1. ^*Clinical Department of Internal Medicine, Clinical Division of General Internal Medicine, Medical University Innsbruck, Innsbruck, Austria
2. ^†First Department of Internal Medicine, St. Johann Hospital, Salzburg, Austria.

Correspondence: Christoph F. Ebenbichler Ebenbichler, Clinical Department of Internal Medicine, Clinical Division of General Internal Medicine, Medical University Innsbruck, Innsbruck, Anichstrasse 35, A-6020 Innsbruck, Austria. E-mail: christoph.ebenbichler@uibk.ac.at

^*The costs of publication of this article were defrayed, in part, by the payment of page charges. This article must, therefore, be hereby marked "advertisement" in accordance with 18 U.S.C. Section 1734 solely to indicate this fact.

Received 18 July 2005; Accepted 8 February 2006.

Abstract

Objective: Low high-density lipoprotein cholesterol (HDL-C), hypertriglyceridemia, and small dense-low density lipoprotein (LDL) are key components of metabolic syndrome (MS). Cholesteryl ester transfer protein (CETP) mediates the transfer of triglycerides (TGs) from TG-rich lipoproteins to HDL and LDL particles in exchange for cholesteryl esters, leading to low HDL-C and small dense-LDL. The aim of this study was to investigate the role of CETP in subjects with MS.

Research Methods and Procedures: In a cross-sectional cohort of 234 middle-aged men and 252 women randomly selected from the Salzburg Atherosclerosis Prevention Program in Subjects at High Individual Risk (SAPHIR) study, MS was diagnosed according to the National Cholesterol Education Program guidelines. CETP mass was determined by enzyme-linked immunosorbent assay and LDL size-by-gradient polyacrylamide gel electrophoresis.

Results: Men and women with MS had lower HDL-C (45 7 vs. 58 13 and 48 10 vs. 71 14 mg/dL for men and women, respectively; p < 0.001 for all) and higher TG levels (222 71 vs. 98 54 and 167 67 vs. 90 35 mg/dL for men and women, respectively; p < 0.001 for all) than healthy subjects. LDL size was lower in subjects with MS (256 11 Å vs. 267 11 Å and 262 10 Å vs. 273 8 Å for men and women, respectively; p < 0.001 for all). CETP mass was higher in men with MS (1.87 0.78 vs. 1.40 0.65 g/mL; p < 0.001) but not in women (1.74 0.79 vs. 1.62 0.62 g/mL). CETP mass correlated inversely with LDL size in both men and women (r = - 0.19, p < 0.01 and r = - 0.13, p < 0.05 in men and women, respectively).

Discussion: MS is associated with increased CETP mass in men. Increased CETP mass may be responsible for reduced HDL-C and reduced LDL particle diameter in MS.