In vitro oxidation of high-density lipoprotein (HDL) diminishes its capacity to mediate cholesterol efflux from J774 macrophages. To investigate the possible role of HDL glycation in the increased atherosclerotic risk in diabetes, we studied the effects of in vitro glycation of HDL on its susceptibility to oxidation and capacity to mediate cholesterol efflux. HDL isolated from normal volunteers was incubated with 25 mmol/L glucose for 70 hours, resulting in 6.1% additional derivatization of apoproteins as determined by trinitrobenzene sulfonic acid (TNBS) reactivity. Unmodified HDL and glycated HDL (glyHDL) were tested for susceptibility to oxidation by incubation with various concentrations of copper and three assays of lipid oxidation. GlyHDL produced 51% to 64% less lipid peroxide than HDL as determined by reaction with xylenol orange (P < .02), indicating decreased susceptibility to oxidation. However, glycation of HDL did not result in significant changes in the formation of conjugated dienes or thiobarbituric acid-reactive substances (TBARS), two other indices of oxidation. To study cholesterol efflux, J774 macrophages were labeled with 3H-cholesterol followed by incubation with the various HDL preparations. HDL and glyHDL had a similar capacity to mediate efflux. The efflux mediated by oxidized HDL (oxHDL) and oxidized glyHDL was reduced to a similar extent compared with the efflux mediated by HDL and glyHDL. These data indicate that in vitro glycation of HDL does not increase its susceptibility to oxidation and does not diminish its capacity to mediate cholesterol efflux.