Thread by @DaveKeto

1/ 👉 "HDL Triglycerides"
or rather HDL-TG
-- As in, triglycerides onboard HDL particles

↗️ Highly associated with: total TG, glycerol, fatty liver index. ↘️Opposite w/ HDL-C/-P

And ofc 👉"Patients with carotid plaques also showed higher HDL-TG."...

pubmed.ncbi.nlm.nih.gov/31252694/

2/ @josefagirona, @lluismasana et al conclude the abstract with:

"HDL-TG should be considered a biomarker of metabolic and cardiovascular risk and could be a marker of HDL dysfunction."

If I can offer a different hypothesis (again, consistent with the #LipidEnergyModel)...

3/ Consider these HDL particles with higher levels of triglycerides aren't really that unique.

They more likely a downstream result of metabolic dysfunction as opposed to a distinct species of particle.

4/ They will coincide with many other aspects of metabolic syndrome, and this includes aspects common to atherogenic dyslipidemia bloodwork: Higher CETP activity, VLDL-TG, Lower HDL-C (And to get extra technical, higher % ≤HDL3 vs ≥HDL2 subtypes)

5/ Why?

I'd posit these are all typically consistent with failed delivery of triglycerides to tissues in the periphery, resulting in lipoproteins (both ApoB and ApoA-1) that have higher TG and lower cholesterol content that would be found in healthier metabolisms.

6/ Plainly stated, I believe it's much more likely the case these lipid and lipoprotein levels are generally a reflection of disease state than a driver of it.*

(*As always, I'd caveat we can have exceptions in genetic abnormalities as well)

7/ As it happens, @lluismasana also released the study on HDL and TG association with #Covid19 outcome severity. (Ironically, this was something I was long requesting since the pandemic began)

nature.com/articles/s4159…

8/ I'm fortunate to be working with @nicknorwitz and @Ad_SotoMota on the #LipidEnergyModel and how it may better explain these and other phenomena where looking to lipid and lipoprotein patterns such as these.