HDL biology
CETP activity correlates with atherogenic VLDL levels in women with anorexia nervosa (Biomedicines 2022)
Original title: Anorexia Nervosa Is Associated with a Shift to Pro-Atherogenic Low-Density Lipoprotein Subclasses
In an exploratory study of 18 women with anorexia nervosa (BMI below 17.5 kg/m2) and 24 normal-weight women, researchers characterised lipoprotein subclass distribution, apolipoprotein content, and LCAT and CETP activities using the Quantimetrix Lipoprint system, alongside HDL functional metrics including cholesterol efflux capacity and paraoxonase activity. Atherogenic VLDL and small LDL particles were increased in anorexia nervosa, and VLDL levels correlated significantly with CETP activity (r equals 0.432, P equals 0.005). HDL-associated apolipoproteins involved in triglyceride catabolism were altered, apolipoprotein C-II up 24% and apoA-II down 27%, but HDL cholesterol, subclass distribution, cholesterol efflux capacity and paraoxonase activity were unchanged, indicating anorexia nervosa shifts patients toward a more atherogenic lipoprotein profile linked to CETP activity, while HDL functionality itself remains preserved.
Original abstract
Anorexia nervosa (AN) is a severe eating disorder affecting primarily female adolescents and younger adults. The energy deprivation associated with AN has been shown to alter lipoprotein metabolism, which may affect cardiovascular risk. However, the mechanisms leading to alterations in the composition, structure, and function of lipoproteins in AN patients are not well-understood yet. Here, we investigated the lipid abnormalities associated with AN, particularly changes in the distribution, composition, metabolism, and function of lipoprotein subclasses. In this exploratory study, we analyzed serum samples of 18 women diagnosed with AN (BMI < 17.5 kg/m2) and 24 normal-weight women (BMI from 18.5−24.9 kg/m2). Using the Quantimetrix Lipoprint® system, we determined low-density lipoprotein (LDL) subclass distribution, including quantitative measurements of very low-density lipoprotein (VLDL), intermediate density lipoprotein (IDL) and high-density lipoprotein (HDL) subclass distribution. We quantified the most abundant apolipoproteins of HDL and assessed lecithin-cholesterol acyltransferase (LCAT) and cholesteryl-ester transfer protein (CETP) activities. In addition, anti-oxidative capacity of apoB-depleted serum and functional metrics of HDL, including cholesterol efflux capacity and paraoxonase activity were assessed. The atherogenic lipoprotein subclasses VLDL and small LDL particles were increased in AN. Levels of VLDL correlated significantly with CETP activity (rs = 0.432, p = 0.005). AN was accompanied by changes in the content of HDL-associated apolipoproteins involved in triglyceride catabolism, such as apolipoprotein C-II (+24%) and apoA-II (−27%), whereas HDL-associated cholesterol, phospholipids, and triglycerides were not altered. Moreover, AN did not affect HDL subclass distribution, cholesterol efflux capacity, and paraoxonase activity. We observed a shift to more atherogenic lipoprotein subclasses in AN patients, whereas HDL functionality and subclass distribution were not altered. This finding underpins potential detrimental effects of AN on lipid metabolism and the cardiovascular system by increasing atherosclerotic risk factors.
Summary written by cetpinhibition.org from the published abstract; figures as published. Page updated 19 August 2026. Methods.