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Updated: May 3, 2026
Cholesterol Efflux Assay
Published on: March 6, 2012
Decreased cholesterol efflux capacity in patients with low cholesteryl ester transfer protein plasma levels
Hubert Scharnagl1, Christina Heuschneider, Sabrina Sailer
1Clinical Institute of Medical and Chemical Laboratory Diagnostics, Medical University of Graz, Graz, Austria.
Background:
Cholesteryl ester transfer protein (CETP) has been considered as a possible target for treatment of cardiovascular disease. However, first clinical studies employing CETP inhibitors have failed to demonstrate clinical benefit. Additionally, we have previously shown that low endogenous plasma levels of CETP are associated with increased mortality in coronary artery disease (CAD) patients. We hypothesized that low CETP plasma levels are associated with decreased high-density lipoprotein (HDL) function.
Materials And Methods:
Serum HDL efflux capacity was measured in 154 patients of the Ludwigshafen Risk and Cardiovascular Health (LURIC) study displaying extremely low (< 0·68 μg/mL, n = 77) or high (> 2·13 μg/mL, n = 77) CETP concentrations in their plasma, respectively. The LURIC study is a prospective observational study of patients referred to coronary angiography at baseline with a median follow-up time of 7·75 years. Primary and secondary endpoints were cardiovascular and all-cause mortality, respectively.
Results:
High CETP patients showed a significant increase in the capacity of their plasma to mediate cholesterol efflux from cholesterol laden macrophages when compared to the efflux capacity observed in low CETP patients (+ 5·4%, P = 0·015). As shown by multiregression analysis, the impact of CETP on cholesterol efflux capacity was independent from classical risk and lifestyle factors, as well as from lipid parameters including HDL cholesterol, LDL cholesterol and triglycerides.
Conclusions:
Our findings indicate that low plasma concentrations of CETP might indeed lead to impaired HDL function within the reverse cholesterol transport pointing towards an atheroprotective role of CETP at least in patients with high risk of CAD.
Insights
Low cholesteryl ester transfer protein (CETP) levels impair high-density lipoprotein (HDL) function, suggesting CETP plays a protective role against atherosclerosis in high-risk patients.
Area of Science:
- Cardiovascular Disease Research
- Lipid Metabolism
- Atherosclerosis
Background:
- Cholesteryl ester transfer protein (CETP) is a potential cardiovascular disease therapeutic target.
- Previous studies show low CETP levels correlate with increased mortality in coronary artery disease (CAD) patients.
- This study investigates the link between low CETP and impaired high-density lipoprotein (HDL) function.
Purpose of the Study:
- To determine if low CETP plasma levels are associated with decreased HDL function.
- To evaluate the role of CETP in reverse cholesterol transport in CAD patients.
Main Methods:
- Serum HDL efflux capacity was measured in 154 LURIC study patients with extremely low or high CETP concentrations.
- Patients were followed prospectively for cardiovascular and all-cause mortality.
- Multiregression analysis assessed CETP's impact independent of other risk factors.
Main Results:
- Patients with high CETP demonstrated significantly higher cholesterol efflux capacity compared to low CETP patients (+5.4%, P=0.015).
- CETP's influence on efflux capacity was independent of traditional risk factors and lipid profiles.
- Low CETP concentrations were linked to reduced HDL function.
Conclusions:
- Low plasma CETP concentrations may impair HDL function in reverse cholesterol transport.
- Findings suggest CETP has an atheroprotective role, particularly in high-risk CAD patients.
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