This study measured the ability of small HDL3 particles from subjects with the metabolic syndrome to protect against endothelial cell apoptosis. In order to create an apoptotic milieu, endothelial cells from 16 subjects with the metabolic syndrome and 7 controls were incubated with mildly oxidized LDL particles. Small, dense HDL3b and 3c were found to have decreased anti-apoptotic effects and be correlated with abdominal obesity, atherogenic dyslipidemia, and systemic oxidative stress. This anti-apoptotic activity of HDL particles was also associated with the apolipoprotein AI/apolipoprotein AII ratio and with altered physicochemical properties of apolipoprotein AI in HDL3c, which are considered to be cholesteryl ester depleted and triglyceride-enriched. These findings led the authors to suggest that therapies to improve HDL quantity and quality might attenuate the cardiovascular risk associated with abdominal obesity, insulin resistance, and the metabolic syndrome.
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