Mechanisms
In the Hoorn Study, high CETP concentration more than triples cardiovascular disease risk in women with Type 2 diabetes, with no such association in men (Diabet Med 2007)
Original title: Elevated cholesteryl ester transfer protein concentration is associated with an increased risk for cardiovascular disease in women, but not in men, with Type 2 diabetes: the Hoorn Study
The role of cholesteryl ester transfer protein (CETP) in atherogenesis remains unclear, so the authors studied the association of CETP concentration with cardiovascular disease (CVD) prevalence and carotid intima-media thickness (IMT) across normal glucose tolerance, impaired glucose tolerance, and Type 2 diabetes. Subjects (n=566) from the 2000-2001 Hoorn Study follow-up had CETP measured by immunoassay; CVD was defined by self-reported history or measured markers, and IMT by ultrasound. In men, CETP concentration was not associated with CVD regardless of glucose tolerance status. In women with normal or impaired glucose tolerance there was also no relationship, but in women with Type 2 diabetes, high CETP was associated with increased CVD risk (odds ratio 3.34 (1.56; 7.14)). No significant association was found between CETP and IMT in the whole cohort.
Original abstract
Aims: Cholesteryl ester transfer protein (CETP) exchanges neutral lipids between lipoproteins. As the role of CETP in the atherogenic process is still not fully clarified, we studied the association of CETP concentration with the prevalence of cardiovascular disease (CVD) and with intima-media thickness of the carotid artery (IMT) in subjects with normal glucose tolerance (NGT), impaird fasting glucose and/or impaired glucose tolerance (IFG/IGT) and Type 2 diabetes mellitus.
Methods: Subjects (n = 566) were recruited from the 2000-2001 follow-up examination of the Hoorn study. CETP concentration was determined by immunoassay. CVD was defined as self-reported history of arterial surgery, cerebral vascular event, amputation, angina, claudication, possible infarction, measured ankle-brachial index < 0.90 or ECG abnormalities. The right common carotid artery IMT was measured by ultrasound at 10 mm proximal to the carotid bulb.
Results: In men, CETP concentration was not associated with CVD, irrespective of glucose tolerance status. In women with NGT or IGT, there was also no relationship. However, in women with Type 2 diabetes, the risk of CVD was increased in those with high CETP concentration [odds ratio = 3.34 (1.56; 7.14)]. No statistically significant association was found between CETP concentration and IMT in the entire cohort.
Conclusions: In an elderly Caucasian population, associations of CETP concentration with CVD were dependent on glucose tolerance status and gender. The finding that high CETP concentration was strongly associated with increased prevalence of CVD in women with Type 2 diabetes warrants further investigation.
Summary written by cetpinhibition.org from the published abstract; figures as published. Page updated 19 August 2026. Methods.