High-Density Lipoprotein Cholesterol (HDL-C)
HDL-C quantifies the cholesterol carried within high-density lipoprotein particles responsible for reverse cholesterol transport from peripheral tissues back to the liver for biliary excretion.
Standard vs. Optimal Reference Rangesmg/dL
Standard reference intervals represent the statistical 95% distribution of unselected commercial populations. Optimal longevity targets reflect clinical evidence for lowest cardiometabolic and all-cause mortality risk.
Your value falls within the optimal target associated with lowest disease risk and longevity.
> 40 mg/dL (Male), > 50 mg/dL (Female)
General reference distribution across unselected commercial populations.
50 - 70 mg/dL
Concentration target associated with minimal all-cause cardiometabolic mortality.
Molecular Mechanism & Clinical Purpose
Apolipoprotein A-I (ApoA-I) interacts with ATP-binding cassette transporter A1 (ABCA1) to lipidate nascent HDL discs. Cholesterol is esterified by lecithin-cholesterol acyltransferase (LCAT) and transported to the liver via scavenger receptor class B type I (SR-BI).
Differential Diagnosis
Elevated Levels (HDL-C High)
- •CETP deficiency (Cholesteryl Ester Transfer Protein mutation)
- •Chronic high-volume alcohol consumption
- •Estrogen replacement therapy
- •Vigorous endurance training
Low Levels (HDL-C Low)
- •Tangier disease (ABCA1 mutation)
- •Severe insulin resistance and hypertriglyceridemia
- •Systemic inflammation and sepsis
- •Smoking
Technical Reference & Deep Dive
Biochemistry & Enzymatic Pathways
Longevity Risk Architecture & Epidemiology
Pre-Analytical Caveats & Diagnostic Workup
Pre-Analytical Considerations:
Standard testing requires a 10 to 12 hour overnight fast to minimize postprandial chylomicron interference, although HDL-C direct immunoassay is less sensitive to prandial state than calculated LDL-C. Avoid strenuous high-intensity exercise 24 hours prior to blood draw. Serum separator tubes (SST) or EDTA plasma should be centrifuged within 2 hours. High-dose biotin (>5 mg/day) supplementation may interfere with competitive streptavidin-biotin immunoassays, requiring a 48-hour washout period.
Reflexive Testing Protocol:
- Advanced Lipoprotein Particle Quantification (NMR spectroscopy or ion mobility LDL-P)
- Lipoprotein(a) [Lp(a)] baseline evaluation for genetic cardiovascular risk stratification
- Coronary Artery Calcium (CAC) score via non-contrast cardiac CT to evaluate calcified plaque burden
- High-sensitivity C-Reactive Protein (hs-CRP) to assess systemic vascular inflammatory tone
- Carotid intima-media thickness (CIMT) duplex ultrasound to assess subclinical atherosclerosis
Clinical Citations & Primary Literature (1)
- [1]High-Density Lipoprotein Cholesterol and All-Cause Mortality: A U-Shaped Relationship - European Heart Journal (2021). PMID: 33734305
Associated Longevity Guides & Clinical Calculators
Medicine 3.0Explore comprehensive evidence-based clinical protocols, testing costs, and algorithmic calculators that incorporate High-Density Lipoprotein Cholesterol (HDL-C) into overall healthspan optimization.