Urban versus rural residence predicts opposite CETP and PLTP activity patterns in Polish men, independent of smoking and alcohol use (Arch Med Sci 2016)

Original title: Serum CETP and PLTP activity in middle-aged men living in urban or rural area of the Lower Silesia region. PURE Poland sub-study

Arch Med Sci · 1 July 2016 · 6

Skoczyńska A, Wojakowska A, Turczyn B, Zatońska K, Wołyniec M, Szuba A

In 427 Polish men from the PURE sub-study, 263 urban and 164 rural residents, researchers measured serum CETP and phospholipid transfer protein (PLTP) activity. Site of residence was the strongest independent predictor of both enzymes' activity in multivariable regression (beta coefficients 0.18 for CETP and -0.29 for PLTP, both P less than 0.001), with neither smoking nor moderate alcohol consumption showing an independent effect, though CETP activity showed an interaction between these two risk factors. Across all men, CETP activity correlated positively with total cholesterol (r=0.24), LDL cholesterol (r=0.18), and non-HDL cholesterol (r=0.21). Rural men, who had higher BMI than urban men, showed increased pro-atherogenic PLTP activity alongside decreased protective CETP activity, a pattern the authors attribute to nutritional or genetic factors tied to residence.

Original abstract

Introduction: The dependence of lipid transfer proteins on significant pro-atherogenic factors is unclear. The aim of the study was to evaluate serum cholesteryl ester transfer protein (CETP) and phospholipid transfer protein (PLTP) activity in relation to lipid disturbances in men living in an urban or rural area.

Material And Methods: A group of 427 men, volunteers for the Prospective Urban Rural Epidemiology (PURE) sub-study - 263 urban inhabitants (aged 51.9 ±6.0) and 164 residents of villages (aged 51.1 ±5.9) - were examined. In the multivariable linear regression model, the following factors were included as potential confounders: age, body mass index (BMI), smoking, alcohol consumption, hs-C-reactive protein reaction (hs-CRP) and co-existence of chronic diseases.

Results: In multiple linear regression models, site of residence (urban or rural area) was the most important independent and consistent predictor of CETP and PLTP activity; β coefficients (95% CI) for CETP (0.18) and PLTP (-0.29) were significant at levels of p < 0.001. Three-way analysis of variance showed no effect of smoking or moderate alcohol consumption on lipid transfer proteins; however, CETP activity showed an interaction effect between these risk factors. In the group of all men, CETP activity was significantly and positively correlated with total cholesterol (r = 0.24), low-density lipoprotein cholesterol (r = 0.18), and non-high density lipoprotein cholesterol (r = 0.21), whereas PLTP activity was correlated with BMI (r = 0.12). Body mass index in rural men was higher than in the urban male population.

Conclusions: Increased PLTP activity, recognized as a pro-atherogenic factor, and decreased CETP activity, known as a protective factor, both observed in men living in rural areas, are probably conditioned by nutritional and/or genetic factors.

Summary written by cetpinhibition.org from the published abstract; figures as published. Page updated 19 August 2026. Methods.