Introduction: Obesity is a prevalent multifactorial disease whose main complication is dyslipidemia. Serum lipid levels also depend on genetic factors including the Taq1B variant of the CETP gene, which is suggested to be influenced by environmental factors and adiposity. Therefore, this study aimed to determine the effect of the Taq1B CETP variant on serum lipid levels associated with anthropometrical variables. Methods: 165 women from western Mexico were enrolled in this cross-sectional study. Weight and body fat were measured by bioimpedance and waist circumference with a measuring tape. Serum lipid levels were determined by dry chemistry. The Taq1B CETP variant was analyzed by allelic discrimination. Results: Women with abdominal obesity and the B1B2/B2B2 genotype had significantly higher total cholesterol levels (195.17 [185.95–204.39] vs. 183 mg/dL [169.83–196.16], p = 0.007) and low density lipoprotein (118.84 [110.65–127.03] vs. 113.84 mg/dL [102.37–125.31], p = 0.037) than carriers of the B1B1 genotype. Likewise, subjects with excessive adiposity and the B1B2/B2B2 genotype showed significantly higher total cholesterol levels (195.05 [186.04–204.06] vs. 182.40 mg/dL [169.03–195.76], p = 0.003) than those with the B1B1 genotype. Conclusion: Women with abdominal obesity or excessive adiposity, who are also carriers of the B1B2/B2B2 genotype, have higher serum lipid levels than women with the B1B1 genotype.

Obesity is a multifactorial disease characterized by excessive accumulation of body fat (BF) that may lead to the development of metabolic comorbidities such as insulin resistance, dyslipidemias, type 2 diabetes, and cardiovascular disease [1, 2]. In addition, the worldwide prevalence of overweight and obesity in adults has been reported as 39% and 13%, respectively [3].

Adipocyte hypertrophy is one of the main metabolic alterations in obesity, characterized by excessive hydrolysis of fatty acids and their release into the blood circulation as free fatty acids. Free fatty acids are then directed to the liver to form VLDL lipoproteins, which in turn promotes the development of dyslipidemia [4, 5]. Moreover, genetic factors are also important in the development of dyslipidemias in patients with obesity, in particular those involved in the transport of lipids, including the CETP gene [6].

The CETP is a plasma glycoprotein that mediates the exchange of cholesterol esters from the high density lipoprotein (HDL) lipoproteins into low density lipoprotein (LDL) and VLDL, as well as triglycerides (TG) from LDL and VLDL into HDL, thus increasing the TG content in HDL lipoproteins [7, 8]. One of the best-described variants in this gene is the Taq1B (rs708272), which results from a change from guanine (B1 allele) to adenine (B2 allele) at +277 in intron 1. The B1 allele has been associated with higher serum levels of CETP, lower serum HDL, and consequently more cardiovascular risk [8, 9].

Nevertheless, the effects of the variant on serum lipid levels have been controversial because they depend on the characteristics of each population, such as ethnicity. It has been proposed that it could be modulated by environmental factors including diet, physical activity, and body composition [10, 11]. Therefore, the purpose of this study was to determine the association of the Taq1B CETP variant on the lipid profile and its interaction with anthropometric variables in Mexican women.

Study Subjects

In this cross-sectional study, women from western Mexico were recruited. Men were not included in this study due to the significantly higher number of women at the Institute of Translational Nutrigenetics and Nutrigenomics (INNUGET) for medical and nutritional checkups. A general medical screening was performed on all the participants at the INNUGET of the University of Guadalajara, Jalisco, Mexico. The inclusion criteria were mestizo women (a group that constitutes the majority of the Mexican population defined by being non-indigenous and non-descendants of immigrants) aged between 18 and 60 years old with a body mass index (BMI) ≥18.5 kg/m2. Subjects were excluded if they had type 2 diabetes, liver disease, or if they had ingested either oral contraceptives or any type of lipid-lowering medication in the last year. Women who smoked or had moderate drinking (>14 g/day) during the past year were also excluded [12]. The sample size was calculated using the OPENEPI [13] software in accordance with the minor allelic frequency of Taq1B reported by Cahua-Pablo et al. [14] in a Mexican sample and considering a confidence interval of 95%.

Anthropometric Measurements

Anthropometric parameters were measured after 8–10 h of fasting and were performed without shoes and with light clothes. Height measurement was determined by a stadiometer (Rochester Clinical Research, Inc., New York, USA). Waist circumference (WC) was measured using a Lufkin Executive® Thinline 2-mm measuring tape (New Brighton, USA). Tetrapolar body electrical bioimpedance was used to assess body composition and BF percentage (InBody 370, Biospace Co., Seoul, Korea). BMI was calculated as weight in kilograms divided by height in square meters (kg/m2).

Biochemical Measurements

Blood samples were taken after 8–10 h of fasting and then centrifuged to obtain the serum, which was frozen at −80°C. Determinations of TG, total cholesterol (TC), and HDL were carried out by dry chemistry using a Vitros 350 Analyzer (Ortho-Clinical Diagnostics, Johnson & Johnson Services Inc., Rochester, NY, USA). LDL was calculated using the Friedewald formula (LDL = TC – [HDL + TG/5]) [15].

Definitions and Cutoffs

Regarding the anthropometric parameters, the cutoff for abdominal obesity was a WC ≥88 cm [16] and for excessive adiposity was a percentage of BF ≥35% [17]. Additionally, dyslipidemias were defined as follows: hypertriglyceridemia ≥150 mg/dL, hypercholesterolemia ≥200 mg/dL, hypoalphalipoproteinemia <50 mg/dL, elevated LDL ≥100 mg/dL [18], and high TG/HDL ratio ≥3.

DNA Extraction and Genotyping

Genomic DNA was extracted from peripheral leukocytes using the High Pure PCR Template Preparation Kit (Roche Diagnostics, Indianapolis, USA) method. The Taq1B CETP variant (rs708272) was determined by allelic discrimination using TaqMan® probes for single-nucleotide variant genotyping assay (Drug Metabolism Assay, Applied Biosystems, Foster City, CA, USA) on a LightCycler® 96 Real-Time PCR System (Roche Diagnostics, Mannheim, Germany) under the following conditions: 95°C for 10 min, 40 cycles of denaturation at 95°C for 15 s, and annealing/extension at 60°C for 1 min. Genotyping was verified using positive controls of the DNA samples (representing the three possible genotypes) and negative controls in each 96-well plate.

Statistical Analysis

The Shapiro-Wilk test was used to determine whether the variables were normally distributed. Descriptive data for quantitative variables were reported as medians and interquartile ranges, and qualitative variables as frequency and percentage. The Hardy-Weinberg equilibrium was calculated using the χ2 test. Comparisons were performed by placing the subjects with at least one allele B2 (B1B2/B2B2) in a single group and the subjects with the wild-type homozygous genotype (B1B1) in a second group. The differences between genotypes were adjusted by age using the analysis of covariance (ANCOVA). ANCOVA was also used to obtain the p value of the interaction between genotypes, abdominal obesity, and BF percentage as a categorical variable on serum lipids as the dependent variable. Finally, the Bonferroni test was used to determine the statistically significant differences between specific groups. Statistical analyses were performed with the SPSS v.20.0 software (IBM Corp., Armonk, NY, USA), and a p value <0.05 was considered statistically significant.

Description of the Study Population

Data from 165 women were analyzed as shown in Figure 1, and the values of anthropometric variables and serum lipid levels are described in Table 1. In this population with an average age of 37.18 ± 11.86 years, 49.1% (n = 81) showed excessive adiposity, and 47.3% (n = 78) abdominal obesity. The most prevalent dyslipidemias were hypoalphalipoproteinemia (63.8%, n = 105) followed by elevated LDL (55.2%, n = 91) (Table 2).

Fig. 1.

Flow diagram of study subjects.

Fig. 1.

Flow diagram of study subjects.

Close modal
Table 1.

Population description (n = 165)

VariablesMedium (interquartile range)
Age, years 36 (28–46) 
Anthropometric variables 
 BMI, kg/m2 24.72 (21.7–33.6) 
 WC, cm 85 (73–102) 
 BF (%) 34.55 (27.8–43.8) 
Serum lipids 
 TG, mg/dL 120 (81–166.2) 
 TC, mg/dL 182 (161–212) 
 LDL, mg/dL 109 (88–130) 
 HDL, mg/dL 44.5 (37–54) 
 TG/HDL ratio 2.6 (1.5–4.3) 
VariablesMedium (interquartile range)
Age, years 36 (28–46) 
Anthropometric variables 
 BMI, kg/m2 24.72 (21.7–33.6) 
 WC, cm 85 (73–102) 
 BF (%) 34.55 (27.8–43.8) 
Serum lipids 
 TG, mg/dL 120 (81–166.2) 
 TC, mg/dL 182 (161–212) 
 LDL, mg/dL 109 (88–130) 
 HDL, mg/dL 44.5 (37–54) 
 TG/HDL ratio 2.6 (1.5–4.3) 

BMI, body mass index; WC, waist circumference; BF, body fat; TG, triglycerides; TC, total cholesterol; LDL, low density lipoprotein; HDL, high density lipoprotein.

Table 2.

Prevalence of dyslipidemias (n = 165)

AlterationSubjects %
Hypoalphalipoproteinemia 63.8 
Elevated LDL 55.2 
Hypercholesterolemia 36.4 
Hypertriglyceridemia 33.3 
High TG/HDL ratio 31.5 
AlterationSubjects %
Hypoalphalipoproteinemia 63.8 
Elevated LDL 55.2 
Hypercholesterolemia 36.4 
Hypertriglyceridemia 33.3 
High TG/HDL ratio 31.5 

LDL, low density lipoprotein cholesterol; HDL, high density lipoprotein; TG, triglycerides.

Characteristics of the Study Population according to the Taq1B CETP Variant

The B1B1 genotype was present in 31.5% (n = 52) of the study population, B1B2 in 44.8% (n = 74), and B2B2 in 23.7% (n = 39). The distribution of the B1 and B2 alleles was 54 and 46%, respectively. The distribution of the genotype frequencies complied with the Hardy-Weinberg equilibrium (p = 0.210).

Comparisons were performed between the groups with the wild-type B1B1 genotype versus the group with the variant B1B2/B2B2. However, there were no significant differences between genotypes regarding serum lipid levels and anthropometric characteristics (data not shown).

Interaction of the Taq1B CETP Variant and Abdominal Obesity on Serum Lipid Levels

When biochemical variables were analyzed on the basis of abdominal obesity (WC ≥88 cm) between B1B1 and B1B2/B2B2 genotypes, subjects with abdominal obesity and the B1B2/B2B2 genotype had significantly higher levels of TC (p for interaction = 0.007) and LDL (p for interaction = 0.037) than subjects with the B1B1 genotype (Table 3).

Table 3.

Serum lipids by Taq1B CETP variant and WC (n = 165)

Adequate WC (n = 84)High WC (abdominal obesity) (n = 81)
B1B1 (n = 26)B1B2/B2B2 (n = 58)B1B1 (n = 26)B1B2/B2B2 (n = 55)P-interaction
TG, mg/dL 108.12 (75.77–140.47) 119.12 (98.13–140.11) 142.76 (111.69–173.84) 165.75 (143.98–187.52) 0.662 
TC, mg/dL 193.24 (179.81–206.66) 173.82 (164.93–182.71) 183.00* (169.83–196.16) 195.17 (185.95–204.39) 0.007 
HDL, mg/dL 54.26 (49.51–59.01) 51.10 (48.08–54.12) 39.15 (34.68–43.62) 39.92 (36.76–43.08) 0.325 
LDL, mg/dL 116.55 (103.47–129.62) 99.48 (91.66–107.29) 113.84* (102.37–125.31) 118.84 (110.65–127.03) 0.037 
Ratio TG/HDL 2.01 (1.67–3.35) 2.60 (1.72–3.49) 4.03 (2.71–5.34) 4.77 (3.86–5.67) 0.899 
Adequate WC (n = 84)High WC (abdominal obesity) (n = 81)
B1B1 (n = 26)B1B2/B2B2 (n = 58)B1B1 (n = 26)B1B2/B2B2 (n = 55)P-interaction
TG, mg/dL 108.12 (75.77–140.47) 119.12 (98.13–140.11) 142.76 (111.69–173.84) 165.75 (143.98–187.52) 0.662 
TC, mg/dL 193.24 (179.81–206.66) 173.82 (164.93–182.71) 183.00* (169.83–196.16) 195.17 (185.95–204.39) 0.007 
HDL, mg/dL 54.26 (49.51–59.01) 51.10 (48.08–54.12) 39.15 (34.68–43.62) 39.92 (36.76–43.08) 0.325 
LDL, mg/dL 116.55 (103.47–129.62) 99.48 (91.66–107.29) 113.84* (102.37–125.31) 118.84 (110.65–127.03) 0.037 
Ratio TG/HDL 2.01 (1.67–3.35) 2.60 (1.72–3.49) 4.03 (2.71–5.34) 4.77 (3.86–5.67) 0.899 

Values are shown as estimated means and confidence intervals.

P-interaction: value obtained from the interaction of the categorical variables (genotypes and WC) on the serum lipids by the ANCOVA.

*Difference in WC ≥88 cm between B1B1 and B1B2/B2B2 genotypes. B1B1, wild homozygote for allele B1; B1B2/B2B2, heterozygous and homozygous polymorphic for allele B2. WC, waist circumference; TG, triglycerides; TC, total cholesterol; LDL, low density lipoprotein; HDL, high density lipoprotein.

Interaction of the Taq1B CETP Variant and Excessive Adiposity on Serum Lipid Levels

Likewise, when biochemical variables were analyzed on the basis of excessive adiposity (BF ≥35%) between B1B1 and B1B2/B2B2 genotypes, subjects with excessive adiposity and the B1B2/B2B2 genotype showed significantly higher levels of TC (p for interaction = 0.003) than subjects with the B1B1 genotype (Table 4).

Table 4.

Serum lipids by Taq1B CETP variant and BF% (n = 165)

Adequate BF% (n = 83)High BF% (n = 82)
B1B1 (n = 27)B1B2/B2B2 (n = 56)B1B1 (n = 25)B1B2/B2B2 (n = 57)P-interaction
TG, mg/dL 110.80 (81.11–140.50) 105.12 (84.70–125.54) 140.48 (110.19–170.76) 178.05 (157.63–198.47) 0.098 
TC, mg/dL 194.29 (181.43–207.16) 173.16 (164.15–182.17) 182.40 (169.03–195.76)* 195.05 (186.04–204.06) 0.003 
HDL, mg/dL 52.96 (48.26–57.65) 50.50 (47.34–53.67) 39.32 (34.62–44.01) 40.94 (37.75–44.13) 0.317 
LDL, mg/dL 118.77 (106.03–131.50) 102.29 (94.16–110.42) 113.20 (101.25–125.14) 115.24 (107.04–123.45) 0.082 
Ratio TG/HDL 2.09 (1.89–3.35) 2.32 (1.44–3.20) 4.03 (2.72–5.34) 5.01 (4.14–5.89) 0.503 
Adequate BF% (n = 83)High BF% (n = 82)
B1B1 (n = 27)B1B2/B2B2 (n = 56)B1B1 (n = 25)B1B2/B2B2 (n = 57)P-interaction
TG, mg/dL 110.80 (81.11–140.50) 105.12 (84.70–125.54) 140.48 (110.19–170.76) 178.05 (157.63–198.47) 0.098 
TC, mg/dL 194.29 (181.43–207.16) 173.16 (164.15–182.17) 182.40 (169.03–195.76)* 195.05 (186.04–204.06) 0.003 
HDL, mg/dL 52.96 (48.26–57.65) 50.50 (47.34–53.67) 39.32 (34.62–44.01) 40.94 (37.75–44.13) 0.317 
LDL, mg/dL 118.77 (106.03–131.50) 102.29 (94.16–110.42) 113.20 (101.25–125.14) 115.24 (107.04–123.45) 0.082 
Ratio TG/HDL 2.09 (1.89–3.35) 2.32 (1.44–3.20) 4.03 (2.72–5.34) 5.01 (4.14–5.89) 0.503 

Values are shown as estimated means and confidence interval.

P-interaction: value obtained from the interaction of the categorical variables (genotypes and BF%) on the serum lipids by the ANCOVA.

*Difference in BF% ≥35% between B1B1 and B1B2/B2B2 genotypes. B1B1, wild homozygote for allele B1; B1B2/B2B2, heterozygous and homozygous polymorphic for allele B2; BF, body fat; TG, triglycerides; TC, total cholesterol; LDL, low density lipoprotein; HDL, high density lipoprotein.

It is well known that obesity is a multifactorial disease in which the patients have excessive BF [2]. The main anthropometric indicators to determine obesity are BMI, WC, and BF percentage; however, it is recommended to use them together for a proper diagnosis [19].

We found a high prevalence of women with abdominal obesity in the study population (47.3%). Nevertheless, according to the ENSANUT 2018–19, 88.4% of women have abdominal obesity, but it is important to note that they employed the cut-off points from the International Diabetes Federation that define a high WC as ≥80 cm [20].

Regarding the percentage of BF (excessive adiposity), in the present study, an average of 35.66 ± 10.38% was obtained, in agreement with what was previously reported by our research group with a mean of 36.4 ± 8.3% [21]. In addition, the percentage of BF is similar to the one described by Campos-Ramírez et al. [22] in 394 subjects from Mexico with an average of 31.13 ± 7.57%.

We also found that the most prevalent dyslipidemias are hypoalphalipoproteinemia and elevated LDL, whereas hypertriglyceridemia was the least prevalent, probably due to other gene variants related to a specific population, physical activity, or diet. Moreover, the most prevalent dyslipidemias can be explained because one of the most frequent causes is excessive adiposity, especially when it accumulates mostly in the abdominal area [23]. It has been reported that in individuals with excessive abdominal fat, there is a greater synthesis of plasma VLDL, higher LDL, and lower HDL concentrations [24]. These alterations in serum lipids could be enhanced due to an increased CETP activity transporting cholesterol and TG [24, 25].

In this study, we found an interaction of the Taq1B CETP variant effect with abdominal obesity and excessive adiposity. We observed higher concentrations of TC and LDL in subjects who had both abdominal obesity and the B1B2/B2B2 genotype. Moreover, we also noted that women with this genotype and excessive adiposity had higher serum TC.

It has been reported that the B2 allele is associated with lower serum levels and lower CETP activity, which would in turn promote a reduction in the transfer of cholesterol from HDL to VLDL and, therefore, higher serum levels of HDL. However, the results in different populations have been inconsistent [26, 27].

Accordingly, it has been reported that associations of gene and environmental factors could highly influence the effect of the variant [28]; for example, in a study published by our research group, when comparing the biochemical variables in subjects classified by genotype, no differences on lipid profile were found, but when environmental factors were considered, the association was significant. The B1B2/B2B2 genotype may interact with the dietary intake of sucrose and physical inactivity on serum lipid levels since the carriers of the B1B2/B2B2 genotype with sucrose consumption higher than 5% of total calories and physical inactivity had higher concentrations of TC and LDL [10]. Nevertheless, to our knowledge, it is the first paper that evaluates the interaction between the variant and anthropometric parameters.

Our results highlight the importance of the regulation of genes by environmental factors. Even though some studies have reported that the wild-type homozygous B1B1 genotype is a risk factor for hyperlipidemia due to its association with elevated TG levels and higher CETP activity [29], an increase of serum TG has also been reported in carriers of the B2 allele. In these individuals, the cardioprotective effect is significantly decreased [30], concluding that there is a greater effect of TG-rich lipoproteins on the cholesterol ester transfer process than the effect provided by the Taq1B variant of CETP in protein levels and activity [31].

In this study, we did not find differences between the concentrations of serum lipids according to genotype; however, despite the lack of statistical difference, we found that the concentration of TG was higher in the subjects with the presence of the variant and high BF % or abdominal obesity. Likewise, we expected to find a higher prevalence of CETP TaqB1 variant in woman with lower serum HDL; however, hypoalphalipoproteinemia is highly prevalent in this population; thus, comparisons are difficult to make. Findings led us to propose that other important factors that may be related to HDL serum levels, including variants in other genes involved in lipid metabolism, as well as physical activity and diet characteristics.

Freeman et al. [32] reported that the variant carriers (B2B2) possess significantly higher HDL levels than wild-type homozygotes (p < 0.005). However, when genotypes were analyzed based on the BMI, the difference in HDL levels between subjects with B2B2 and B1B1 genotypes with a BMI between 18.3 and 23.5 kg/m2 was 11.21 mg/dL (p < 0.05), while no statistical difference was found in subjects with a BMI between 26.2 and 40.4 kg/m2.

Similarly, in an investigation carried out in 187 Caucasian men, carriers of the B2B2 genotype had higher plasma HDL concentrations than B1B2 and B1B1 (p < 0.05); however, the effect of the B2 allele on plasma concentrations of HDL was reduced in the presence of a BMI ≥27 kg/m2, a higher accumulation of visceral adipose tissue, and insulin levels ≥13.07 µU/mL. The percentage of decrease in HDL concentrations related to these three conditions (high BMI, visceral obesity, and insulin levels) was more evident in the B2B2 group than in the B1B1 group, for which the authors suggest that the B2 allele is more influenced by the environmental factors compared to the B1 allele [33].

The conflicting results reveal that there is a need for more studies that evaluate other genetic variants affecting lipoprotein metabolism and changes in body composition in patients nutritionally addressed and classified by genotype (B1B2/B2B2 vs. B1B1) to find the best response to the nutrition intervention and to fully understand the role of the genotype in this population.

The limitations of this work include that it was not possible to evaluate the effect of the variant and the anthropometric variables on other serum determinations, such as oxidized LDL and oxidized HDL. Also, it would be important to determine the serum levels and activity of CETP protein in a higher number of subjects including men.

In the present study, we provide evidence that women with abdominal obesity or excessive adiposity who are also carriers of the B1B2/B2B2 CETP genotype had higher serum lipid levels than women with the B1B1 genotype, making evident the gene-environmental interaction. Therefore, it is important to include in future studies the Taq1B CETP variant and other genetic variants related to lipid metabolism to better treat and prevent metabolic disturbances. Moreover, it is important to promote a healthy BF% and WC.

Subjects were informed about the research procedures, and those who agreed to participate signed an informed consent. This study was approved by the Ethics and Biosafety Committee for Human Research of the Health Sciences Center, Universidad de Guadalajara, Jalisco, Mexico (Registration number: CI/019/2010). All procedures were conducted following the Code of Ethics of the World Medical Association (Declaration of Helsinki), and informed consent was obtained from all participants.

The authors have no conflicts of interest to declare.

This investigation was supported financially through a grant from FODECIJAL 8057-2019 and Fortalecimiento Universidad de Guadalajara 2020.

M.P.-R.: formal analysis and writing – original draft. W.C.-P.: methodology and investigation. J.T.-V.: visualization and writing. S.C.R.-R.: data curation. J.J.R.-V.: validation. E.M.-L.: conceptualization, resources, and project administration. All authors read and approved the final manuscript.

All data generated or analyzed during this study are included in this article. Further inquiries can be directed to the corresponding author.

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