HDL biology
Plasma cholesteryl ester transfer activity, not CETP mass, predicts incident cardiovascular disease in a nested case-control study (Atherosclerosis 2011)
Original title: High plasma cholesteryl ester transfer but not CETP mass predicts incident cardiovascular disease: a nested case-control study
In a prospective nested case-control study of 114 men who developed cardiovascular disease (CVD) and 105 controls, none using lipid-lowering drugs at baseline, plasma cholesteryl ester transfer (CET) activity was 19% higher in cases than controls (P=0.030), while CETP mass did not differ (P=0.30). Plasma CET independently predicted incident CVD (age-adjusted hazard ratio 1.20, 95% CI 1.02 to 1.46, P=0.028), remaining significant after adjusting for total cholesterol/HDL cholesterol ratio, triglycerides, and non-lipid risk markers (HR 1.22, P=0.031), whereas CETP mass showed no association with incident CVD (HR 0.88, 95% CI 0.73 to 1.07, P=0.20). The authors conclude functional cholesteryl ester transfer, rather than the amount of CETP protein present, better determines cardiovascular risk.
Original abstract
Objective: The relationship of cardiovascular disease (CVD) with plasma cholesteryl ester transfer protein (CETP) levels is controversial. We determined whether plasma cholesteryl ester transfer (CET), reflecting CETP-mediated transfer of cholesteryl esters from endogenous HDL towards apolipoprotein B-lipoproteins, predicts incident CVD.
Methods: A prospective nested case-control study was carried out in 114 men who developed CVD and 105 controls. Participants did not use lipid lowering drugs at baseline. Plasma CET was assayed using an isotope method.
Results: Plasma CET was 19% higher (P=0.030), whereas CETP mass was unaltered (P=0.30) in cases vs. controls. Plasma CET predicted CVD (age-adjusted hazard ratio (HR): 1.20 (95% CI 1.02-1.46, P=0.028), but incident CVD was unrelated to CETP mass (HR: 0.88 (95% CI 0.73-1.07), P=0.20). Plasma CET still predicted CVD after additional adjustment for total cholesterol/HDL cholesterol, triglycerides and non-lipid risk markers (HR: 1.22 (95% CI 1.02-1.46, P=0.031).
Conclusion: Plasma CET rather than CETP mass may be a determinant of cardiovascular risk.
Summary written by cetpinhibition.org from the published abstract; figures as published. Page updated 19 August 2026. Methods.