What is the pathophysiology of low LDL cholesterol syndromes?

Updated: Mar 06, 2018
  • Author: Vibhuti N Singh, MD, MPH, FACC, FSCAI; Chief Editor: George T Griffing, MD  more...
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Answer

Cholesterol and triglycerides are transported from sites of synthesis to sites of utilization in the form of lipoproteins. These particles consist of a core of cholesterol esters and triglycerides surrounded by a monolayer of free cholesterol, phospholipids, and proteins (apolipoproteins). The 4 major lipoproteins are very low-density lipoprotein (VLDL), low-density lipoprotein (LDL), high-density lipoprotein (HDL), and chylomicrons (CMs). VLDL and CMs are assembled within the lumen of the endoplasmic reticulum of hepatocytes and enterocytes, respectively, transported to the Golgi complex, and then secreted into the circulation.

Each lipoprotein is characterized by its lipid composition and by the type and number of apolipoproteins it possesses. CMs, VLDL, and LDL carry apolipoproteins on their surface; these apolipoproteins have lipid-soluble segments, the beta apolipoproteins, which remain part of the lipoprotein throughout its metabolism. Other apolipoproteins (A, C, D, E, and their subtypes) are soluble and are exchanged between lipoproteins during metabolism.


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