Resequencing finds rare CETP mutations and a common variant far more often in Thai patients with very high HDL cholesterol (Am J Cardiol 2012)

Genetic factors associated with hyperalphalipoproteinemia (HALP; or high levels of high-density lipoprotein cholesterol) are incompletely understood. The aim of this study was to resequence 3 candidate genes, CETP, LIPC, and LIPG, which encode cholesteryl ester transfer protein, hepatic lipase, and endothelial lipase, respectively, in Thai subjects with HALP and compare them to normolipidemic controls. Sequence variants of CETP, LIPC, and LIPG were identified by sequencing exons and exon-intron junctions in 64 subjects with high-density lipoprotein cholesterol levels ≥2.59 mmol/L (100 mg/dl) and compared to those of 113 normolipidemic subjects. Two heterozygous frameshift mutations in CETP (p.Leu262ProfsX31 and p.Val411ArgfsX6) and two heterozygous missense mutations in LIPC (p.Gly141Ser and p.Val173Met) were found. One deletion mutation and 3 point mutations in the CETP promoter were also identified. Collectively, these rare mutations were found only in the HALP group but not in the control group (8% vs 0%, p = 0.0056). One common variant of CETP (p.Asp459Gly) was found at a higher frequency in the HALP group (23% vs 4%, p = 0.000074). Altogether, rare variants of CETP or LIPC and/or the common CETP p.Asp459Gly variant were found in 30% of the HALP group and 4% of the controls (p = 0.0000014). No rare variant of LIPG was identified. In conclusion, common and rare genetic variants in CETP and LIPC, but not LIPG, were more commonly found in the Thai HALP group, which could potentially contribute to high high-density lipoprotein cholesterol phenotypes in this population.