Metabolism of Lipids: Hyperlipidemia Flashcards
Levels of certain plasma lipids and lipoproteins are key risk factors for
cardiovascular disease (CVD)
most important plasma lipids are
cholesterol and triglyceride.
The main TG-carrying lipoproteins are
chylomicron (CM) and very low-density lipoprotein (VLDL)
The main cholesterol carrying lipoproteins are
low-density lipoprotein (LDL) and high-density lipoprotein (HDL)
Cholesterol is the precursor for
steroid hormones, vitamin D, and bile acids
Triglycerides is a key energy source that is made up of
Free fatty acids that are ester-linked to a glycerol backbone
Triglycerides is synthesized in
intestinal and liver cells
After being synthesized in intestinal and liver cells triglycerides are then ….
transported through the plasma to peripheral cells for β- oxidation or storage
Lipids that are engulfed by macrophages become oxidized, generating toxic intermediates, which induce…
cytokine production and chemotaxis of inflammatory cells
LDL-loaded arterial-wall macrophages become
foam cells
What do foam cells take part of?
atherogenic plaques
What LDL has greater atherogenic potential?
small dense LDLs (sdLDLs)
Modified sdLDL is a
potent inductor of inflammatory processes associated with cardiovascular disease
What apolipoprotein ratios has strongest predictor of CHD risk?
ApoB to ApoA-I
Different homozygous loss- of-function mutations in the APOB or PCSK9 genes cause a monogenic syndrome called …
Hypobetalipoproteinaemia (HHbL)
Homozygous mutations in microsomal triglyceride transfer protein (MTTP), cause a disease called
abetalipoproteinaemia (ABL)
homozygous mutations in the ATP-binding cassette gene (ABCA1) or homozygous deficiencies of apolipoprotein A-I (ApoA1) or lecithin-cholesterol acyltransferase (LCAT) disease is called…
Tangier disease
Individuals with HDL cholesterol levels above the ninety-fifth percentile have homozygous deficiencies of:
CETP
plasma LDL cholesterol levels depend crucially on
LDL receptor function
LDL receptor function requires proper binding of ______, the presence of _______, and regulated intracellular receptor degradation by __________.
apolipoprotein B, LDL receptor accessory protein 1 (LDLRAP1), the convertase PCSK9
Mutations in two genes encoding ATP-binding cassette proteins, ABCG5 and ABCG8, were discovered in patients with
Sitosterolaemia
Intestinal hyperabsorption and decreased biliary excretion of dietary sterols leading to hypercholesterolaemia, lipid deposits in the skin and tendons (xanthomas), and accelerated CVD
Sitosterolaemia
Which was the first member of drugs that inhibit sterol absorption?
ezetimibe
Name the disease that is characterized by low HDL cholesterol
Hypoalphalipoproteinemia
In hypoalphalipoproteinemia, there are several factors that contribute to low HDL cholesterol levels that need to be identified in clinical practice. These include:
● Elevated serum triglycerides
● Overweight and obesity
● Physical inactivity
● Cigarette smoking
● Very high carbohydrate intakes (>60 percent of total energy intake)
● Type 2 diabetes
● Certain drugs (beta-blockers, anabolic steroids, progestational agents)
●Genetic factors
Therapeutic lifestyle changes if LDL is above goal include?
- TLC Diet:
- saturated fat <7% of calories
- cholesterol <200mg/day
- increase soluble fiber and plant sterols
- weight management
- increase physical activity
Coronary heart disease modifiable risk factors?
- Hypertension
- cigarrette smoking
- thrombogenic/hemostatic state
- diabetes
- obesity
- physical inactivity
- atherogenic diet
Coronary heart disease non-modifiable risk factors?
- age
- male sex
- family history of premature CHD
