Letters Section Editor: Robert M. Golub, MD, Senior Editor.
In Reply: Dr Kim distinguishes the effects of saturated fatty acids and trans-fatty acids on lipoproteins. However, reports of the effect of trans-fatty acids on HDL-C have been variable, with a large meta-analysis finding a statistically nonsignificant effect on HDL-C.1 In addition to increasing levels of LDL-C, trans-fatty acids promote vascular inflammation and endothelial dysfunction and reduce paraoxonase activity.2 These lipid and biochemical effects act synergistically to increase cardiovascular disease risk.2
Singh IM, Shishehbor MH, Ansell BJ. High-Density Lipoprotein and Dietary Fatty Acids—Reply. JAMA. 2007;298(19):2263-2264. doi:10.1001/jama.298.19.2264