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University of Kentucky biochemist Eric J. Smart thinks for diabetics, having high level of high-density lipoprotein - commonly known as good cholesterol - could be too much of a good thing.

Smart, who led a team doing research on high-density lipoprotein, said having high levels of it in the bloodstream might increase the risk of cardiovascular disease.

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"In fact, it appears that for a person with diabetes, having high levels of HDL could be counterproductive," Smart said. "It was an outcome that we completely didn't expect. But I think it's really profound, because it says that HDL doesn't always have to be good for you."

That seems to fly in the face of more than 20 years of medical wisdom, which has held generally that HDL helps protect us from heart problems.

Reams of medical advice have been written, diets have been devised, and drugs have been developed around the proposition that high levels of "good" HDL are desirable, and that levels of "bad" LDL, or low density lipoprotein, should be kept low.

The University of Kentucky research, reported recently in the American Journal of Physiology, suggests that scientists have more work to do on HDL.

Despite his findings, Smart said, people should not try to lower their HDL levels. Smart directs the Kentucky Pediatric Research Institute and holds the Barnstable-Brown endowed chair for diabetes research at the University of Kentucky.

Smart and his team made their discovery while researching HDL and diabetes over the past year. They found that in people with diabetes, HDL molecules bind with a natural compound called myristic acid, which causes the HDL to inhibit the body's natural production of nitric oxide, a substance known to protect against cardiovascular disease.

Myristic acid is a long-chain fatty acid suspected of increasing cardiovascular risk, Smart said. Smart's team reported that the effect was seen in both men and women with diabetes. In effect, HDL in diabetics may reverse its usual role, becoming a potential threat rather than a protector, the study indicates.

Is Too Much Good Cholesterol, Bad?
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