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Article History

Received: 2 March 2026

Accepted: 17 April 2026

First Online: 25 April 2026

Declarations

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: The corresponding author affirms that this manuscript is a honest, accurate, and transparent account of the study being reported; that no important aspects of the study have been omitted; and that any discrepancies from the study as planned (and, if relevant, registered) have been explained. All authors have read and approved the final version of the manuscript and takes complete responsibility for the integrity of the data presented. 

: This article was conducted as a narrative review aimed at foundational concepts and recent advances related to HDL function, particle size and its cardiometabolic implications. A narrative review approach was selected to allow an integrative and interpretive discussion of mechanistic, clinical and translational evidence in a conceptually heterogeneous and rapidly evolving field. A comprehensive literature search was performed using PubMed, Scopus, Google Scholar databases. Inclusion criteria comprised peer reviewed original research articles, revies and clinical studies that addressed HDL biology, functionality and particle heterogeneity. Both experimental and clinical studies were considered to provide a comprehensive overview. Exclusion criteria included conference abstracts, non-peer reviewed articles, case reports and articles not directly relevant to the objectives of this review. The selected literature was synthesised thematically and emphasis was placed on integrating mechanistic insights with clinical findings to highlight emerging perspectives on HDL functionality beyond traditional HDL cholesterol measurements. 

: The authors declare no competing interests.