Mechanisms
Across 6,606 adults and multiple imaging-based fat measures, no association is found between body fat and serum CETP, challenging the adipose-tissue-as-CETP-source hypothesis (Atherosclerosis 2016)
Original title: Serum CETP concentration is not associated with measures of body fat: The NEO study
Adipose tissue has been proposed to contribute substantially to the serum cholesteryl ester transfer protein (CETP) pool, but a recent large cohort study found no association between waist circumference and plasma CETP. The authors further examined body-fat measures against serum CETP in the Netherlands Epidemiology of Obesity study. In 6,606 participants aged 45-65, total body fat, BMI, waist circumference, waist-to-hip ratio, and MRI-assessed abdominal and visceral adipose tissue (n=2547), plus DXA-assessed total and trunk fat mass (n=909), were examined against serum CETP, adjusting for age, ethnicity, sex, diet, activity, smoking and menopausal status. Mean serum CETP was 2.47 microgram/mL. Differences in serum CETP per SD of total body fat or BMI were both around the null (0.02 microgram/mL), with similarly null associations for all other adiposity measures, indicating adipose tissue does not contribute to the CETP pool in serum.
Original abstract
Introduction: Adipose tissue has been postulated to contribute substantially to the serum cholesteryl ester transfer protein (CETP) pool. However, in a recent large cohort study waist circumference was not associated with plasma CETP. The aim of the present study was to further examine associations of accurate measures of body fat and body fat distribution with serum CETP concentration.
Methods: In this cross-sectional analysis of the Netherlands Epidemiology of Obesity study, we examined in 6606 participants (aged 45-65 years) the associations of total body fat, body mass index (BMI), waist circumference, waist-to-hip ratio (WHR), abdominal subcutaneous (aSAT) and visceral adipose tissue (VAT) assessed with magnetic resonance imaging (n = 2547) and total and trunk fat mass assessed with dual-energy X-ray absorptiometry (n = 909) with serum CETP concentration. Regression models were adjusted for age, ethnicity, sex, dietary intake of fat and cholesterol, physical activity, smoking and menopausal status.
Results: Mean (SD) age was 56 (6) years and BMI 26.3 (4.4) kg/m(2), 56% were women. Mean serum CETP concentration was 2.47 μg/mL. The difference in serum CETP was 0.02 μg/mL (95%CI: -0.01, 0.05) per SD total body fat (8.7%), and 0.02 μg/mL (0.00, 0.04) per SD BMI (4.4 kg/m(2)). Similar associations around the null were observed for waist circumference, WHR, aSAT, VAT, total and trunk fat mass.
Conclusion: In this population-based study, there was no evidence for clinically relevant associations between several measures of body fat and serum CETP concentration. This finding implies that adipose tissue does not contribute to the CETP pool in serum.
Summary written by cetpinhibition.org from the published abstract; figures as published. Page updated 19 August 2026. Methods.