A patient with uncontrolled type 1 diabetes presents with markedly elevated plasma triglycerides and eruptive xanthomas. Lipoprotein lipase activity in post-heparin plasma is severely reduced. Which lipoprotein accumulates most prominently?
- A LDL
- B Chylomicrons ✓
- C IDL
- D Lp(a)
Correct answer: B. Chylomicrons
Explanation
Lipoprotein lipase (LPL) is anchored on capillary endothelium and requires apolipoprotein C-II as a cofactor to hydrolyze triglycerides in chylomicrons and VLDL. Insulin normally induces LPL expression; in uncontrolled type 1 diabetes, LPL activity is severely diminished. Chylomicrons, the largest triglyceride-rich particles assembled from dietary fat, are cleared almost exclusively by LPL and therefore accumulate dramatically when LPL is inactive.
Reference: Harper's Illustrated Biochemistry, 32nd ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.