Borggreve Susanna E, Hillege Hans L, Dallinga-Thie Geesje M, de Jong Paul E, Wolffenbuttel Bruce H R, Grobbee Diederik E, van Tol Arie, Dullaart Robin P F
Department of Endocrinology, University Medical Centre Groningen, University of Groningen, Hanzeplein 1, PO Box 30.001, 9700 RB Groningen, The Netherlands.
Eur Heart J. 2007 Apr;28(8):1012-8. doi: 10.1093/eurheartj/ehm062. Epub 2007 Apr 4.
High cholesteryl ester transfer protein (CETP) concentrations are associated with increased risk of cardiovascular disease (CVD) in subjects with high triglycerides. We determined the relationship of plasma CETP with incident CVD in a population with relatively low triglycerides.
A nested case-control study was performed in men participating in the prospective PREVEND study, after exclusion of CVD, diabetes mellitus, and lipid-lowering drugs use at baseline. Plasma CETP was measured in 111 men who developed a cardiovascular event (cases) during follow-up and in 116 controls who remained free of CVD. Fasting total cholesterol (P < 0.001) and triglycerides (P < 0.001) were higher, HDL cholesterol was lower (P = 0.001), but CETP was similar in cases and controls (P = 0.39). Cox proportional hazards regression analysis showed that CVD risk tended to be lower with higher plasma CETP after adjustment for age and lipids (hazard ratio 0.84; 95% CI 0.69-1.03, P = 0.10). Plasma CETP was lower in cases than in controls (P = 0.05) with triglycerides < or = 1.38 mmol/L (median), but not with higher triglycerides. The age-adjusted hazard ratio for CVD was 0.46 (95% CI 0.24-0.90) in men with triglycerides < or = 1.38 mmol/L and CETP > 2.26 mg/L (median) compared with men with similarly low triglycerides and CETP < or = 2.26 mg/L. With higher triglycerides, the hazard ratio for CVD was similar in both CETP categories.
Relatively high plasma CETP may favour reduced CVD risk in the context of low triglycerides.
在高甘油三酯受试者中，高胆固醇酯转运蛋白（CETP）浓度与心血管疾病（CVD）风险增加相关。我们确定了在甘油三酯相对较低的人群中血浆CETP与新发CVD之间的关系。
在参与前瞻性预防心血管疾病（PREVEND）研究的男性中进行了一项巢式病例对照研究，排除了基线时患有CVD、糖尿病和使用降脂药物的情况。对随访期间发生心血管事件的111名男性（病例组）和116名未患CVD的对照者测量了血浆CETP。病例组的空腹总胆固醇（P<0.001）和甘油三酯（P<0.001）较高，高密度脂蛋白胆固醇较低（P=0.001），但病例组和对照组的CETP相似（P=0.39）。Cox比例风险回归分析显示，在调整年龄和血脂后，血浆CETP越高，CVD风险倾向于越低（风险比0.84；95%可信区间0.69-1.03，P=0.10）。甘油三酯≤1.38 mmol/L（中位数）的病例组血浆CETP低于对照组（P=0.05），而甘油三酯较高时则不然。与甘油三酯和CETP≤2.26 mg/L（中位数）相似的男性相比，甘油三酯≤1.38 mmol/L且CETP>2.26 mg/L的男性经年龄调整后的CVD风险比为0.46（95%可信区间0.24-0.90）。甘油三酯较高时，两种CETP类别中的CVD风险比相似。
在甘油三酯水平较低的情况下，相对较高的血浆CETP可能有利于降低CVD风险。
