HDL biology
CETP activity does not track carotid intima-media thickness once diabetes control is poor, unlike in well-controlled patients (Acta Diabetol 2019)
Original title: CETP activity is not associated with carotid intima-media thickness in patients with poorly controlled type 2 diabetes
Since plasma cholesteryl ester transfer was previously linked to carotid intima-media thickness (IMT) in type 2 diabetic patients with adequate metabolic control, this study tested whether CETP activity still predicts carotid IMT in patients with poor control. In 110 individuals with type 2 diabetes (mean HbA1c 8.8%), CETP mass was measured by ELISA and activity by a radioactivity method alongside carotid IMT by ultrasonography. Carotid IMT did not correlate with CETP activity in the total population, nor in the subgroup with HbA1c below 8% (n=33, mean HbA1c 6.9%, p=0.09). Multivariable analysis found carotid IMT positively associated with diabetes duration (p=0.02) but not with CETP activity or HbA1c. The authors conclude that disease duration may blunt any effect of CETP on atherosclerosis, and that metabolic control is essential to determining whether CETP acts pro- or anti-atherogenically in type 2 diabetes.
Original abstract
Aim: The impact of cholesteryl ester transfer protein (CETP) on atherosclerotic development in humans remains unclear. Plasma cholesteryl ester transfer was shown to be associated with carotid intima-media thickness in type 2 diabetic (T2D) patients with adequate metabolic control. Since glycation of CETP may influence cholesteryl ester transfer processes, it is important to determine if plasma cholesteryl ester transfer is still a determinant of carotid intima-media thickness (IMT) in patients with poorly controlled diabetes. The aim of the present study was to determine whether CETP activity influences carotid IMT in T2D patients with poor metabolic control.
Methods: In 110 individuals with T2D, we measured CETP mass concentration with ELISA, CETP activity with a radioactivity method and carotid intima-media thickness with high-resolution real-time B-mode ultrasonography.
Results: The mean HbA1C was 8.8 ± 1.7%. Carotid IMT did not correlate with CETP activity in the total population. In T2D patients with HbA1C < 8% (n = 33), mean HbA1C was 6.9% and the correlation between carotid IMT and CETP activity was not significant (p = 0.09). In a multivariable analysis that included the total population, carotid intima-media thickness was positively associated with diabetes duration (p = 0.02) but not with CETP activity or HbA1C.
Conclusions: We observed no correlation between carotid intima-media thickness, a marker of early atherosclerosis, and CETP activity in T2D patients with poor metabolic control. Disease duration, which reflects accumulated metabolic abnormalities, may have blunted the potential effect of CETP on atherosclerosis. Metabolic control appears essential to determine the pro- or anti-atherogenic influence of CETP in patients with T2D.
diabetesHDL biologyplaque imaging
Summary written by cetpinhibition.org from the published abstract; figures as published. Page updated 19 August 2026. Methods.