Plasma levels of cholesteryl ester transfer protein and the risk of future coronary artery disease in apparently healthy men and women: the prospective EPIC (European Prospective Investigation into Cancer and nutrition)-Norfolk population study

Circulation. 2004 Sep 14;110(11):1418-23. doi: 10.1161/01.CIR.0000141730.65972.95. Epub 2004 Aug 30.

Abstract

Background: Low plasma levels of cholesteryl ester transfer protein (CETP) are associated with elevated levels of HDL cholesterol (HDL-C), but it remains unclear whether this translates into a concomitant reduction in the risk of coronary artery disease (CAD). Evidence exists that the effect of CETP depends on metabolic context, in particular on triglyceride levels.

Methods and results: A nested case-control study was performed in the prospective EPIC-Norfolk cohort study. Cases were apparently healthy men and women aged 45 to 79 years who developed fatal or nonfatal CAD during follow-up. Control subjects were matched by age, sex, and enrollment time. CETP levels were not significantly different between cases and controls (4.0+/-2.2 versus 3.8+/-2.1 mg/L, P=0.07). CETP levels were significantly related to plasma levels of total cholesterol, LDL cholesterol, and HDL-C. The risk of CAD increased with increasing CETP quintiles (P for linearity=0.02), such that subjects in the highest quintile had an adjusted OR of 1.43 (95% CI 1.03 to 1.99, P=0.03) versus those in the lowest. Among individuals with triglyceride levels below the median (1.7 mmol/L), no relationship between CETP levels and CAD risk was observed (P for linearity=0.5), but this relationship was strong among those with high triglyceride levels (P for linearity=0.02), such that those in the highest CETP quintile had an OR of 1.87 (95% CI 1.06 to 3.30, P=0.02).

Conclusions: Elevated CETP levels are associated with an increasing risk of future CAD in apparently healthy individuals, but only in those with high triglyceride levels.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Carrier Proteins / blood*
  • Case-Control Studies
  • Cholesterol Ester Transfer Proteins
  • Cholesterol, HDL / blood
  • Cholesterol, LDL / blood
  • Cohort Studies
  • Comorbidity
  • Coronary Disease / blood*
  • Coronary Disease / epidemiology
  • Diabetes Mellitus / epidemiology
  • Female
  • Glycoproteins / blood*
  • Humans
  • Hyperlipidemias / epidemiology
  • Hypertension / epidemiology
  • Male
  • Middle Aged
  • Prognosis
  • Prospective Studies
  • Risk
  • Smoking / epidemiology
  • Triglycerides / blood

Substances

  • CETP protein, human
  • Carrier Proteins
  • Cholesterol Ester Transfer Proteins
  • Cholesterol, HDL
  • Cholesterol, LDL
  • Glycoproteins
  • Triglycerides