A 45-year-old man with a 20-year history of type 2 diabetes controlled with metformin presents with substernal chest pain. Vital signs: BP 142/88 mmHg, HR 92 bpm, RR 18, Temp 37°C, SpO2 98% on room air. Labs show triglycerides 450 mg/dL, HDL cholesterol 28 mg/dL, LDL cholesterol 95 mg/dL, and fasting glucose 185 mg/dL. EKG shows no acute ST changes. Which lipoprotein abnormality best explains his dyslipidemic pattern?
- A)Decreased LDL receptor expression leading to accumulation of LDL particles
- B)Lipoprotein lipase deficiency causing chylomicronemia
- C)Apolipoprotein C-II deficiency preventing triglyceride clearance
- D)Increased VLDL production from hepatic overproduction of triglyceridesGABARITO
- E)CETP deficiency resulting in elevated HDL and low triglycerides
Explicação
Type 2 diabetes causes insulin resistance, leading to increased hepatic VLDL production and elevated triglycerides. VLDL particles compete with HDL for CETP-mediated cholesteryl ester transfer, resulting in low HDL. LDL remains relatively normal despite high t... Ver explicação completa e trilha adaptativa →