CETP (cholesteryl ester transfer protein) is a plasma lipid transfer protein that mediates the bidirectional exchange of neutral lipids among lipoprotein particles 1. Its primary function is to facilitate the net transfer of cholesteryl esters from HDL to triglyceride-rich VLDL and LDL, while transporting triglycerides in the opposite direction 2. CETP plays a central role in reverse cholesterol transport, the process by which excess cholesterol is removed from peripheral tissues and returned to the liver for elimination 3. CETP activity is upregulated by increased dietary or endogenous cholesterol 1. Naturally occurring CETP gene variants, including the -629 C→A promoter variant, I405V, and TaqIB polymorphisms, are associated with altered CETP activity and HDL-cholesterol levels 4. CETP deficiency mutations result in markedly elevated HDL-cholesterol and reduced LDL-cholesterol, with heterozygous CETP deficiency being common in Japanese populations 5. Clinically, CETP inhibitors (such as obicetrapib, anacetrapib, and evacetrapib) are therapeutic targets that substantially raise HDL-cholesterol while reducing LDL-cholesterol, potentially reducing atherosclerotic cardiovascular disease risk 6. However, CETP demonstrates sex-specific vascular effects independent of HDL modulation, with impaired endothelial function and increased oxidative stress in males but preserved anticontractile function in females 7.