A 55-year-old man with metabolic syndrome and prior MI at age 48 presents with elevated apolipoprotein B (142 mg/dL) despite normal LDL cholesterol (110 mg/L). Vitals: BP 148/92, HR 88, RR 16, Temp 37°C, SpO2 98%. Labs reveal elevated triglycerides (280 mg/dL), normal glucose, and reduced HDL (32 mg/dL). He takes atorvastatin. Which mechanism best explains the discordance between LDL-C and apoB levels?
- A)Laboratory error in apoB measurement with falsely elevated results
- B)Elevated lipoprotein(a) with excess apolipoprotein(a) but reduced apoB content
- C)Presence of small, dense LDL particles carrying less cholesterol per particle but increased particle numberGABARITO
- D)Genetic polymorphism in apoB causing increased protein synthesis without lipid changes
- E)High VLDL levels increasing apoB content independent of cholesterol concentration
Explicação
In metabolic syndrome and insulin resistance, lipoprotein particles become smaller and denser while maintaining similar total cholesterol content. Since each LDL particle carries one apoB molecule regardless of size, small dense LDL creates discordance: normal... Ver explicação completa e trilha adaptativa →