Department of Cardiovascular Medicine
Cleveland Clinic
Cleveland, Ohio
Benjamin J. Ansell, MD
Department of Medicine
David Geffen School of Medicine at UCLA
Los Angeles, California
RELATED LETTER
High-Density Lipoprotein and Dietary Fatty Acids
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JAMA. 2007;298(19):2263-2264.
EXTRACT
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RELATED ARTICLE
High-Density Lipoprotein as a Therapeutic Target: A Systematic Review
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ABSTRACT
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