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Figure 3 Effect of cholesteryl ester transfer protein (CETP) on lipoprotein particle size. Cholesteryl ester transfer protein mediates the transfer of triglycerides (TG) from TG-rich lipoproteins to high-density lipoprotein (HDL) and low-density lipoprotein (LDL) in exchange for cholesteryl esters (CE). Through the action of TG lipases, HDL particles decrease in size and apolipoprotein (Apo) A1 dissociates from HDL. Although dissociated Apo A1 may be reused in the first step of reverse cholesterol transport as an acceptor of cholesterol effluxed from cells, it may also be lost by renal clearance. Triglyceride lipases similarly reduce the size of LDL particles. The resultant small, dense LDL is more susceptible to oxidation and subsequent uptake by arterial macrophages. VLDL = very low-density lipoprotein.