title: A low prevalence of coronary heart disease among subjects with increased high-density lipoprotein cholesterol levels, including those with plasma cholesteryl ester transfer protein deficiency.
abstract: BACKGROUND
  Use of genetic analysis may improve the predictive value of risk factors for disease. A high plasma level of high-density lipoprotein (HDL) cholesterol is a strong negative risk factor for coronary heart disease (CHD). Cholesteryl ester transfer protein (CETP) deficiency causes increased levels of HDL cholesterol. However, recent studies suggest that CETP deficiency is a risk factor for CHD despite elevated HDL cholesterol levels.
  
  
  METHODS
  Plasma lipid levels, CHD prevalence, resting electrocardiograms, and common CETP gene mutations were analyzed cross-sectionally in a population of 19,044 male and 29,487 female Japanese subjects (ages 45-79 years).
  
  
  RESULTS
  High HDL cholesterol levels (serum HDL cholesterol >/=80 mg/dl, >/=95th percentile) were found in 6 and 5% of Japanese men and women, respectively. In the group with HDL cholesterol >/=80 mg/dl, common CETP gene mutations were identified in 23-24% of men and 31-49% of women. The prevalence of CHD in the group with high HDL cholesterol (>/=80 mg/dl) was low among both men (1.0%) and women (1.3%). There was no difference in CHD prevalence between hyper-HDL-cholesterolemic subjects with and without CETP mutations.
  
  
  CONCLUSIONS
  Subjects with very high HDL levels (HDL cholesterol >/=80 mg/dl) as well as mild-to-moderate HDL elevations (60-79 mg/dl) appear to be protected against CHD, whether or not they have CETP deficiency, a genetic cause of elevated HDL.
authors.affiliation: Kochi Prefectural Institute of Public Health, Marunouchi 2-4-1, Kochi, 780-0850, Japan.
authors.forename: Y
authors.initials: Y
authors.lastname: Moriyama
authors.forename: T
authors.initials: T
authors.lastname: Okamura
authors.forename: A
authors.initials: A
authors.lastname: Inazu
authors.forename: M
authors.initials: M
authors.lastname: Doi
authors.forename: H
authors.initials: H
authors.lastname: Iso
authors.forename: Y
authors.initials: Y
authors.lastname: Mouri
authors.forename: Y
authors.initials: Y
authors.lastname: Ishikawa
authors.forename: H
authors.initials: H
authors.lastname: Suzuki
authors.forename: M
authors.initials: M
authors.lastname: Iida
authors.forename: J
authors.initials: J
authors.lastname: Koizumi
authors.forename: H
authors.initials: H
authors.lastname: Mabuchi
authors.forename: Y
authors.initials: Y
authors.lastname: Komachi
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002352:Carrier Proteins / Q000097:blood*; D015217:Cholesterol Ester Storage Disease / Q000097:blood / Q000150:complications* / Q000235:genetics; D053480:Cholesterol Ester Transfer Proteins; D008076:Cholesterol, HDL / Q000097:blood*; D003327:Coronary Disease / Q000453:epidemiology / Q000209:etiology*; D003430:Cross-Sectional Studies; D005260:Female; D006023:Glycoproteins; D006801:Humans; D006937:Hypercholesterolemia; D007564:Japan / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D009154:Mutation / Q000235:genetics; D015995:Prevalence; D012307:Risk Factors
chemical_list: C506642:CETP protein, human; D002352:Carrier Proteins; D053480:Cholesterol Ester Transfer Proteins; D008076:Cholesterol, HDL; D006023:Glycoproteins