CETPと動脈硬化

Abstract

Heterozygous CETP deficiency is found in ∼10% of the general Japanese population, and is an important genetic factor of increased HDL levels. A crosssectional epidemiologic survey in Kochi prefecture showed that subjects with very high HDL cholesterol levels≥80mg/dl exhibit a low CHD prevalence, irrespective of the CETP genotype. The cholesterol esterification rate was decreased in both homo- and heterozygous CETP deficiency. Increased levels of HDL itself, along with low non-HDL cholesterol levels, manifest anti-atherogenicity in subjects with very high HDL levels and CETP deficiency, possibly through direct effects of HDL on the arterial wall or an antioxidative mechanism. However, normolipidemic elderly men with low-to-intermediate HDL-C levels (<60mg/dl) and a D442G mutation, demonstrated ischemic ST-T change 3times more frequently. Thus, antiatherogenicity of CETP deficiency is dependent on serum HDL-C levels, and CETP genotyping/serum CETP measurement may be useful to identify a high-risk grop in subjects with serum HDL-C<60mg/dl.