A 68-year-old man with metabolic syndrome presents with BP 148/92 mmHg, HR 88/min, and fasting glucose 118 mg/dL despite metformin 1000 mg daily. Labs show triglycerides 280 mg/dL, HDL 32 mg/dL, and HOMA-IR 3.2 indicating insulin resistance. LDL is 105 mg/dL. He denies chest pain or dyspnea. Which of the following best describes the pathophysiology of his dyslipidemia?
- A)Insulin resistance increases hepatic VLDL production and decreases HDL synthesisGABARITO
- B)High blood glucose directly inhibits lipoprotein lipase in adipose tissue
- C)Hyperglycemia directly increases apolipoprotein C-III production
- D)Insulin resistance increases LDL receptor expression on hepatocytes
- E)Metformin impairs HMG-CoA reductase feedback inhibition
Explicação
Insulin resistance causes dyslipoproteinemia characterized by elevated triglycerides and low HDL. Insulin normally suppresses hepatic apoB synthesis and VLDL production, and promotes HDL synthesis. With insulin resistance, VLDL production increases and HDL syn... Ver explicação completa e trilha adaptativa →