Module 1: Deck3/Cards 16-20
No description yet. This curated deck is ready for daily study.
Card preview (24)
Common causes of low HDL? 12
• Visceral obesity (often associated with physical inactivity • insulin resistance) • type 2 diabetes and • HIV. (But wouldn’t expect severe) • High carbohydrate, low-fat diets • Diet rich in polyunsaturated fats • Hypertriglyceridemia • Metabolic syndrome • Cigarette smoking • Severe stress states i.e. sepsis or burns • Liver disease • Renal insufficiency
Drugs associated with low HDL? 6
• Isotretinoin • Sirolimus • Protease inhibitors Lower by causing hypertriglyceridemia • Androgenic steroids • Nonselective beta-blockers • Recombinant interleukin-2 Lower by directly altering HDL metabolism by activation of hepatic lipase.
Severe HDL deficiency, defined as below 20mg/dL, may be cause by genetic defects affecting HDL metabolism including mutations of what? How do they cause low HDL?
• apo A-I deficiency • ABCA1 • LCAT deficiency inability to form mature HDL particles
What medications can cause idiosyncratic reactions causing low HDL (high TG)? 2
• thiazolidinediones (TZDs, Rosiglitazone, Pioglitazone) • fibrates Also separately paraproteinemias.
Causes of severe HDL deficiency? 16
• Moderate to severe hypertriglyceridemia • Critical illness, including sepsis, burns, small bowel exclusion • Anabolic steroid • Acquired L cat deficiency (possibly decreased ApoA-I synthesis) • Severe cholestasis • Cholestatic liver disease with liver failure • Alcoholic hepatitis • Acute viral hepatitis • Alcoholic cirrhosis • Cholesterol deficiency • Partial hepatectomy • Recombinant interleukin-2 therapy • Disappearing HDL syndrome • Paraproteinemia • True deficiency • Artifactual deficiency
What mutation is associated with marked HDL reduction with HDL concentrations less than 5 mg/dL?
a mutation of the ABC-binding cassette transporter-A1
How does LCAT Deficiency result in very low HDL C levels?
Prevents adequate lipidation of HDL particles
Patients with which of the following have been reported to have dysfunctional HDL particles?
psoriasis
There is evidence that HDL particles in patients with (4), carry different proteins as compared to those who do not have these condition.
• chronic inflammatory states • end-stage renal disease • diabetes • coronary artery disease
Phospholipid depletion and enrichment with pro-inflammatory proteins include (2) and others may generate dysfunctional HDL particles, regardless of the HDL-C concentration?
• serum amyloid A proteins 2. apolipoprotein C-III
List the known functions for ApoA-I: 4 What inflammatory states affect this apolipoprotein? 3
• major protein of HDL • lipid binding and transport • Cofactor of LCAT • Anti-oxidative properties • ESRD decreases Apo A-I • psoriasis, RA, decrease ApoA-1
List the known functions for ApoA-II: 2 What inflammatory states affect this apolipoprotein? 3
• 2nd major protein of HDL • Inhibitor of hepatic lipase • decreased in ESRD • decreased in DM • increased in psoriasis
List the known functions for SAA1/SAA2 : 2 What inflammatory states affect this apolipoprotein? 5
• major acute phase protein • pro-inflammatory properties • increases in ESRD • increases in HD • Increases in ACS • Increases in psoriasis • Increases in RA
List the known functions for Complement C3 : 3 What inflammatory states affect this apolipoprotein?3
• Cleaved into C3A and C3B • C3a: Mediator of local inflammation • C3b: Opsonizing factor • Increases in CAD • Increases in psoriasis • Increases in RA
List the known functions for hemoglobin/haptoglobin : 2 What inflammatory states affect this apolipoprotein? 4
• Oxygen transport • Hemoglobin pending • Increases in ES RD • Increases in psoriasis • Increases in RA • Increases in CAD
List the known functions for ApoAI-IV : 2 What inflammatory states affect this apolipoprotein? 2
• Modulates LPL • Activator of LCAT • Increases in ESRD • Increases in stage
List the known functions for ApoC-II : 2 What inflammatory states affect this apolipoprotein? 1
• Activates LPL • Inhibitor LCAT • Decrease his ESRD
List the known functions for ApoC-III : 3 What inflammatory states affect this apolipoprotein? 2
• Inhibits LPL and HL • Delays TGR L catabolism • Ligand of TLR2 • Increases in ESRD • Increases CAD
List the known functions for ApoM: 2 What inflammatory states affect this apolipoprotein? 3
• Lipid transport • Binds S1P and fatty acids • Decreases in ESRD • decreases in diabetes • decreases in stress
List the known functions for Clusterin: 2 What inflammatory states affect this apolipoprotein? 2
• ATP independent chaperone • Inhibits apoptosis • Decreases in CAD • decreases in diabetes
List the known functions for PON1 activity: 1 What inflammatory states affect this apolipoprotein? 6
• hydrolyzes lactones, aromatic carboxylic acid esters, organophosphates • decreases in ESRD • decreases in diabetes • decreases in CAD, ACS • decreases in RA • decreases in psoriasis • decreases in heart disease
List the known functions for Lp-PLA2 activity: 3 What inflammatory states affect this apolipoprotein? 2
• hydrolyzes PAF • Ca2+ independent PLA2 • Phospholipid binding • increases in psoriasis • increases in ESRD
Patients with which of the following have been reported to have dysfunctional HDL particles?
psoriasis
What is associated with very low HDL levels but no increased risk of ASCVD?
Apo A-I Milano