Liver damage and protective effect of high density lipoprotein cholesterol.

Prospective population studies have shown that a raised concentration of high density lipoprotein (HDL) cholesterol is associated with a reduced incidence of coronary events and atherosclerotic progression. 2 According to one paradigm any raised concentration of HDL cholesterol is beneficial to health. This is, however, challenged by two unexplained observations. Firstly, in populations with heavy alcohol intake a high concentration of HDL cholesterol is not associated with reduced coronary and total mortality. Secondly, in such populations a high concentration of HDL cholesterol is not associated with effective reverse cholesterol transport. Alcohol raises concentrations of both HDL cholesterol and liver transaminase.