Pathogenesis of Atherogenic Dyslipidemia

Scott M. Grundy, MD, PhD.

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In This Article

Atherogenic Dyslipidemia and the Metabolic Syndrome

Besides the multiple mechanisms for atherogenesis accompanying the lipid triad, atherogenic dyslipidemia commonly is associated with several nonlipid risk factors as part of the insulin resistance syndrome (Figure 2).[32] As reviewed by H. Lebovitz in this supplement (p. 8), glucose intolerance can be characterized either by impaired fasting glucose (fasting glucose, 110 to 125 mg/dL) or by categorical hyperglycemia (fasting glucose > 126 mg/dL). The prothrombotic state may be accompanied by several abnormalities in the coagulation system; most notable are elevations in fibrinogen and plasminogen activator inhibitor-1 (PAI-1). The reasons for this clustering of multiple metabolic risk factors in single individuals have been the subject of intense research and speculation. Clearly, the pathogenesis of the metabolic syndrome is metabolically complex.

Besides the multiple mechanisms for atherogenesis accompanying the lipid triad, atherogenic dyslipidemia is commonly associated with several nonlipid risk factors. This clustering of lipid and nonlipid risk factors has been called the metabolic syndrome. (TG, triglycerides; LDL, low-density lipoproteins; HDL, high-density lipoproteins.)

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