Mechanisms
CETP activity peaks in the second trimester of pregnancy and tracks HDL-triglyceride accumulation (Clin Biochem 1994)
Original title: Changes in cholesteryl ester transfer protein activity during normal gestation and postpartum
CETP activity was measured in the plasma fraction of density greater than 1.21 kg/L from healthy women across gestation, postpartum, and matched controls. Activity was highest in the second trimester, significantly different from controls only at that timepoint, declined by the third trimester, and was lowest postpartum, a pattern distinct from circulating lipoproteins: VLDL lipids rose progressively through the third trimester before falling postpartum, LDL cholesterol rose during gestation and stayed elevated postpartum, HDL cholesterol and apolipoprotein A-I peaked in the second trimester and remained elevated in the third, and HDL triglyceride rose markedly from the first to second trimester before declining postpartum. Across all pregnant-women samples, CETP activity correlated significantly with HDL triglyceride levels and tracked the HDL-triglyceride-to-VLDL-triglyceride ratio through gestation and postpartum, suggesting CETP contributes to the triglyceride enrichment of HDL that begins in the second trimester of human pregnancy.
Original abstract
Cholesteryl ester transfer protein (CETP) activity was measured in a d > 1.21 kg/L plasma fraction collected from healthy women at different times during gestation, postpartum, and in control women. CETP activity was highest in the second trimester of gestation, declined at the third trimester, and was lowest at postpartum. Only the value at the second trimester was significantly different from that of control women. This trend differed from that of circulating lipoproteins: very low-density lipoprotein (VLDL)-lipids, including triglycerides and cholesterol, increased progressively from the first to the third trimester, and then declined at postpartum. Low-density lipoprotein (LDL)-cholesterol levels, like VLDL levels, rose during gestation but then remained elevated at postpartum. High-density lipoprotein (HDL)-cholesterol as well as HDL-phospholipids and apolipoprotein A-I, peaked in the second trimester, remaining elevated in the third trimester and then fell at postpartum. Finally, HDL-triglyceride increased markedly from the first to the second trimester, rose somewhat higher during the third trimester, and declined at postpartum. When all the samples from pregnant women were considered together, CETP activity correlated significantly with HDL-triglyceride levels and the changes in CETP activity during gestation and postpartum paralleled those of the HDL-triglyceride/VLDL-triglyceride ratio. These results suggest that CETP contributes to the exaggerated accumulation of triglycerides in HDL that begins in the second trimester of human gestation.
Summary written by cetpinhibition.org from the published abstract; figures as published. Page updated 18 August 2026. Methods.