A 68-year-old man with longstanding type 2 diabetes (BP 148/92, HR 88, on atorvastatin 80 mg daily) presents with advanced atherosclerosis. Current labs show LDL cholesterol 95 mg/dL (goal-achieved) and apolipoprotein B 135 mg/dL (elevated). Fasting triglycerides are 320 mg/dL. He denies chest pain. Which mechanism best explains his persistently elevated apoB despite apparently controlled LDL cholesterol concentrations?
- A)Increased number of small, cholesteryl ester-depleted LDL particles each carrying one apoB moleculeGABARITO
- B)Overproduction of large, triglyceride-enriched VLDL particles
- C)Impaired hepatic clearance of apoB-48-containing chylomicrons
- D)Enhanced production of HDL particles containing apoB
- E)Decreased catabolism of LDL receptors on hepatocytes
Explicação
In insulin resistance and diabetes, LDL particles become small and dense with reduced cholesterol content per particle. Since each LDL particle contains one apoB molecule regardless of size, elevated apoB despite normal LDL cholesterol indicates more numerous ... Ver explicação completa e trilha adaptativa →