A 41-year-old man with Type 2 diabetes presents with fatigue. Vital signs: BP 138/88 mmHg, HR 92 bpm, RR 16/min, Temp 37.0°C, SpO2 98% on room air. He denies chest pain. Labs show HDL cholesterol 28 mg/dL, triglycerides 280 mg/dL, LDL 145 mg/dL, and elevated fasting glucose of 156 mg/dL. He takes metformin and atorvastatin without improvement in lipid profile. A fibrate is added. Which mechanism best explains how fibrates improve his lipid abnormalities?
- A)Inhibition of intestinal cholesterol absorption
- B)Competitive inhibition of hepatic HMG-CoA reductase
- C)Direct activation of hepatic cholesterol 7-alpha-hydroxylase
- D)Activation of PPAR-alpha increases lipoprotein lipase expression and reduces triglyceridesGABARITO
- E)Inhibition of hepatic apolipoprotein B-100 synthesis
Explicação
Fibrates are PPAR-alpha agonists. Activation of PPAR-alpha increases transcription of lipoprotein lipase and apoA-I, leading to increased triglyceride hydrolysis and modest HDL elevation. This makes fibrates especially useful for hypertriglyceridemia and low H... Ver explicação completa e trilha adaptativa →