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Disorders of Lipoprotein Metabolism

Chapter 419 | Part 12: Endocrinology and Metabolism · Part 12 – Endocrinology & Metabolism · Chapter 419


Key Clinical Points

  1. Lipoproteins are complexes of lipids (TGs, cholesterol) and proteins (apolipoproteins) essential for the transport of lipids and fat-soluble vitamins.
  2. Lipoproteins are classified by density: Chylomicrons (least dense, largest) to HDL (most dense, smallest).
  3. Severe Hypertriglyceridemia (HTG) is defined as fasting TG >500 mg/dL and carries a significant risk of acute pancreatitis.
  4. Familial Hypercholesterolemia (FH) results from mutations in LDLR, APOB, or PCSK9, leading to elevated LDL-C and premature ASCVD.
  5. Lp(a) is an independent, heritable risk factor for ASCVD and aortic stenosis; elevated levels require aggressive management.
  6. The Friedewald formula (LDL-C = total cholesterol - (TG/5) - HDL-C) is only reliable if TG < 200 mg/dL and cannot be used if TG > 400 mg/dL.
  7. ApoB levels may provide a more accurate assessment of cardiovascular risk than LDL-C alone as it reflects the number of atherogenic particles.
  8. Chylomicron remnants are cleared by the liver via ApoE as a ligand; ApoB-48 lacks the region required to bind to the LDLR.
  9. Reverse Cholesterol Transport (RCT) is mediated by HDL and involves LCAT for esterification, CETP for lipid exchange, and SR-BI for liver uptake.
  10. Primary dyslipidemias are often monogenic (e.g., FCS, FH), while many cases of HTG are polygenic or secondary to conditions like obesity, diabetes, or alcohol use.

DEFINITION & OVERVIEW

Lipoproteins: Complexes of lipids and proteins essential for transporting cholesterol, triglycerides (TGs), and fat-soluble vitamins. • Structure: ◦ Core: Hydrophobic lipids (TGs and cholesteryl esters). ◦ Shell: Hydrophilic lipids (phospholipids, unesterified cholesterol) and apolipoproteins. • Classification by Density/Size: ◦ Chylomicrons: Largest, most lipid-rich, least dense. ◦ VLDL: Very-low-density; intermediate size. ◦ IDL: Intermediate-density; transition between VLDL and LDL. ◦ LDL: Low-density; small, high-density particles. ◦ HDL: High-density; smallest, most dense particles. • Apolipoproteins: Required for assembly, structure, function, metabolism, and catabolism. ◦ ApoB: Major structural protein of chylomicrons (ApoB-48), VLDL, IDL, and LDL (ApoB-100). ◦ ApoA-I: Core structural protein for HDL; promotes cellular lipid efflux via ABCA1; activates LCAT. ◦ ApoC-II & ApoA-V: Regulate TG-rich lipoprotein metabolism; ApoC-II is a required cofactor for LPL. ◦ ApoE: Critical for clearance of TG-rich particles (remnants and IDL) by the liver. ◦ Apo(a): Distinctive apolipoprotein that results in the formation of Lp(a).

Table 419-1 summarizes major apolipoproteins: • ApoA-I: Intestine/Liver; HDL, chylomicrons; promotes efflux via ABCA1, activates LCAT. • ApoA-II: Liver; HDL, chylomicrons; structural protein. • ApoA-V: Liver; VLDL, chylomicrons; promotes LPL-mediated triglyceride lipolysis. • Apo(a): Liver; Lp(a); structural protein. • ApoB-48: Intestine; Chylomicrons, chylomicron remnants; core structural protein. • ApoB-100: Liver; VLDL, IDL, LDL, Lp(a); ligand for LDLR (except for Lp(a)). • ApoC-II: Liver; Chylomicrons, VLDL, HDL; cofactor for LPL. • ApoC-III: Liver/Intestine; Chylomicrons, VLDL, HDL; inhibitor of LPL activity and remnant binding. • ApoE: Liver; Chylomicron remnants, IDL, HDL; ligand for LDLR and other receptors.


EPIDEMIOLOGY

Screening: All adults (and many children) should be screened for plasma lipids. • Measurement Methods: ◦ Total Cholesterol & TGs: Measured enzymatically. ◦ HDL-C: Determined after precipitation of apoB-containing lipoproteins. ◦ LDL-C Calculation (Friedewald): LDL-C = total cholesterol - (TG/5) - HDL-C. → Valid if: Fasted plasma and TG ≤ 200 mg/dL. → Invalid if: TG > 400 mg/dL. ◦ Non-HDL-C: Total cholesterol - HDL-C; includes VLDL and IDL (both atherogenic). • Risk Markers: ◦ ApoB: May provide a better assessment of cardiovascular risk than LDL-C or non-HDL-C. ◦ Lp(a): Independent, highly heritable risk factor for ASCVD and aortic stenosis. • Prevalence of Specific Disorders: ◦ Familial chylomicronemia syndrome (FCS): ~1/200,000–300,000. ◦ Familial hypercholesterolemia (FH): ~1/250 (heterozygous). ◦ Familial dysbetalipoproteinemia (FDBL): ~1/10,000. ◦ Multifactorial severe hypertriglyceridemia: ~1 in 1,000.


ETIOLOGY & PATHOPHYSIOLOGY

Metabolic Pathways: ◦ Exogenous Pathway (Chylomicrons): Chylomicrons → Capillary system → LPL action → Chylomicron remnants → Liver clearance via ApoE. ◦ Endogenous Pathway (VLDL/LDL): VLDL → IDL → LDL → Capillary system → LPL action → FFA release to Muscle/Adipose tissue. ◦ Reverse Cholesterol Transport (HDL): Peripheral cells → Free cholesterol → Nascent HDL (ApoA-I) → Mature HDL (via LCAT) → Liver (via SR-BI).

Key Metabolic Nodes: 1. Lipolysis of TG-rich lipoproteins by LPL. 2. Receptor-mediated uptake of apoB-containing lipoproteins by the liver. 3. Cellular cholesterol metabolism in the hepatocyte and enterocyte. 4. Assembly and secretion of VLDLs by the liver. 5. Neutral lipid transfer and phospholipid hydrolysis in the plasma.

Genetic vs. Secondary Factors: ◦ Primary (Monogenic): → FCS: Mutations in LPL, APOC2, APOA5, GPIHBP1, LMF1. → FPLD: Mutations in LMNA, PPARG, PLIN1, AKT2, ADRA2A. → FH: Mutations in LDLR, APOB (receptor binding region), PCSK9 (GoF), LDLRAP1. → Sitosterolemia: ABCG5, ABCG8. → FDBL: APOE2 variant, LIPC. ◦ Secondary (Multifactorial): → Obesity, Type 2 diabetes, insulin resistance, high-carbohydrate diet, alcohol use.

Figure 419-1 illustrates the inverse relationship between size and density. Figure 419-2 maps the exogenous and endogenous pathways. Figure 419-3 details HDL metabolism and reverse cholesterol transport.


CLINICAL FEATURES

Severe Hypertriglyceridemia (HTG): ◦ Definition: Fasting TG >500 mg/dL. ◦ Clinical Findings: → Eruptive xanthomas. → Hepatosplenomegaly. ◦ Risk: Acute pancreatitis; potential for increased ASCVD risk if exacerbated by other factors. • Elevated LDL-C: ◦ Associated with Atherosclerotic Cardiovascular Disease (ASCVD). ◦ Clinical signs in FH: Tendon xanthomas, premature ASCVD. • Mixed Dyslipidemia and Low HDL: ◦ Characterized by elevated chylomicron remnants and IDL. ◦ Clinical signs in FDBL: Palmar and tuberoeruptive xanthomas, premature ASCVD.


DIFFERENTIAL DIAGNOSIS

Primary vs. Secondary Dyslipidemia: ◦ Primary: Genetic mutations (e.g., LPL, ApoC-II, ApoA-V, GPIHBP1, LMF1). ◦ Secondary: Induced by lifestyle or medical conditions.

Table 419-3 lists secondary causes of altered lipid levels: • TG Elevated: High-carbohydrate diet, Alcohol, Obesity, Insulin resistance, Type 2 diabetes, Lipodystrophy, Chronic kidney disease, Nephrotic syndrome, Viral hepatitis, Sepsis, Cushing’s syndrome. • LDL-C Elevated: Obesity, Type 2 diabetes, Lipodystrophy, Chronic kidney disease, Nephrotic syndrome, Viral hepatitis, Sepsis, Cushing’s syndrome. • HDL-C Reduced: High-carbohydrate diet, Alcohol, Obesity, Insulin resistance, Type 2 diabetes, Lipodystrophy, Chronic kidney disease, Nephrotic syndrome, Viral hepatitis, Sepsis, Cushing’s syndrome. • Lp(a) Elevated: Chronic kidney disease, Nephrotic syndrome, Inflammation, Menopause, Orchidectomy, Hypothyroidism, Acromegaly.


DIAGNOSTIC APPROACH

  1. Initial Screening: Obtain a lipid panel (preferably after an overnight fast).
  2. Calculation of LDL-C:
  3. If TG < 200 mg/dL → Use Friedewald formula (LDL = TC - [TG/5] - HDL).
  4. If TG > 200 mg/dL → Direct measurement of LDL-C.
  5. Assessment of Non-HDL-C:
  6. Calculate by subtracting HDL-C from total cholesterol to include VLDL and IDL.
  7. Identification of Secondary Causes:
  8. Evaluate for alcohol, obesity, diabetes, and renal disease (Table 419-3).
  9. Clinical Correlation for Specific Syndromes:
  10. Presence of eruptive xanthomas → suspect FCS.
  11. Presence of tendon xanthomas → suspect FH.
  12. Presence of palmar/tuberoeruptive xanthomas → suspect FDBL.

MANAGEMENT & TREATMENT

  1. Lifestyle Modifications:
  2. Implement dietary changes and exercise to manage lipids.
  3. LDL-Lowering Therapy (HMG-CoA reductase inhibitors/Statins):
  4. Lovastatin: 20–40 mg daily (Max 80).
  5. Pravastatin: 40–80 mg daily (Max 80).
  6. Simvastatin: 20–40 mg daily (Max 80).
  7. Fluvastatin: 20–40 mg daily (Max 80).
  8. Atorvastatin: 20–40 mg daily (Max 80).
  9. Rosuvastatin: 5–20 mg daily (Max 40).
  10. Pitavastatin: 1–2 mg daily (Max 4).
  11. Bile Acid Sequestrants (for elevated LDL-C):
  12. Cholestyramine: 4 g daily (Max 32 g).
  13. Colestipol: 5 g daily (Max 40 g).
  14. Colesevelam: 3750 mg daily (Max 4375 mg).
  15. Bempedoic Acid (ATP citrate lyase inhibitor):
  16. Dose: 180 mg daily.
  17. Mipomersen (ApoB inhibitor):
  18. Use in HoFH; Dose: 200 mg SC weekly.
  19. ANGPTL3 Inhibitor:
  20. Dose: 15 mg/kg IV q 4 weeks.
  21. TG-Lowering Therapy (for elevated TG):
  22. Fibrates (Gemfibrozil, Fenofibrate).
  23. Fish oil (e.g., 4 g daily).
  24. Escalation for High Risk:
  25. Patients with TG >500 mg/dL after trial of diet/exercise → initiate fibrate or fish oil to prevent pancreatitis.

PROGNOSIS & COMPLICATIONS

Acute Pancreatitis: Risk in patients with severe hypertriglyceridemia (TG >500 mg/dL). • Atherosclerotic Cardiovascular Disease (ASCVD): Primary risk for elevated LDL-C, high Lp(a), and chylomicron remnants. • Aortic Stenosis: Associated with elevated Lp(a) levels.


KEY PEARLS & CLINICAL TRAPS

Friedewald Rule: Only use if TG < 200 mg/dL; never use if TG > 400 mg/dL. • ApoB vs. LDL-C: ApoB may be a superior marker for cardiovascular risk as it reflects the total number of atherogenic particles. • Lp(a) Significance: It is an independent, heritable risk factor; high levels require aggressive therapy to lower LDL-C. • Chylomicron Clearance: Requires ApoE as a ligand for liver receptors (ApoB-48 lacks the LDLR binding site). • HDL Function: Reverse cholesterol transport involves LCAT (esterification), CETP (lipid exchange), and SR-BI (liver uptake).


Reference Tables

TABLE 419-1 Major Apolipoproteins APOLIPOPROTEIN ApoA-I ApoA-II ApoA-V Apo(a) ApoB-48 ApoB-100 ApoC-II ApoC-III ApoE…

Harrison's 22e, p.3237

APOLIPOPROTEIN PRIMARY SOURCE LIPOPROTEIN ASSOCIATION FUNCTION
ApoA-I Intestine, liver HDL, chylomicrons Core structural protein for HDL, promotes cellular lipid efflux via ABCA1,
activates LCAT
Liver HDL, chylomicrons
ApoA-V Liver VLDL, chylomicrons Promotes LPL-mediated triglyceride lipolysis
Liver Lp(a)
ApoB-48 Intestine Chylomicrons, chylomicron remnants Core structural protein for chylomicrons
Liver VLDL, IDL, LDL, Lp(a)
ApoC-II Liver Chylomicrons, VLDL, HDL Cofactor for LPL
Liver, intestine Chylomicrons, VLDL, HDL
ApoE Liver Chylomicron remnants, IDL, HDL Ligand for binding to LDL receptor and other receptors

TABLE 419-2 Primary Dyslipoproteinemias Caused by Known Single-Gene Mutations

Harrison's 22e, p.3241

GENETIC DISORDER GENES MUTATED LIPOPROTEINS AFFECTED CLINICAL FINDINGS GENETIC TRANSMISSION ESTIMATED PREVALENCE
Severe Hypertriglyceridemia
Familial chylomicronemia
syndrome (FCS)
Biallelic LoF mutations
in: LPL, APOC2, APOA5,
GPIHBP1, LMF1
Elevated: Chylomicrons,
VLDL
Reduced: HDL
Pancreatitis,
eruptive xanthomas,
hepatosplenomegaly
AR ~1/200,000–300,000
Heterozygous LoF
mutations in: LMNA,
PPARG, PLIN1, AKT2,
ADRA2A
Elevated: Chylomicrons,
VLDL, LDL
Reduced: HDL
Insulin resistance, fatty
liver disease, pancreatitis,
central obesity, lack of
subcutaneous adipose in
extremities
AD
Hypercholesterolemia
Familial
hypercholesterolemia
(FH)
Heterozygous LoF
mutations in LDLR
Elevated: LDL Tendon xanthomas,
premature atherosclerotic
cardiovascular disease
(ASCVD)
AD ~1/250
Heterozygous LoF
receptor binding region
mutations in APOB
Elevated: LDL Tendon xanthomas,
premature ASCVD
AD
Autosomal dominant
hypercholesterolemia
(ADH), type 3
Heterozygous GoF
mutations in PCSK9
Elevated: LDL Tendon xanthomas,
premature ASCVD
AD <1/1,000,000
Biallelic LoF mutations in
LDLRAP1
Elevated: LDL Tendon xanthomas,
premature ASCVD
AR
Sitosterolemia Biallelic LoF mutations in
ABCG5, ABCG8
Elevated: LDL Tendon xanthomas,
premature ASCVD
AR <1/1,000,000
Biallelic LoF mutations
in LIPA
Elevated: LDL
Reduced: HDL
Fatty liver disease,
micronodular cirrhosis
AR
Mixed Dyslipidemia
Familial
dysbetalipoproteinemia
(FDBL)
Biallelic carriers of the
APOE2 variant
Elevated: Chylomicron
remnants, IDL
Palmar and
tuberoeruptive
xanthomas, premature
ASCVD
AR ~1/10,000
Biallelic LoF mutations
in LIPC
Elevated: Chylomicron
remnants, IDL, HDL
Premature ASCVD AR
Familial Hypolipidemia Syndromes
Abetalipoproteinemia Biallelic LoF mutations in
MTTP
Absent: LDL
Reduced: TG, HDL
Spinocerebellar
degeneration, retinal
degeneration
AR <1/1,000,000
Heterozygous truncating
mutations in APOB
Reduced: LDL Fatty liver, reduced risk of
ASCVD
AD
Familial PCSK9 deficiency Heterozygous LoF
mutations in PCSK9
Reduced: LDL Reduced risk of ASCVD AD ~1/1,000
Heterozygous LoF
mutations in ANGPTL3
Reduced: TG, LDL, HDL Reduced risk of ASCVD AD
Primary Low HDL Cholesterol Syndromes
ApoA-I deletions/
mutations
Heterozygous structural
mutations in APOA1
Reduced: HDL Variable depending on
mutation: premature
ASCVD, systemic
amyloidosis
AD <1/1,000,000
Biallelic LoF mutations in
ABCA1
Nearly absent: HDL
Reduced: LDL
Elevated: TG
Peripheral neuropathy,
hepatosplenomegaly
AR
Familial LCAT deficiency
(FLD); fish eye disease
(FED)
Biallelic LoF mutations
in LCAT
Markedly reduced: HDL Corneal opacities (both
FLD and FED), progressive
chronic kidney disease
(FLD only)
AR <1/1,000,000

TABLE 419-3 Secondary Causes of Altered Lipid and Lipoprotein Levels TG ELEVATED High-carbohydrate diet Alcohol Obesity…

Harrison's 22e, p.3242

LDL-C HDL-C LP(a) ELEVATED
TG ELEVATED ELEVATED REDUCED ELEVATED REDUCED
High-carbohydrate diet
Alcohol
Obesity
Insulin resistance
Type 2 diabetes
Lipodystrophy
Chronic kidney disease
Nephrotic syndrome
Viral hepatitis
Sepsis
Cushing’s syndrome
Acromegaly
Glycogen storage disease
Pregnancy
Drugs: estrogen, glucocorticoids,
isotretinoin, bexarotene, other
retinoids, beta blockers, bile acid
binding resins
Hypothyroidism
Cholestasis
Nephrotic syndrome
Cushing’s syndrome
Acute intermittent
porphyria
Drugs: corticosteroids,
cyclosporin, sirolimus,
carbamazepine
Vegan diet
Malabsorption
Malnutrition
Severe liver disease
Gaucher’s disease
Chronic infectious
disease
Hyperthyroidism
High-fat diet
Alcohol
Exercise
Drugs:
estrogen,
phenytoin
Hypertriglyceridemia
Vegan diet
Malabsorption
Malnutrition
Sedentary lifestyle
Smoking
Obesity
Gaucher’s disease
LAL deficiency
Drugs: anabolic steroids,
testosterone, beta blockers
Chronic kidney disease
Nephrotic syndrome
Inflammation
Menopause
Orchidectomy
Hypothyroidism
Acromegaly
Drugs: growth hormone,
isotretinoin

TABLE 419-4 Drugs Used to Treat Dyslipidemia DRUG LDL-Lowering Drugs HMG-CoA reductase inhibitors (statins)

Harrison's 22e, p.3244

DRUG MAJOR
INDICATIONS
STARTING DOSE MAXIMAL DOSE MECHANISM ADVERSE EFFECTS
LDL-Lowering Drugs
HMG-CoA reductase
inhibitors (statins)
Elevated LDL-C;
increased CV risk
↓ Inhibition of cholesterol
synthesis → ↑ Hepatic LDL
receptors
Myalgias and myopathy, ↑
transaminases, ↑ diabetes
risk
Lovastatin 20–40 mg daily 80 mg daily
Pravastatin 40–80 mg daily 80 mg daily
Simvastatin 20–40 mg daily 80 mg daily
Fluvastatin 20–40 mg daily 80 mg daily
Atorvastatin 20–40 mg daily 80 mg daily
Rosuvastatin 5–20 mg daily 40 mg daily
Pitavastatin 1–2 mg daily 4 mg daily
Elevated LDL-C 10 mg daily 10 mg daily ↓ Cholesterol absorption→ ↑
LDL receptors
Bile acid sequestrants Elevated LDL-C ↑ Bile acid excretion → ↑ LDL
receptors
Bloating, constipation,
elevated triglycerides
Cholestyramine 4 g daily 32 g daily
Colestipol 5 g daily 40 g daily
Colesevelam 3750 mg daily 4375 mg daily
Elevated LDL-C 140 mg SC every 2 weeks
75 mg SC every 2 weeks
300 mg SC every 6 months
420 mg SC every 1 month
(HoFH)
150 mg SC every 2 weeks
300 mg SC every 6 months
↓ PCSK9 activity due to Ab
inhibition → ↑ LDL receptors
↓ PCSK9 synthesis due to
siRNA silencing → ↑ LDL
receptors
ATP citrate lyase inhibitor
Bempedoic acid
Elevated LDL-C 180 mg daily 180 mg daily ↓ Inhibition of cholesterol
synthesis → ↑ LDL receptors
↑ uric acid and gout
↑ cholelithiasis
HoFH 5 mg daily 60 mg daily MTP inhibition → ↓ VLDL
assembly and secretion
ApoB inhibitor (ASO)
Mipomersen
HoFH 200 mg SC weekly 200 mg SC weekly ↓ ApoB synthesis due to ASO
silencing → ↓ ApoB/VLDL
secretion
Injection site reactions,
flu-like symptoms,
increased hepatic fat
HoFH 15 mg/kg IV q 4 weeks 15 mg/kg IV q 4 weeks ↓ ANGPTL3 activity due to
Ab inhibition → ↑ LPL and EL
activity, ↑ LDL catabolism
TG-Lowering Drugs
Fibric acid derivatives
(fibrates)
Gemfibrozil
Fenofibrate
Elevated TG 600 mg bid
40–160 mg daily
depending on product
600 mg bid
40–160 mg daily
depending on product
↑ LPL, ↓ VLDL synthesis Dyspepsia, myalgia,
cholelithiasis, elevated
transaminases
Elevated TG 4 g daily
4 g daily
4 g daily
4 g daily
↑ TG catabolism