LDL and apoB
Two hyperalphalipoproteinemia profiles show elevated, not deficient, CETP activity, with differing atherosclerosis risk (Atherosclerosis 1998)
Original title: Characterization of two HDL subfractions and LpA-I, LpA-I:A-II distribution profiles and clinical characteristics of hyperalphalipoproteinemic subjects without cholesterol ester transfer protein deficiency
Twenty-nine hyperalphalipoproteinemic (HALP) patients with combined hypercholesterolemia were characterized for HDL2/HDL3 and LpA-I/LpA-I:A-II distribution, carotid atherosclerotic lesions by ultrasonography, and CETP activity and concentration. Twenty-two patients (profile A) had elevated HDL2/HDL3 and LpA-I/LpA-I:A-II ratios versus controls (both P<0.001) and a low lesion prevalence, while seven patients (profile B) had ratios within the normal range and a higher lesion and plaque prevalence. CETP activity and concentration were similar between profiles A and B, but both were significantly higher than in controls (348 and 371%/mL/h versus 190%/mL/h, and 2.4 and 2.5 microg/mL versus 1.8 microg/mL, all P<0.001). The authors conclude that these hyperalphalipoproteinemic profiles are not related to CETP deficiency, and that only profile A, with its distinct HDL subfraction pattern, is associated with reduced atherosclerosis risk.
Original abstract
The aims of the present study were (i) to characterize the HDL2, HDL3 and the LpA-I, LpA-I:A-II distribution, (ii) to investigate the prevalence of atherosclerotic lesions and (iii) to assess the activity of cholesteryl ester transfer protein (CETP) in 29 hyperalphalipoproteinemic (HALP) patients (HDL-C=90+/-11 mg/dl) with combined hypercholesterolemia (LDL-C=180+/-16 mg/dl). According to the HDL2/HDL3 and LpA-I/LpA-I:A-II ratios, two HALP profiles (A and B) were defined: in 22 patients (HALP profile A) these ratios were increased compared to the normolipidemic control subjects (1.19+/-0.11 versus 0.53+/-0.19, P < 0.001 and 1.01+/-0.2 versus 0.51+/-0.25, P < 0.001, respectively) and in seven patients (HALP profile B) these ratios were within the normal range (0.64+/-0.20 and 0.69+/-0.2, respectively). The atherosclerotic lesions were assessed by ultrasonography of the carotid arteries. Amongst patients with HALP profile A, 17 were free from lesions, five had intimal wall thickening and none displayed plaques, whereas for patients within the HALP profile B, only one was free from lesions, two had intimal wall thickening and four displayed plaques. CETP activities (348+/-116 versus 371+/-75%/ml/h) and CETP concentrations (2.4+/-0.5 versus 2.5+/-0.6 microg/ml) were similar in HALP profiles A and B, however these values were both higher than in control subjects (190+/-40%/ml/h, P < 0.001 and 1.8+/-0.3 microg/ml, P < 0.001, respectively). Hence the hyperalphalipoproteinemic profiles (A and B) described here were not related to CETP deficiency. In conclusion, the HALP profile A was characterized by both increased HDL2/HDL3 and LpA-I/LpA-I:A-II ratios and was associated with a low prevalence of atherosclerosis, whereas the HALP profile B, characterized by HDL2/HDL3 and LpA-I/LpA-I:A-II ratios within the normal range, was less cardioprotective.
Summary written by cetpinhibition.org from the published abstract; figures as published. Page updated 19 August 2026. Methods.