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

Yuri Moriyama, Tomonori Okamura, Akihiro Inazu, Mitsunori Doi, Hiroyasu Iso, Yoshitaka Mouri, Yoshinori Ishikawa, Hideyoshi Suzuki, Minoru Iida, Junji Koizumi, Hiroshi Mabuchi, Yoshio Komachi

Research output: Contribution to journalArticle

151 Citations (Scopus)


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.

Original languageEnglish
Pages (from-to)659-667
Number of pages9
JournalPreventive Medicine
Issue number5 I
Publication statusPublished - 1998 Jan 1
Externally publishedYes



  • Cholesterol
  • Cholesteryl ester transfer protein deficiency
  • Coronary heart disease
  • Genetic epidemiology
  • High-density lipoprotein

ASJC Scopus subject areas

  • Epidemiology
  • Public Health, Environmental and Occupational Health

Cite this