Children with obesity show reduced CETP activity alongside broader HDL antioxidant breakdown and higher oxidative stress (J Clin Lipidol 2026)

Original title: Disruption of HDL antioxidant properties in children and adolescents with obesity

J Clin Lipidol · 8 November 2025 · 5

Davico B, Lozano Chiappe E, Gaete L, Sanchez AY, Tetzlaff WF, Martinez V, De Giusti V, Bava A, Rodriguez C, Masci I, Kurtz M, Tasat D et al.

A cross-sectional study compared 15 children and adolescents with obesity to 15 normal-weight controls on HDL antioxidant capacity and its conditioning factors: CETP, paraoxonase 1, LCAT, lipoprotein-associated phospholipase A2 and apoA-I. Children with obesity had lower HDL cholesterol and apoA-I (P < .01), and reduced activity of CETP (P < .05), arylesterase (P < .05), LCAT (P < .05) and HDL-associated Lp-PLA2 (P < .01), alongside increased HDL intrinsic oxidation (P < .01) and reduced total HDL antioxidant activity (P < .05). Oxidative stress markers were also higher: reactive oxygen species (P < .001) and nitric oxide (P < .05) rose while the glutathione ratio (P < .01) and catalase activity (P < .001) fell. A small cross-sectional study of thirty children reporting CETP as one of several disrupted HDL-conditioning enzymes in paediatric obesity, with plausible implications for long-term cardiovascular risk.

Original abstract

Background: Childhood obesity is associated with alterations in lipoprotein metabolism and increased oxidative stress, assessed by lipid peroxidation products, reactive oxygen species (ROS) and nitric oxide (NO) levels, oxidized/reduced glutathione (GSH/GSSG) ratio, and the activities of superoxide dismutase (SOD) and catalase. High-density lipoproteins (HDL) play an antioxidant role, conditioned by cholesteryl ester transfer protein (CETP), paraoxonase (PON) 1, lecithin:cholesterol acyltransferase (LCAT), lipoprotein-associated phospholipase A2 (Lp-PLA2), and apolipoprotein (apo) A-I.

Objective: This study aims to evaluate HDL antioxidant capacity in children and adolescents with obesity and the status of its conditioning factors.

Methods: Thirty children and adolescents, 15 with obesity and 15 normal-weight controls were studied in a cross-sectional observational study. Lipid profile and high-sensitivity C-reactive protein were assessed using standardized methods. Lipid peroxidation products, ROS, NO, GSH and GSSG levels, and catalase, SOD, CETP, LCAT, PON 1 (PON and arylesterase [ARE]) and Lp-PLA2 activities were assessed by developed techniques. Total HDL antioxidant activity and its intrinsic oxidation were evaluated.

Results: Children with obesity showed lower HDL cholesterol and apo A-I levels (P < .01), reduced CETP (P < .05), ARE (Lp-PLA2 < .05), LCAT (P < .05), and HDL-associated Lp-PLA2 (P < .01) activities, increased HDL intrinsic oxidation (P < 0.01) and reduced total HDL antioxidant activity (P < .05). Patients revealed increased oxidative stress: higher ROS (P < .001) and NO levels (P < .05), lower GSH/GSSG ratio (P < .01) and catalase activity (P < .001).

Conclusions: Children and adolescents with obesity exhibited reduced HDL antioxidant activity, alterations in its conditioning factors, intrinsic oxidative modification of HDL particles, and increased oxidative stress. These alterations may affect long-term cardiovascular risk in children and adolescents with obesity.

Summary written by cetpinhibition.org from the published abstract; figures as published. Page updated 18 August 2026. Methods.