J. Lipid Res.
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Originally published In Press as doi:10.1194/jlr.M700108-JLR200 on May 24, 2007

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Journal of Lipid Research, Vol. 48, 1763-1771, August 2007
Copyright © 2007 by American Society for Biochemistry and Molecular Biology

Fenofibrate increases HDL-cholesterol by reducing cholesteryl ester transfer protein expression

Caroline C. van der Hoogt1,*,{dagger}, Willeke de Haan1,*,{dagger}, Marit Westerterp*,{dagger}, Menno Hoekstra§, Geesje M. Dallinga-Thie**, Johannes A. Romijn{dagger}, Hans M. G. Princen*, J. Wouter Jukema{dagger}{dagger}, Louis M. Havekes*,{dagger},{dagger}{dagger} and Patrick C. N. Rensen2,*,{dagger}

* Netherlands Organization for Applied Scientific Research-Quality of Life, Gaubius Laboratory, 2301 CE Leiden, The Netherlands
{dagger} Department of General Internal Medicine, Endocrinology, and Metabolic Diseases, Leiden University Medical Center, 2300 RC Leiden, The Netherlands
{dagger}{dagger} Department of Cardiology, Leiden University Medical Center, 2300 RC Leiden, The Netherlands
§ Leiden/Amsterdam Center for Drug Research, Division of Biopharmaceutics, 2300 RA Leiden, The Netherlands
** Department of Internal Medicine, Erasmus University Rotterdam, 3000 DR Rotterdam, The Netherlands

Published, JLR Papers in Press, May 24, 2007.

1 C. C. van der Hoogt and W. de Haan contributed equally to this study.

2 To whom correspondence should be addressed. e-mail: p.c.n.rensen{at}lumc.nl

In addition to efficiently decreasing VLDL-triglycerides (TGs), fenofibrate increases HDL-cholesterol levels in humans. We investigated whether the fenofibrate-induced increase in HDL-cholesterol is dependent on the expression of the cholesteryl ester transfer protein (CETP). To this end, APOE*3-Leiden (E3L) transgenic mice without and with the human CETP transgene, under the control of its natural regulatory flanking regions, were fed a Western-type diet with or without fenofibrate. Fenofibrate (0.04% in the diet) decreased plasma TG in E3L and E3L.CETP mice (–59% and –60%; P < 0.001), caused by a strong reduction in VLDL. Whereas fenofibrate did not affect HDL-cholesterol in E3L mice, fenofibrate dose-dependently increased HDL-cholesterol in E3L.CETP mice (up to +91%). Fenofibrate did not affect the turnover of HDL-cholesteryl ester (CE), indicating that fenofibrate causes a higher steady-state HDL-cholesterol level without altering the HDL-cholesterol flux through plasma. Analysis of the hepatic gene expression profile showed that fenofibrate did not differentially affect the main players in HDL metabolism in E3L.CETP mice compared with E3L mice. However, in E3L.CETP mice, fenofibrate reduced hepatic CETP mRNA (–72%; P < 0.01) as well as the CE transfer activity in plasma (–73%; P < 0.01). We conclude that fenofibrate increases HDL-cholesterol by reducing the CETP-dependent transfer of cholesterol from HDL to (V)LDL, as related to lower hepatic CETP expression and a reduced plasma (V)LDL pool.

Supplementary key words fibrate • high density lipoprotein • peroxisome proliferator-activated receptor {alpha} • transgenic mice

Abbreviations: apoE, apolipoprotein E; CE, cholesteryl ester; CETP, cholesteryl ester transfer protein; COEth, cholesteryl oleyl ether; E3L, APOE*3-Leiden; FCR, fractional catabolic rate; LXR, liver X receptor; PLTP, phospholipid transfer protein; PPAR{alpha}, peroxisome proliferator-activated receptor {alpha}; PPRE, peroxisome proliferator response element; SR-BI, scavenger receptor class B type I; TC, total plasma cholesterol; TG, triglyceride


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