A 45-year-old man with a 20-year history of poorly controlled type 2 diabetes presents with fasting triglyceride level of 450 mg/dL and HDL of 28 mg/dL. He is not on statin therapy. On examination, he has eruptive xanthomas on his elbows and knees. Which of the following best explains the relationship between his hyperglycemia and dyslipidemia?
- A)Enhanced lipoprotein lipase activity secondary to hyperglycemia
- B)Decreased hepatic VLDL production due to insulin resistance
- C)Impaired cholesterol esterification in VLDL particles
- D)Decreased free fatty acid uptake by adipose tissue
- E)Increased hepatic acetyl-CoA availability from excess glucose metabolism leading to increased triglyceride synthesisGABARITO
Explicação
In insulin resistance and hyperglycemia, excess glucose is shunted through glycolysis producing acetyl-CoA, which is diverted toward de novo lipogenesis in the liver. This increases VLDL-triglyceride production, leading to hypertriglyceridemia and reciprocal H... Ver explicação completa e trilha adaptativa →