HDL biology
Very low plasma CETP is linked to impaired HDL cholesterol efflux in the LURIC cohort (Eur J Clin Invest 2014)
Original title: Decreased cholesterol efflux capacity in patients with low cholesteryl ester transfer protein plasma levels
Since low endogenous CETP has previously been linked to increased mortality in coronary artery disease patients, researchers tested whether low plasma CETP also relates to impaired HDL function. In 154 patients from the LURIC study, 77 with extremely low plasma CETP (below 0·68 micrograms per mL) and 77 with high CETP (above 2·13 micrograms per mL), serum HDL cholesterol efflux capacity from cholesterol-laden macrophages was measured. High-CETP patients showed significantly higher efflux capacity than low-CETP patients (plus 5·4 percent, P = 0·015), an effect independent of classical risk and lifestyle factors and of HDL, LDL, and triglyceride levels. The findings suggest low plasma CETP impairs HDL function within reverse cholesterol transport, pointing to an atheroprotective role for CETP in high-risk coronary artery disease patients.
Original abstract
Background: Cholesteryl ester transfer protein (CETP) has been considered as a possible target for treatment of cardiovascular disease. However, first clinical studies employing CETP inhibitors have failed to demonstrate clinical benefit. Additionally, we have previously shown that low endogenous plasma levels of CETP are associated with increased mortality in coronary artery disease (CAD) patients. We hypothesized that low CETP plasma levels are associated with decreased high-density lipoprotein (HDL) function.
Materials And Methods: Serum HDL efflux capacity was measured in 154 patients of the Ludwigshafen Risk and Cardiovascular Health (LURIC) study displaying extremely low (< 0·68 μg/mL, n = 77) or high (> 2·13 μg/mL, n = 77) CETP concentrations in their plasma, respectively. The LURIC study is a prospective observational study of patients referred to coronary angiography at baseline with a median follow-up time of 7·75 years. Primary and secondary endpoints were cardiovascular and all-cause mortality, respectively.
Results: High CETP patients showed a significant increase in the capacity of their plasma to mediate cholesterol efflux from cholesterol laden macrophages when compared to the efflux capacity observed in low CETP patients (+ 5·4%, P = 0·015). As shown by multiregression analysis, the impact of CETP on cholesterol efflux capacity was independent from classical risk and lifestyle factors, as well as from lipid parameters including HDL cholesterol, LDL cholesterol and triglycerides.
Conclusions: Our findings indicate that low plasma concentrations of CETP might indeed lead to impaired HDL function within the reverse cholesterol transport pointing towards an atheroprotective role of CETP at least in patients with high risk of CAD.
Summary written by cetpinhibition.org from the published abstract; figures as published. Page updated 19 August 2026. Methods.