HDL biology
Prebeta-1 HDL, the particle CETP feeds on, is elevated across three dyslipidaemia phenotypes in 2,435 people (J Clin Lipidol 2018)
Original title: Levels of prebeta-1 high-density lipoprotein are elevated in 3 phenotypes of dyslipidemia
Prebeta-1 HDL is a small HDL subspecies that acts as the principal acceptor of cholesterol effluxed from macrophages via ABCA1, and high levels are linked to increased risk of coronary artery disease and myocardial infarction. This study compared prebeta-1 HDL levels among 2,435 individuals (1,388 women, 1,047 men), including 392 normolipidaemic controls and 2,018 untreated subjects split into elevated LDL-C (713), combined hyperlipidaemia (623) and hypertriglyceridaemia (290) phenotypes. Prebeta-1 HDL was elevated in all three dyslipidaemic phenotypes relative to controls, most markedly in the combined and hypertriglyceridaemia groups, a pattern the authors suggest may reflect increased acceptor capacity of apoB-containing lipoproteins for the entropically driven transfer of cholesteryl esters out of HDL via CETP. ApoA-I, triglyceride, HDL-C and age were the main predictors of prebeta-1 HDL level, with an apoA-I by sex interaction; estrogen use made no difference among postmenopausal women. CETP appears here as the proposed mechanism linking dyslipidaemia to prebeta-1 HDL elevation, not as a directly measured exposure.
Original abstract
Background: Prebeta-1 high-density lipoprotein (HDL) is a small subspecies of HDL that functions as the HDL quantum particle and is the principal acceptor of cholesterol effluxed from macrophages through the ATP-binding cassette transporter, ABCA1. High levels of prebeta-1 HDL are associated with increased risk of structural coronary artery disease and myocardial infarction.
Objective: We aimed to compare prebeta-1 HDL levels in normal subjects and in 3 phenotypes of dyslipidemia.
Methods: We studied 2435 individuals (1388 women; 1047 men). Of these, 2018 were not taking lipid-lowering medication when enrolled: 392 were normolipidemic controls; 713 had elevated levels of low-density lipoprotein cholesterol; 623 had combined hyperlipidemia; and 290 had hypertriglyceridemia.
Results: Relative to controls, prebeta-1 HDL levels were increased in all 3 dyslipidemic phenotypes, particularly the combined and hypertriglyceridemia groups. This increase possibly reflects increased acceptor capacity of apolipoprotein B-100 containing lipoproteins for entropically driven transfer of cholesteryl esters from HDL via cholesteryl ester transfer protein. Multiple regression analysis revealed that the main predictor variables significantly associated with prebeta-1 HDL levels were apolipoprotein A-I (apoA-1) (β = 0.500), triglyceride (β = 0.285), HDL-C (β = -0.237), and age (β = -0.169). There was an interaction between apoA-1 and sex (female vs male; β = -0.110). Among postmenopausal women, estrogenized subjects had a similar level of prebeta-1 HDL compared to those not receiving estrogens.
Conclusions: Prebeta-1 HDL levels are elevated in the 3 most common types of hyperlipidemia and are most strongly influenced by the levels of apoA-1, triglyceride, and HDL-C.
Summary written by cetpinhibition.org from the published abstract; figures as published. Page updated 18 August 2026. Methods.