Lipid Biochemistry USMLE Step 1 Practice Question
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?
Answer choices
- AEnhanced lipoprotein lipase activity secondary to hyperglycemia
- BDecreased hepatic VLDL production due to insulin resistance
- CImpaired cholesterol esterification in VLDL particles
- DDecreased free fatty acid uptake by adipose tissue
- EIncreased hepatic acetyl-CoA availability from excess glucose metabolism leading to increased triglyceride synthesisCorrect answer
- FReduced apolipoprotein B-100 synthesis causing impaired VLDL secretion and triglyceride accumulation
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