A 52-year-old man with type 2 diabetes and hypertension presents with BP 148/92 mmHg, HR 88/min, and truncal obesity. Laboratory studies show fasting glucose 156 mg/dL, triglycerides 350 mg/dL, HDL cholesterol 28 mg/dL, and LDL cholesterol 165 mg/dL. He denies smoking and takes metformin monotherapy. Which of the following best describes the primary defect in lipoprotein metabolism underlying his metabolic syndrome?
- A)Primary defect in apolipoprotein E synthesis impairing remnant particle clearance
- B)Insulin resistance leading to increased hepatic VLDL secretion and decreased HDL catabolismGABARITO
- C)Primary hyperproduction of chylomicrons from excessive intestinal fat absorption
- D)Genetic mutation in the CETP gene causing impaired cholesterol ester transfer
- E)Deficiency of lecithin-cholesterol acyltransferase preventing reverse cholesterol transport
Explicação
Metabolic syndrome features insulin resistance, which increases hepatic VLDL production (via increased free fatty acid delivery and upregulated MTP) while simultaneously decreasing HDL cholesterol through enhanced CETP-mediated transfer and increased HDL catab... Ver explicação completa e trilha adaptativa →