However, a study involving a large cohort of patients presenting at least three criteria of MetS, clearly demonstrated that the increased ABCA1-dependent CEC is unable to counterbalance the reduction in ABCG1- and SR-BI-mediated CEC; accordingly, multivariate analyses suggested a significant association between total CEC and established MetS, independently of age, LDL-C, lipid lowering therapy, smoking or alcohol consumption [155]. This evidence concerns the gene ABCA1 and metabolic syndrome.