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Flashcards in Fat-bottomed girls (Lipid transport) Deck (24):
1

Pancreatic lipase

Degradation of dietary TG in small intestine

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Lipoprotein lipase (LPL)

Degradation of TG circulating in chylomicrons & VLDLs

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Hepatic TG lipase

Degradation of TG remaining in IDL

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Hormone-sensitive lipase

Degradation of TG stored in adipocytes

5

Lecithin-cholesterol acyltransferase

aka LCAT

Catalyzes esterification of cholesterol

6

Cholesterol ester transfer protein

aka CETP

Mediates transfer of cholesterol esters to other lipoprotein particles

7

Hyperchylomicronemia

Type I familial dyslipidemia

Increased chylomicrons
Elevated TG, cholesterol

LPL deficiency or altered apolipoprotein C-II (LPL cofactor)

Causes pancreatitis, hepatomegaly, & eruptive/pruritic xanthomas

*No increased risk for atherosclerosis!

8

Familial hypercholesterolemia

Familial dyslipidemia type IIa

Increased LDL
Elevated cholesterol

AD absence or decrease of LDL receptors

Causes accelerated atherosclerosis (heart attacks in 20s!), tendon xanthomas, & corneal arcus

9

Hypertriglyceridemia

Family dyslipidemia type IV

Increased VLDL
Elevated TG

Hepatic overproduction of VLDL. Causes pancreatitis

10

Abetalipoproteinemia

Hereditary inability to synthesize lipoproteins due to deficiencies in apoB-100 (Binds LDL recepto) & apoB-48 (Mediates chylomicron secretion)

AR; symptoms occur in 1st few months of life
Intestinal biopsy --> accumulation win enterocytes

Findings: failure to thrive, steatorrhea, acanthocytosis, ataxia, night blindness

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Roles of the 5 types of lipoproteins

Chylomicrons- deliver dietary TGs to peripheral tissue; deliver cholesterol to liver as chylomicron remnants (depleted of triacylglycerols); secreted by intestinal epithelial cells

VLDL- Delivers hepatic TGs to peripheral tissue; secreted by liver

IDL- Formed in the degradation of VLDL; delivers triglycerides & cholesterol to liver to be degraded to LDL

LDL- Delivers hepatic cholesterol to peripheral tissues; formed by LPL modification of VLDL in peripheral tissue; taken up by target cells via receptor-mediated endocytosis

HDL- Mediates reverse cholesterol transport from periphery to liver; acts as a repository for apoC and apoE (needed for chylomicron & VLDL metabolism); secreted from both liver & intestine

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Statins MOA

HMG-CoA reductase inhibitors

Significantly decrease LDL; slight increase in HDL; minimal decrease in TGs

Inhibit cholesterol precursor, mevalonate; upregulate apo B/E receptors on hepatocytes

SE: Hepatotoxicity, rhabdo, teratogenic

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Niacin MOA

Inhibits lipolysis in adipose tissue; reduces hepatic VLDL secretion into circulation

Significantly increases HDL; decreases LDL & triglycerides

SE: Red, flushed face (pre-treat w/ aspirin)
Hyperglycemia, hyperuricemia (look out for gout)

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Resins

Prevent intestinal reabsorption of bile acids; liver must use cholesterol to make more

Decreases LDL, slightly increases HDL, increases triglycerides

SE: It tastes NASTY; causes GI discomfort, decreased absorption of fat soluble vitamins; cholesterol gallstones

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Ezetimbe

Prevents reabsorption of cholesterol at small intestine brush border

SE: rarely increases LFTs

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Fibrates

Upregulate LPL causing increased TG clearance

SE: myositis, hepatotoxicity, cholesterol gallstones

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Cholestyramine

Resin

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Colestipol

Resin

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Colesevelam

Resin

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Gemfibrozil

Fibrate

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Clofibrate

Fibrate

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Bezafibrate

Fibrate

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Fenofibrate

Fibrate

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Major apolipoproteins

E: mediates remnant uptake by liver

A-1: Activates LCAT

C-II: LPL cofactor

B-48: Chylomicron assembly & secretion by the intestine

B-100: LDL particle uptake by extrahepatic cells