LDL and apoB
Reducing proteinuria lowers LDL cholesterol together with plasma CETP mass, but also lowers HDL cholesterol (Expert Opin Ther Targets 2009)
Original title: Antiproteinuric therapy decreases LDL-cholesterol as well as HDL-cholesterol in non-diabetic proteinuric patients: relationships with cholesteryl ester transfer protein mass and adiponectin
In thirty-two non-diabetic proteinuric patients (12 on statin therapy) followed through two double-blind six-week periods of placebo and antiproteinuric treatment (low sodium plus 100mg losartan plus 25 mg hydrochlorothiazide), HDL-cholesterol was lower on placebo than in matched controls while LDL-cholesterol and CETP mass were not different. Antiproteinuric treatment reduced LDL-cholesterol, HDL-cholesterol, and CETP mass together; the fall in LDL-cholesterol correlated with the drop in CETP mass and with the degree of proteinuria reduction, while the fall in HDL-cholesterol was proportional to proteinuria lowering and correlated with changes in adiponectin. LDL-cholesterol lowering from robust proteinuria reduction may thus be mediated partly through plasma CETP mass, though the same treatment adversely lowers HDL-cholesterol.
Original abstract
Objective: Dyslipidemia contributes to increased cardiovascular risk in nephrotic syndrome. We questioned whether reduction in proteinuria not only lowers low-density lipoprotein cholesterol (LDL-C), but also high-density lipoprotein cholesterol (HDL-C) and cholesteryl ester transfer protein (CETP) mass and whether changes in HDL-C were related to changes in plasma adiponectin.
Methods: Thirty-two non-diabetic proteinuric patients (12 on statin therapy), were followed during two double blind 6-week periods of placebo and treatment (low sodium + 100mg losartan + 25 mg hydrochlorothiazide).
Results: With placebo HDL-C was lower but LDL-C and CETP were not different in proteinuric patients compared with matched controls. LDL-C, HDL-C and CETP decreased upon proteinuria reduction. The decrease in LDL-C correlated with the drop in CETP and the degree of proteinuria reduction. HDL-C also decreased in proportion to proteinuria lowering. Individual changes in HDL-C were correlated with changes in adiponectin.
Conclusion: LDL-C lowering upon robust reduction of proteinuria may be affected by changes in plasma CETP mass, but this treatment also decreases HDL-C in relation to the degree of proteinuria reduction. This adverse effect on HDL-C may in part be attributable to changes in adiponectin.
Summary written by cetpinhibition.org from the published abstract; figures as published. Page updated 19 August 2026. Methods.