Tuesday 13 April 2010

Whatever happened to...Torcetrapib?

Peter of Hyperlipid mentioned this stuff back in July 2007 but it didn't get much attention back then, so I am resurrecting it. It's another "Great Idea" that turned out to be absolute crock.

Inhibiting the enzyme that converts A into B results in less of B but more of A. This also applies to something called Cholesterol Ester Transport Protein (CETP) that transports esterified cholesterol (acid + alcohol = ester + water & cholesterol is technically an alcohol) from the tiny HDL discs to the much larger LDL & relatively huge VLDL particles. To see what HDL, LDL, VLDL & chylomicrons look like, see Large LDL and small HDL particles: The best combination.

Inhibiting CETP with Torcetrapib reduces LDL and increases HDL which sounds absolutely wonderful. Unfortunately, what has actually happened is that the cholesterol reverse transport pathway has been buggered-about with. Not surprisingly, this results in increased mortality. To see how cholesterol transport pathways work, see Figure 3 in Effect of Torcetrapib on the Progression of Coronary Atherosclerosis. See also Effect of Torcetrapib on Carotid Atherosclerosis in Familial Hypercholesterolemia.

If you want to raise your HDL, be more active and eat more monounsaturated fats, also fish oils and/or take high-dose extended-release niacin. Don't bugger-about with your cholesterol reverse transport pathway!

Monday 5 April 2010