Elevated cholesteryl ester transfer protein concentration is associated with an increased risk for cardiovascular disease in women, but not in men, with Type 2 diabetes: the Hoorn Study.
OBJECTIVE
Cholesteryl ester transfer protein (CETP) exchanges neutral lipids between lipoproteins. As the role of CETP in the atherogenic process is still not fully clarified, we studied the association of CETP concentration with the prevalence of cardiovascular disease (CVD) and with intima-media thickness of the carotid artery (IMT) in subjects with normal glucose tolerance (NGT), impaird fasting glucose and/or impaired glucose tolerance (IFG/IGT) and Type 2 diabetes mellitus.


METHODS
Subjects (n = 566) were recruited from the 2000-2001 follow-up examination of the Hoorn study. CETP concentration was determined by immunoassay. CVD was defined as self-reported history of arterial surgery, cerebral vascular event, amputation, angina, claudication, possible infarction, measured ankle-brachial index < 0.90 or ECG abnormalities. The right common carotid artery IMT was measured by ultrasound at 10 mm proximal to the carotid bulb.


RESULTS
In men, CETP concentration was not associated with CVD, irrespective of glucose tolerance status. In women with NGT or IGT, there was also no relationship. However, in women with Type 2 diabetes, the risk of CVD was increased in those with high CETP concentration [odds ratio = 3.34 (1.56; 7.14)]. No statistically significant association was found between CETP concentration and IMT in the entire cohort.


CONCLUSIONS
In an elderly Caucasian population, associations of CETP concentration with CVD were dependent on glucose tolerance status and gender. The finding that high CETP concentration was strongly associated with increased prevalence of CVD in women with Type 2 diabetes warrants further investigation.
Alssema
M
M
EMGO-Institute, VU University Medical Center, Amsterdam, The Netherlands. m.alssema@vumc.nl
Dekker
J M
JM
Kuivenhoven
J A
JA
Nijpels
G
G
Teerlink
T
T
Scheffer
P G
PG
Diamant
M
M
Stehouwer
C D A
CD
Bouter
L M
LM
Heine
R J
RJ
D000368:Aged; D015992:Body Mass Index; D002340:Carotid Artery Diseases / Q000473:pathology; D053480:Cholesterol Ester Transfer Proteins / Q000378:metabolism*; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000209:etiology* / Q000473:pathology; D003925:Diabetic Angiopathies / Q000097:blood / Q000209:etiology* / Q000473:pathology; D005260:Female; D006801:Humans; D008297:Male; D009426:Netherlands / Q000453:epidemiology; D015995:Prevalence; D012307:Risk Factors; D017539:Tunica Intima / Q000473:pathology
D053480:Cholesterol Ester Transfer Proteins