A 28-year-old woman at 20 weeks gestation presents with severe epigastric pain and nausea. Vital signs show BP 128/82 mmHg, HR 102 bpm, RR 18, temp 37.2°C. Serum triglycerides are 1,850 mg/dL (normal <150 mg/dL); total cholesterol is elevated. She denies alcohol use. She has a known history of familial lipoprotein lipase deficiency. Which of the following best explains the dramatically elevated triglyceride level during pregnancy?
- A)Pregnancy-induced suppression of hepatic cholesterol synthesis pathways
- B)Estrogen-induced increase in VLDL production exceeding impaired lipolytic clearanceGABARITO
- C)Lipoprotein lipase gene expression upregulation in response to fetal growth
- D)Increased intestinal absorption of dietary triglycerides during pregnancy
- E)Fetal demands for cholesterol overwhelming maternal lipid metabolism
Explicação
Pregnancy increases estrogen, which stimulates hepatic VLDL production and triglyceride synthesis. In lipoprotein lipase deficiency, chylomicrons and VLDL cannot be hydrolyzed normally. The combination of increased production (pregnancy) and severely impaired ... Ver explicação completa e trilha adaptativa →