Serum HDL-cholesterol Concentrations Research Articles

Apolipoprotein A-IFin. Dominantly inherited hypoalphalipoproteinemia due to a single base substitution in the apolipoprotein A-I gene.

We have identified a large kindred with severe serum HDL cholesterol deficiency. The proband, a 65-year-old woman, had greatly diminished concentrations of serum HDL cholesterol (0.19 mmol/L) and apolipoprotein (apo) A-I (21.9 mg/dL). HDL cholesterol and apo A-I levels were similarly reduced in all affected family members, while apo A-II levels were about half of those in the nonaffected family members. Pedigree analysis suggested a dominant inheritance pattern of the phenotype. Sequence analysis of the exons and exon-intron boundaries of the apo A-I gene revealed heterozygosity for a single T-to-G point mutation substituting arginine for leucine at residue 159 of the mature apo A-I protein (apo A-IFin). The T-to-G substitution destroys an Fsp I cleavage site, permitting direct polymerase chain reaction/restriction enzyme analysis of the mutation. All the affected family members were shown to be heterozygous for the apo A-IFin mutation. Isoelectric focusing revealed the presence of the mutant apo A-IFin protein in both serum and HDL of the affected subjects. Functional consequences of the mutation were examined by expressing the mutated and wild-type apo A-I cDNAs in COS-7 cells. The mutant apo A-I mRNA had a size similar to that of the normal mRNA, and both mutant and wild-type apo A-I proteins were secreted into the cell media. In vivo kinetic studies of apo A-I revealed increased catabolism in affected subjects. In conclusion, we describe a novel point mutation of the apo A-I gene, apo A-IFin, causing a dominantly negative phenotype as regards serum HDL levels, possibly due to increased catabolism of apo A-I.

The hypocholesterolemic effect of extracellular polysaccharide from the submerged fermentation of mushroom

Male Sprague-Dawley rats were fed two semisynthetic diets supplemented with 2% cholesterol and 1% β-glucan type extracellular polysaccharide isolated from two liquid cultures of straw mushroom ( Volvariella volvacea) mycelium containing different carbon sources. The experimental diets containing the two mycelial extracellular polysaccharides had induced a significant reduction in the levels of serum total cholesterol, LDL-cholesterol, and liver total cholesterol in the animals. There was no significant changes in the concentrations of serum triacylglycerol, HDL-cholesterol and liver total lipids. The fecal neutral steroid level was significantly increased while the fecal bile acid excretion was not significantly affected. Both mycelial extracellular polysaccharides exhibited hypocholesterolemic activity in rats with alimentary-induced hypercholesterolemia.

The hypocholesterolemic effect of two edible mushrooms: Auricularia auricula (tree-ear) and Tremella fuciformis (white jelly-leaf) in hypercholesterolemic rats 1

The effect of two edible mushrooms, namely Auricularia auricula (Tree-ear) and Tremella fuciformis (White jelly-leaf) of the Heterobasidiae, on serum and liver lipids, fecal neutral steroids and bile acid excretion was investigated in rats. Male Sprague-Dawley rats were fed two semisynthetic hypercholesterolemic diets (1.5% cholesterol, 5% fat) each containing 5% dried powder of the two mushrooms. After 4 wk of mushroom diet consumption, the serum total cholesterol concentration was significantly decreased in both A. auricula and T. fuciformis diet groups (17 and 19%, respectively). Similar significant decrease in serum LDL cholesterol level was observed (24 and 31%, respectively). There was no significant difference found in serum HDL cholesterol concentration and the amount of liver total cholesterol and total lipids among the two mushroom diet groups and the control group. Only animals fed T. fuciformis diet had a significant decrease in serum triacylglycerol level. Animals fed A. auricula diet had a significant increase in the levels of fecal neutral steriods and bile acids by 39 and 46%, respectively. T. fuciformis diet also increased significantly the fecal excretion of neutral steroids and bile acids in rats by 51 and 36%, respectively. In the present study, both mushrooms had effective hypocholesterolemic activity in rats.

Effects of postmenopausal estrogen/progestin replacement therapy on LDL particles; comparison of transdermal and oral treatment regimens

The aim of the study was to compare the effects of continuous oral estrogen/progestin therapy to the effects of transdermal estrogen therapy combined with cyclic oral progestin on the properties of LDL particles. Eighty postmenopausal women were randomly allocated to receive either oral (continuous 17-beta-estradiol 2 mg and norethisterone acetate 1 mg per day, E2/NETA) or transdermal therapy (patches delivering continuous 17-beta-estradiol, E2, 0.05 mg/day with sequential oral medroxyprogesterone acetate, MPA, 10 mg/day for 12 days/cycle). The groups had similar mean values and ranges of age, BMI and postmenopausal status. The blood samples were taken at baseline, and twice at 1 year before and after MPA administration. LDL particle size distribution was determined by gradient gel electrophoresis and LDL was isolated by sequential ultracentrifugation for compositional analyses. Concentrations of total LDL mass, LDL cholesterol and LDL protein decreased in the oral treatment group ( p < 0.01, p < 0.001 and p < 0.01, respectively), whereas they remained unchanged during the transdermal therapy. Particle size of the major LDL peak remained unchanged during both transdermal and oral therapies. HDL cholesterol concentration decreased significantly in both treatment groups ( p < 0.001 for both). Serum triglyceride and HDL cholesterol concentrations were the strongest determinants of LDL particle size ( r = − 0.50 and r = 0.54, respectively, p < 0.001 for both). The cholesteryl esters and free cholesterol content of the LDL particles decreased in the oral treatment group ( p < 0.05). Phospholipid content of LDL increased in both groups receiving either oral or transdermal therapy ( p < 0.01 for both). In conclusion, oral administration of 17-beta-estradiol and norethisterone acetate caused a decrease in LDL mass by decreasing the number and cholesterol content of LDL particles. The concomitant decrease of HDL cholesterol by progestins may partly negate this beneficial effect of LDL lowering.

Dietary fibres reduce blood pressure, serum total cholesterol and platelet aggregation in rats.

The effects of dietary fat and dietary fibres on blood pressure, serum lipids and platelet aggregation in spontaneously hypertensive and Wistar-Kyoto rats have been investigated. The systolic and diastolic blood pressure values were increased with increasing amounts of dietary fat and normalized by dietary fibre supplementation. The greatest reduction in blood pressure was obtained by a combination of reduced dietary fat and supplementary dietary fibre. Addition of dietary fibre when the amount of dietary fat was high or reduction of dietary fat when the amount of dietary fibre was low gave a smaller effect. In both rat strains the decreases in systolic and diastolic blood pressure values after reducing dietary fat and/or increasing dietary fibre were about 10-15 mmHg. Serum total cholesterol and serum HDL-cholesterol concentrations were reduced by reduction of dietary fat or a combination of dietary fat reduction and dietary fibre addition. A combination of dietary fat reduction and dietary fibre addition was the most effective dietary change for reducing serum triacylglycerol concentration and platelet aggregation. The present study demonstrates that in this experimental model it is possible to reduce risk indicators of coronary heart disease significantly by changing dietary habits.

Magnetic Resonance Imaging–Assessed Adipose Tissue and Serum Lipid and Insulin Concentrations in Growth Hormone–Deficient Adults

The visceral and subcutaneous abdominal adipose tissue (AT) areas and the subcutaneous hip AT area were assessed by magnetic resonance imaging (MRI) in relation to serum lipid and plasma insulin levels in 12 growth hormone-deficient (GHD) adults before and after 6 months of replacement therapy with recombinant human growth hormone (rhGH) and in 12 healthy control subjects. Compared with control subjects, GHD patients had a significantly increased amount of visceral AT, which was inversely related with plasma HDL cholesterol and positively correlated with plasma triglyceride levels. Visceral AT was not associated with plasma total and LDL cholesterol or plasma insulin concentrations. GHD patients also had elevated serum total cholesterol, LDL cholesterol, and triglyceride levels compared with control subjects. After 6 months of rhGH replacement therapy the mean visceral, subcutaneous abdominal, and subcutaneous hip AT areas and serum concentration of total cholesterol decreased significantly, whereas serum HDL cholesterol concentration increased significantly. No significant correlations were found between changes in the amount of AT and changes in serum lipid and plasma insulin levels.

Dietary fat and vitamin E have differential effects on serum lipid levels

The experiment was designed to study the effects of dietary fat and vitamin E on serum lipid status, an important indicator of risk for atherosclerosis. The influences of dietary fat and d,1-α-tocopheryl acetate (vitamin E) on serum fatty acid profiles, total cholesterol, HDL-cholesterol, LDL-cholesterol and triglyceride concentrations were studied in 40 weanling male Sprague-Dawley rats. Rats were fed semipurified diets containing corn oil or lard and graded levels (0, 100, 5000 or 15000 ppm) of vitamin E for 8 weeks. Serum vitamin E level was significantly greater in the corn oil group with 100 ppm vitamin E than in the lard group with 100 ppm vitamin E (p<0.05). Lipid status was verified by serum fatty acid profiles. Serum C18:0 (stearic acid) and C18:1 n-9 (oleic acid) of rats were significantly greater in the lard groups than in the corn oil groups with an equal amount of vitamin E except with the 100 ppm vitamin E, serum C18:2 n-6 (linoleic acid) of rats was significantly greater in the corn oil groups than in the lard groups with an equal amount of vitamin E, and C20:4 n-6 (arachidonic acid) of rats was significantly greater in the corn oil group with 15000 ppm vitamin E than in the lard group with 15000 ppm vitamin E (p<0.05). Rats fed corn oil had significantly greater serum HDL-cholesterol than rats fed lard with 100 or 15000 ppm vitamin E (p<0.05). However, serum LDL-cholesterol level was significantly greater in the rats fed corn oil with 100 ppm vitamin E compared with that in the rats fed lard with 100 ppm vitamin E (p<0.05). Both dietary fat and vitamin E had effects on serum HDL-cholesterol, however, no interaction existed between dietary fat and vitamin E on serum HDL-cholesterol. With regard to serum LDL-cholesterol, only vitamin E had a significant effect. The results suggested that both dietary fat and vitamin E can influence atherosclerosis progression via their effects on serum lipid status, but no interaction between them on serum lipid status was found.

Magnesium status, serum HDL cholesterol, and apolipoprotein A-1 levels.

To determine the relationship between low magnesium status and lipids, we divided 27 patients with microscopic hematuria and normal renal function into two groups according to magnesium retention, as measured by a magnesium-loading test, and compared their serum lipid and apolipoproteins. Patients with low magnesium status (n = 7) had significantly lower levels of cholesterol, HDL cholesterol, and apolipoprotein A-1 than those with normal magnesium status (n = 20); however, there were no significant differences between the groups in serum concentrations of magnesium and apolipoprotein B. These data suggest that magnesium deficiencies are associated with low serum concentration of HDL cholesterol and apolipoprotein A-1.

Magnesium Status, Serum HDL Cholesterol, and Apolipoprotein A‐1 Levels

SummaryTo determine the relationship between low magnesium status and lipids, we divided 27 patients with microscopic hematuria and normal renal function into two groups according to magnesium retention, as measured by a magnesium‐loading test, and compared their serum lipid and apolipoproteins. Patients with low magnesium status (n = 7) had significantly lower levels of cholesterol, HDL cholesterol, and apolipoprotein A‐1 than those with normal magnesium status (n = 20); however, there were no significant differences between the groups in serum concentrations of magnesium and apolipoprotein B. These data suggest that magnesium deficiencies are associated with low serum concentration of HDL cholesterol and apolipoprotein A‐1.

Severity of Coronary Atherosclerosis in Relation to Hypertension and Dyslipidemia

The association of the severity of coronary atherosclerosis with hypertension and dyslipidemia, independent of other known coronary risk factors, was examined in 313 men and 155 women who underwent coronary angiography. The severity of coronary atherosclerosis was quantified using Gensini's scoring system. The following criteria were used to define dyslipidemia : hypercholesterolemia (total serum cholesterol concentration ≥220 mg/dl), hypertriglyceridemia (serum triglyceride concentration ≥150 mg/dl), and low HDL-cholesterolemia (serum HDL-cholesterol concentration<40 mg/dl). In men, age, total cholesterol, fasting blood sugar, uric acid, and plasma fibrinogen levels were significantly higher inpatients with coronary atherosclerosis than in those without. Significantly higher frequency of hypertension and lower levels of HDL-cholesterol were also found in male patients with coronary atherosclerosis. In women, age, total cholesterol, fasting blood sugar, and plasma fibrinogen levels were significantly higher in patients with coronary atherosclerosis than in those without. No significant interaction between hypertension and each dyslipidemia was found after adjustment for the other coronary risk factors ; only hypercholesterlemia in men was significantly associated with coronary atherosclerosis. However, the degree of coronary atherosclerosis was most severe among patients with both hypertension and hypercholesterolemia in both sexes. The combination of hypertension and hypercholesterolemia seems to be important in the progression of coronary atherosclerosis. J Epidemiol, 1995; 5 : 17-22.

Association of hyperinsulinemia and serum free fatty acids with serum high density lipoprotein-cholesterol.

A total of 155 Japanese subjects (79 men and 76 women) who were classified as having normal or borderline glucose tolerance, according to the criteria for the 50-g oral glucose tolerance test (GTT) of the Japanese Diabetes Society, were analyzed for factors related to serum high density lipoprotein (HDL)-cholesterol concentration, especially the responses of insulin and free fatty acid (FFA) after a glucose challenge. In men, significant negative univariate correlations were observed with body mass index (P < 0.01), the summed values of triceps and subscapular skin-folds (P < 0.01), serum insulin concentration at all time intervals, and serum FFA at 30 and 60 min of GTT. Serum insulin at 60, 120, and 180 min, sum insulin, and FFA at 30 and 60 min of GTT were significantly related to serum HDL-cholesterol after adjustment for body mass index and triglyceride concentration. Multiple linear regression analysis with the step-forward method showed that sum insulin (P < 0.01), FFA at 60 min of GTT (P < 0.001), and alcohol consumption (P < 0.01) were independently related to serum HDL-cholesterol concentration. Only the triglyceride concentration was inversely correlated (P < 0.05) with HDL-cholesterol concentration in women. These data indicate that both insulin and FFA concentration, as markers of insulin resistance, apparently influence on HDL kinetics in men, but not in women. The lack of this association in women was appeared to related to the degree of obesity.

Atherosclerotic risk factors are increased in clinically healthy subjects with microalbuminuria

Increased morbidity and mortality from atherosclerotic vascular disease were observed in subjects with slightly elevated urinary albumin excretion rate (UAER), known as microalbuminuria. Therefore, the association between microalbuminuria and established atherogenic risk factors was studied in clinically healthy subjects. All healthy 40–65 year-old participants with microalbuminuria, examined within the first 21 months of The Copenhagen City Heart Study, were invited, and 28 were studied. An age- and sex-matched group of 60 randomly chosen subjects with normoalbuminuria served as control. Microalbuminuria was defined as a UAER of 6.6–150 μg/min, and normoalbuminuria as a UAER ≤6.6 μg/min. In the microalbuminuric group, systolic and diastolic blood pressures were both elevated (mean (95% C.I.) 128 (123–134) vs. 119 (116–122) mmHg; P = 0.005, and 75 (71–78) vs. 69 (67–71) mmHg; P = 0.008, respectively), and serum apolipoprotein (apo) A-1 concentration was lower (1.30 (1.20–1.37) vs. 1.42 (1.36–1.47) g/l; P = 0.02) in comparison with the normoalbuminuric group. Furthermore, serum HDL-cholesterol concentration tended to be lower, whereas body weight, body mass index and fasting serum insulin concentration were slightly elevated in the microalbuminuric group but not statistically significant. It is concluded that microalbuminuria in clinically healthy subjects is associated with increased levels of atherogenic risk factors. This may contribute to the increased vascular morbidity and mortality observed in these individuals.

Quantitative trait locus analysis of susceptibility to diet-induced atherosclerosis in recombinant inbred mice

Quantitative trait locus (QTL) analysis is a statistical method that can be applied to identify loci making a significant impact on a phenotype. For the phenotype of susceptibility to diet-induced atherosclerosis in the mouse, we have studied four quantitative traits: area of aortic fatty streaks and serum concentrations of high-density lipoprotein-bound cholesterol (HDL-cholesterol), apolipoprotein A-I, and apolipoprotein A-II (apo A-II). QTL analysis revealed a significant locus on chromosome 1 distal impacting serum apo A-II concentration on a high-fat diet and serum HDL-cholesterol concentration on a chow diet. This locus is presumably Apoa-2, the structural gene for apo A-II. QTL analysis of aortic fatty streaks failed to reveal a significant locus.

Effects of Dietary Nasunin on the Serum Cholesterol Level in Rats

The effects of nasunin, a major anthocyanin in eggplant, and its aglycone, delphinidin, on the serum cholesterol conpentration were determined in rats fed with a cholesterol-enriched diet. The serum total cholesterol and HDL-cholesterol concentrations tended to be decreased and increased, respectively, by feeding nasunin and delphinidin, while the fecal excretion of both cholesterol and bile acids tended to be increased by feeding with the anthocyanins. There was no difference between the nasunin and delphinidin activity to decrease serum total cholesterol, nor to increase serum HDL-cholesterol or the fecal excretion of cholesterol and bile acids. These results suggest that the slightly lower serum total cholesterol concentration in rats fed with nasunin and delphinidin may in part be due to inhibition of the intestinal absorption of both cholesterol and bile acids by these anthocyanins, and that the delphinidin moiety of nasunin mainly contributes to this activity.

Low-Dose Simvastatin Is a Well-Tolerated and Efficacious Cholesterol-Lowering Agent in Ciclosporin-Treated Kidney Transplant Recipients: Double-Blind, Randomized, Placebo-Controlled Study in 40 Patients

The high prevalence of hypercholesterolemia in kidney transplant recipients probably contributes to the high cardiovascular mortality in these patients. Except for diet, there is no generally recommended cholesterol-lowering treatment. We conducted a double-blind, randomized, placebo-controlled study with low-dose simvastatin in 40 ciclosporin (CS)-treated kidney transplant recipients during 16 weeks, focusing on side effects and dose finding. In the simvastatin group, the mean serum total and LDL cholesterol concentrations decreased by 23 and 33%, respectively, and the mean serum HDL cholesterol concentration increased by 12%, after 4 weeks of treatment with simvastatin 10 mg daily. Increasing the dose to 20 mg daily in a few patients only resulted in marginal further reductions of the serum cholesterol concentrations at the expense of doubling the plasma simvastatin 3-hydroxy-3-methylglutaryl-coenzyme A reductase inhibitory activity concentrations. The differences between the changes in the serum cholesterol concentrations in the simvastatin group and the negligible changes in the placebo group were statistically significant. There was no case of proximal myopathy and the serum creatine kinase concentrations did not differ between treatment groups. In conclusion, low-dose simvastatin appears to be a well tolerated and efficacious cholesterol-lowering treatment in CS-treated kidney transplant recipients. Simvastatin 10 mg daily seems to be the most suitable dose for the majority of these patients.

Eggs without significant effect on human serum cholesterol concentrations

Food labeling guidelines have now extended the National Cholesterol Education Program recommendations for limiting dietary fat and cholesterol to the general U.S. population more than 2 years of age. In addition to limiting total fat to 30% of energy intake and saturated fat to 10% of energy intake, cholesterol is limited to 300 mg/day. Thus menus of schools, hospitals, and long-term care facilities typically provide clients fewer than 4 egg yolks per week, despite the high quality protein and nutrient density of whole eggs. This study was designed to determine if there were significant adverse effects on serum cholesterol of including 12 modified eggs per week in a low-fat diet of free-living adults with inital serum total cholesterol concentrations of 5.17–7.76 mmol/l (200–300 mg/dl). Hens fed a controlled ration produced modified eggs that consistently contained significantly more vitamin E and iodine than generic eggs, with the same amount of fat and cholesterol. Subjects were randomly assigned to and then counseled in a low-fat diet including either no whole eggs (N=49, 32 women) or 12 whole modified eggs (N=47, 29 women) a week for 6 weeks. Both groups reduced their serum total, LDL, and HDL cholesterol concentrations, and there were no significant differences between the group means of these variables at any study time point. The study had statistical power sufficient to detect the expected differences. We conclude that 12 modified eggs per week, consumed as part of a low-fat diet for 6 weeks, did not adversely affect serum cholesterol levels of free-living, middle aged hypercholesterolemic individuals. Such eggs may provide increased flexibility for planning menus in institutional settings.

Effects of lovastatin on high-density lipoprotein subfractions in hypercholesterolemic patients with peripheral vascular disease.

The effects of lovastatin treatment on high-density lipoprotein subfractions (HDL2 and HLD3) were investigated in 34 patients with severe peripheral vascular disease and type IIa or type IIb hyperlipoproteinemia by use of a density gradient ultracentrifugation method. Lovastatin therapy caused greater percentage changes in HDL2 than in HDL3. In HDL2 the increases of cholesterol, total lipid, apolipoprotein AI (apoAI) and apolipoprotein AII (apoAII) concentrations were 23% (p < 0.05), 28% (p < 0.01), 24% (p < 0.01) and 11% (p < 0.01), respectively, in subjects with the type IIa phenotype. In patients with the type IIb phenotype the corresponding increases were 42% (p < 0.01), 44% (p < 0.01), 38% (p < 0.01) and 21% (p < 0.05), respectively. The apoAI/apoAII weight ratio in HDL2 rose by 11% and by 13% in type IIa and type IIb patients, respectively. The present results suggest that during lovastatin treatment the slight increase in serum HDL-cholesterol concentration was due, not to cholesterol enrichment by high-density lipoproteins, but more probably to an increase of the number of HDL particles. The observed changes were more pronounced in type IIb than in type IIa patients.

Modification of Plasma and Hepatic Lipids of Guinea Pigs by Feeding High Oleic Acid Pork Compared with Regular Pork

Meat from such monogastric animals as swine can be modified to substitute monounsaturated fatty acids for saturated fatty acids. Because monounsaturated fatty acids have a beneficial effect on serum lipids as compared with saturated fatty acids, the objective of this study was to assess the effect of modified pork as compared with regular pork on serum and hepatic lipids. Guinea pigs were fed diets containing pork from control diet-fed hogs or from hogs fed a diet containing high oleic acid sunflower oil. The pork provided almost all of the fat in the diets at the level of 4 and 15 g/100 g diet, 10 or 34% energy. The high oleic pork muscle and fat contained 26 and 46% less palmitic and stearic acids (the primary saturated fatty acids), respectively, and 31 and 29% more oleic acid (the primary monounsaturated fatty acid) than the regular pork muscle and fat, respectively. Cholesterol concentration of diets ranged from 0.06 to 0.08% of the diet. Although total serum cholesterol, HDL cholesterol and triglyceride concentrations did not differ due to type of pork, results indicated that serum LDL cholesterol was lower (15%) and hepatic cholesterol was greater (15%) in the high oleic pork, 15% fat group as compared with the control pork 15% fat group. Also, serum LDL cholesterol concentration was higher in the groups fed 15% fat compared with those fed 4% fat. In this study pork modified to have more oleic acid and less saturated fatty acids had a positive effect on tissue lipids when fed to animals.

Dietary β-Carotene Reduces Serum Lipid Concentrations in Spontaneously Hypertensive Rats Fed a Vitamin A-Fortified and Cholesterol-Enriched Diet

The effects of dietary β-carotene on serum lipid concentrations were examined in spontaneously hypertensive (SH) rats. Groups of SH rats were fed a semipurified, vitamin A-fortified and cholesterol-enriched diet supplemented with 0, 125, 250 or 500 mg β-carotene/kg diet for a period of 44 d. β-Carotene supplementation resulted in significant dose-related decreases in serum total, LDL and HDL cholesterol concentrations and serum total, VLDL and LDL triacylglycerol concentrations. The ratio of HDL cholesterol to total cholesterol was unchanged or slightly increased by dietary β-carotene. The study suggests that dietary β-carotene has antihyperlipidemic effects in SH rats. The effects in humans and the mechanism of the effects remain to be investigated.

Liver transplantation restores low serum levels of very low density and high density lipoproteins in end-stage primary biliary cirrhosis.

Amounts of serum lipids were determined in 10 women suffering from end-stage primary biliary cirrhosis (PBC) in order to evaluate the concentrations of and changes in very low density (VLDL), high density (HDL) lipoprotein cholesterol and apoprotein A-I before and after liver transplantation. The concentrations of some preoperative serum total lipids, especially HDL cholesterol and VLDL triglyceride, and apoprotein A-I, were significantly lower, but those of serum total triglycerides and cholestanol (a metabolite of cholesterol) were higher in the PBC patients than in 12 controls matched for age, sex, and body mass index. The relation between the serum concentrations of HDL cholesterol and cholestanol was markedly different before transplantation in the PBC group and in the control group. Liver transplantation was followed by a significant and rapid increase in serum apoprotein A-I and HDL cholesterol concentrations, which were affected by CMV and Klebsiella infections and acute rejections and immunosuppressive treatments. As a result the patients serum values did not quite return to normal during the three month follow up. The concentrations of serum VLDL cholesterol, triglycerides and cholestanol returned to normal during the follow up, and the changes in cholestanol were inversely related to the increases in amounts of HDL cholesterol. Thus, the restoration of low HDL concentrations after liver transplantation suggests that the liver plays a key role in HDL metabolism and indicates that concentrations of serum HDL cholesterol may be useful in monitoring the recovery of liver function.