CETP activity rises stepwise from underweight to overweight/obese children, tracking with visceral-adiposity and lipid-accumulation indexes (Nutr Metab Cardiovasc Dis 2023)

Original title: Impaired HDL-associated enzymes and proteins in children and adolescents with weight disorders and their association with novel cardiometabolic indexes

Nutr Metab Cardiovasc Dis · 9 September 2023 · 6

Martin M, Davico B, Verona MF, Tetzlaff WF, Lozano Chiappe E, Gilligan L, Jimenez G, Gomez Rosso L, Ballerini G, Boero L, Verona J, Brites F

Comparing 30 underweight (UW), 66 normal-weight (NW), and 30 overweight/obese (OW/OB) children and adolescents, cholesteryl ester transfer protein (CETP) activity rose stepwise across weight categories (218 +/- 38 vs. 224 +/- 26 vs. 237 +/- 26 %/mL.h; P < 0.05), while paraoxonase 1 activity was lower in both UW and OW/OB than NW (318 +/- 170 vs. 409 +/- 200 vs. 310 +/- 184 nmol/mL.min; P < 0.05). The triglycerides-glucose index was higher in OW/OB than UW (P < 0.01), and both the lipid accumulation product and visceral adiposity index followed a linear trend across weight categories. After adjusting for age and body mass index z-score, the triglycerides-glucose index independently predicted CETP activity (r2 = 0.25, beta = -0.22, P < 0.01), as did visceral adiposity index (r2 = 0.21, beta = -0.32, P < 0.01) and lipid accumulation product (r2 = 0.20, beta = -0.31, P < 0.01).

Original abstract

Background And Aims: Overweight/obesity (OW/OB) is associated with modifications in lipoprotein (Lp)-associated enzymes and proteins, such as cholesteryl ester transfer protein (CETP), Lp-associated phospholipase A2 (LpPLA2) and paraoxonase (PON)1. No evidence is available regarding underweight (UW). The following indexes have been proposed to better assess atherogenic risk related to weight alterations: triglycerides-glucose index (TyG), visceral adiposity index (VAI) and height-corrected lipid accumulation product (HLAP).

Aim: To analyze the presence of alterations in Lp-associated enzymes and proteins in children and adolescents with UW and OW/OB and their relation to novel cardiometabolic indexes.

Methods And Results: Thirty male children and adolescents with UW, 66 with normal weight (NW) and 30 with OW/OB were included. Anthropometric parameters, glucose, Lp profile and the activities of CETP, LpPLA2 and PON1 were evaluated. Body mass index (BMI)-z, TyG, VAI and HLAP were calculated. UW and NW showed lower CETP activity than OW/OB (Mean ± SD) (218 ± 38vs.224 ± 26vs.237 ± 26%/mL.h; p < 0.05). UW and OW/OB showed lower PON1 activity than NW (318 ± 170vs.409 ± 200vs.310 ± 184 nmol/mL.min; p < 0.05). TyG was higher in OW/OB than UW (p < 0.01), whilst both HLAP (p < 0.05) and VAI (p < 0.01) followed a linear trend across weight categories. After adjusting for age and BMI-z, TyG was an independent predictor of CETP (r2 = 0.25, β = -0.22, p < 0.01) and LpPLA2 (r2 = 0.21,β = -0.21,p < 0.05), while VAI (r2 = 0.21,β = -0.32,p < 0.01) and HLAP (r2 = 0.20,β = -0.31,p < 0.01) of CETP.

Conclusions: Both UW and OW/OB showed impaired antioxidant PON1 activity. Moreover, TyG, VAI and HLAP were all capable of predicting alterations in crucial modulators of Lp metabolism and vascular inflammation in children and adolescents with varying degrees of alterations in body weight.

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