Mechanisms
Egg-induced cholesterol hyperresponders show higher CETP and LCAT activity than hyporesponders (Metabolism 2004)
Original title: High intake of cholesterol results in less atherogenic low-density lipoprotein particles in men and women independent of response classification
In a randomized crossover trial, 27 premenopausal women and 25 men consumed an egg diet (640 mg/day additional dietary cholesterol) or placebo for 30 days to test effects on LDL particle atherogenicity. Sex significantly affected several parameters: LDL peak diameter was larger in women than men (P<.005), men's LDL particles carried more triglyceride and cholesteryl ester molecules (P<.01), and CETP activity was higher in women (P<.05). Regardless of sex, the less atherogenic LDL-1 subclass predominated in hyperresponders to dietary cholesterol (P<.05, interaction P<.001), and CETP and LCAT activities were higher in hyperresponders during the egg period (interaction P<.05). Because LDL peak diameter did not decrease and the larger LDL-1 subclass increased in hyperresponders after egg intake, the authors conclude a high-cholesterol diet does not worsen LDL particle atherogenicity.
Original abstract
The influence of a high-cholesterol diet on the atherogenicity of the low-density lipoprotein (LDL) particle was examined by measuring LDL peak diameter and composition, LDL susceptibility to oxidation, and the distribution of cholesterol between LDL subclasses. The crossover intervention randomly assigned 27 premenopausal women and 25 men (18 to 50 years) to an egg (640 mg/d additional dietary cholesterol) or placebo (0 mg/d additional dietary cholesterol) diet for 30 days, followed by a 3-week washout period. Subjects were classified as either hyperresponders (>2.5 mg/dL increase in plasma cholesterol for each 100 mg additional dietary cholesterol consumed) or hyporesponders to dietary cholesterol. Sex was found to have a significant effect on 3 of the parameters examined. LDL peak diameter was significantly larger (P <.005) in females (26.78 +/- 0.59 nm, n = 27) as compared with males (26.52 +/- 0.49 nm, n = 25), regardless of response to dietary cholesterol. The LDL particles of the male participants also had a higher number of triglyceride (TG) and cholesteryl ester (CE) molecules (P <.01); however, cholesterol ester transfer protein (CETP) activity was higher in females (P <.05). Response classification also revealed significant differences in the determination of LDL subclasses. Independent of sex, the LDL-1 particle (P <.05), which is considered to be less atherogenic, was predominant in hyperresponders and this finding was associated with increased cholesterol intake (interactive effect, P <.001). In addition, CETP and lecithin: cholesterol acyltransferase (LCAT) activities were higher in hyperresponders during the egg period (interactive effect, P <.05). Sex, response to cholesterol intake, and diet were not found to affect the susceptibility of LDL to oxidation (P > 0.5). Because LDL peak diameter was not decreased and the larger LDL-1 subclass was greater in hyperresponders following egg intake, these data indicate that the consumption of a high-cholesterol diet does not negatively influence the atherogenicity of the LDL particle.
Summary written by cetpinhibition.org from the published abstract; figures as published. Page updated 18 August 2026. Methods.