Lipids and lipid disorders
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Questions and Answers

What is the primary function of lipids in living cells?

  • Structural component of cell membranes
  • Cell signaling
  • Energy storage for excess calories (correct)
  • Protein synthesis

    • What is the characteristic of fatty acids in plasma?

  • Non-covalently bound to albumin (correct)
  • Covalently bound to albumin
  • Bound to other proteins
  • Free fatty acids

    • What is a precursor to steroid hormones?

  • Carbohydrates
  • Proteins
  • Lipids (correct)
  • Nucleic acids

    • What is the characteristic of the bonds in lipids?

    <p>Mostly C-H bonds</p> Signup and view all the answers

    What are some of the biomolecules that lipids can be converted to?

    <p>Prostaglandins, leukotrienes, and lipoxins</p> Signup and view all the answers

    What is the typical carbon atom count of short-chain fatty acids?

    <p>4 to 6</p> Signup and view all the answers

    What type of fatty acid has a carbon atom count of more than 12?

    <p>Long-chain</p> Signup and view all the answers

    Which type of fatty acid is bound to albumin?

    <p>Unesterified</p> Signup and view all the answers

    What is a characteristic of esterified fatty acids?

    <p>Part of triglycerides or phospholipids</p> Signup and view all the answers

    What is the main difference between medium-chain and long-chain fatty acids?

    <p>Their carbon atom count</p> Signup and view all the answers

    What type of fatty acid has no double bonds?

    <p>Saturated</p> Signup and view all the answers

    How many fatty acids are attached to a molecule of glycerol in a triglyceride?

    <p>3</p> Signup and view all the answers

    What is the characteristic of triglycerides in terms of their charge?

    <p>Neutral</p> Signup and view all the answers

    What type of bond holds the fatty acids to the glycerol molecule in a triglyceride?

    <p>Ester bond</p> Signup and view all the answers

    What is the characteristic of triglycerides in terms of their solubility in water?

    <p>Insoluble in water</p> Signup and view all the answers

    What is the number of fatty acids attached to a molecule of glycerol in a phospholipid?

    <p>2</p> Signup and view all the answers

    What is the characteristic of the head and tails of phospholipids?

    <p>Hydrophobic head and hydrophilic tails</p> Signup and view all the answers

    What is the structure of cholesterol?

    <p>A 4-ring unsaturated steroid</p> Signup and view all the answers

    What is the characteristic of phospholipids and cholesterol?

    <p>Both are amphipathic</p> Signup and view all the answers

    What is the location of the phospholipid head group?

    <p>3rd position</p> Signup and view all the answers

    Synthesized from acetyl co-A

    <p>CHOLESTEROL</p> Signup and view all the answers

    What is the range of size of lipoproteins?

    <p>10-1200 nm</p> Signup and view all the answers

    What is the composition of lipoproteins?

    <p>Lipids and proteins</p> Signup and view all the answers

    What is the term for unesterified cholesterol?

    <p>Free cholesterol</p> Signup and view all the answers

    What is the term for esterified cholesterol?

    <p>Cholesteryl ester</p> Signup and view all the answers

    What shape are lipoproteins typically?

    <p>Spherical</p> Signup and view all the answers

    What is the main apoprotein found on the surface of chylomicrons?

    <p>Apo B-48</p> Signup and view all the answers

    What percentage of chylomicrons are composed of triglycerides?

    <p>86%</p> Signup and view all the answers

    What is the characteristic of chylomicrons when plasma is stored overnight?

    <p>They float to the top and form a creamy layer</p> Signup and view all the answers

    What is the percentage of phospholipid in chylomicrons?

    <p>7%</p> Signup and view all the answers

    What is the function of chylomicrons in the body?

    <p>To transport triglycerides after a meal</p> Signup and view all the answers

    What percentage of triglycerides are present in VLDL molecules?

    <p>55%</p> Signup and view all the answers

    Which apolipoprotein is mainly present on the surface of VLDL molecules?

    <p>Apolipoprotein B-100</p> Signup and view all the answers

    Where are VLDL molecules secreted into the blood from?

    <p>The liver</p> Signup and view all the answers

    What percentage of phospholipid is present in VLDL molecules?

    <p>18%</p> Signup and view all the answers

    What is the purpose of VLDL molecules in normal lipid metabolism?

    <p>To transport endogenous triglycerides to peripheral tissues</p> Signup and view all the answers

    What percentage of triglycerides are present in IDL molecules?

    <p>23%</p> Signup and view all the answers

    What is the main apolipoprotein present on the surface of IDL molecules?

    <p>Apolipoprotein B-100</p> Signup and view all the answers

    What is the percentage of cholesterol in IDL molecules?

    <p>38%</p> Signup and view all the answers

    What is the percentage of phospholipid in IDL molecules?

    <p>19%</p> Signup and view all the answers

    What is formed from IDL molecules after modification in the liver?

    <p>LDL molecules</p> Signup and view all the answers

    What percentage of LDL is composed of cholesterol?

    <p>50%</p> Signup and view all the answers

    What is the main function of LDL in the body?

    <p>To transport a large amount of endogenous cholesterol</p> Signup and view all the answers

    What is the composition of LDL?

    <p>50% cholesterol, 22% phospholipids, 6% triglycerides, and 22% protein</p> Signup and view all the answers

    What is present on the surface of LDL molecules?

    <p>Apoprotein B-100</p> Signup and view all the answers

    What is the consequence of elevated levels of LDL in the body?

    <p>Increased risk for atherosclerosis</p> Signup and view all the answers

    What is the primary site of HDL synthesis?

    <p>Intestine and liver cells</p> Signup and view all the answers

    What is the main apoprotein present on the surface of HDL molecules?

    <p>ApoA-I</p> Signup and view all the answers

    What is the percentage of cholesterol in HDL molecules?

    <p>19%</p> Signup and view all the answers

    What is HDL composed of?

    <p>50% protein, 28% phospholipids, 19% cholesterol, and 3% triglycerides</p> Signup and view all the answers

    What are HDL molecules formed from?

    <p>Recycled chylomicron and VLDL molecules</p> Signup and view all the answers

    What is Lp(a) primarily composed of?

    <p>Cholesterol esters, phospholipids, and apolipoprotein (a) and B-100</p> Signup and view all the answers

    What is associated with elevated levels of Lp(a)?

    <p>Increased risk for coronary heart disease, myocardial infarction, and cerebrovascular disease</p> Signup and view all the answers

    What is the significance of Lp(a) in the body?

    <p>It is associated with increased risk of cardiovascular disease</p> Signup and view all the answers

    What apolipoprotein is present in Lp(a)?

    <p>Apolipoprotein B-100</p> Signup and view all the answers

    What is the composition of Lp(a) lipoprotein?

    <p>Cholesterol esters, phospholipids, and apolipoprotein (a) and B-100</p> Signup and view all the answers

    What are the two main pathways involved in lipoprotein physiology and metabolism?

    <p>Lipid absorption reverse cholesterol pathways Endogenous and exogenous pathways</p> Signup and view all the answers

    What is the role of lipase, lipoprotein lipase, epinephrine, and cortisol in lipid metabolism?

    <p>To break down triglycerides</p> Signup and view all the answers

    What is the consequence of abnormal lipid metabolism?

    <p>Increased risk of coronary heart disease</p> Signup and view all the answers

    What is the purpose of the ATP III Classification?

    <p>To set cutoff values for cholesterol and triglyceride levels</p> Signup and view all the answers

    What is the result of recycling glycerol in lipid metabolism?

    <p>The formation of triglycerides</p> Signup and view all the answers

    What is the relationship between lipid metabolism and coronary heart disease?

    <p>Abnormal lipid metabolism is associated with an increased risk of coronary heart disease</p> Signup and view all the answers

    What is hypercholesterolemia characterized by?

    <p>Increased levels of cholesterol in the blood</p> Signup and view all the answers

    What is combined hyperlipidemia characterized by?

    <p>Elevated levels of fats in the blood, including LDL cholesterol and triglycerides</p> Signup and view all the answers

    What is hypertriglyceridemia characterized by?

    <p>High levels of triglycerides in the blood</p> Signup and view all the answers

    What is hypoproteinemia characterized by?

    <p>Very low protein levels in the blood</p> Signup and view all the answers

    Which condition is characterized by high levels of lipoproteins in the blood?

    <p>Hyperlipoproteinemia</p> Signup and view all the answers

    What is the term for abnormally high levels of lipids in the blood?

    <p>Dyslipidemia</p> Signup and view all the answers

    What is the term for the narrowing, blockage, or spasms in a blood vessel?

    <p>Peripheral vascular disease (PVD)</p> Signup and view all the answers

    What is the deposition of esterified cholesterol in the artery wall known as?

    <p>Arteriosclerosis</p> Signup and view all the answers

    What is the term for the class of diseases that involve the heart or blood vessels?

    <p>Cardiovascular disease</p> Signup and view all the answers

    What is the term for a common heart condition where the coronary arteries struggle to send enough blood, oxygen, and nutrients to the heart muscle?

    <p>Coronary artery disease</p> Signup and view all the answers

    What is the primary cause of elevated cholesterol in Familial Hypercholesterolemia?

    <p>Genetic abnormalities affecting LDL receptors</p> Signup and view all the answers

    What is the characteristic of intracellular cholesterol in Familial Hypercholesterolemia?

    <p>Normal</p> Signup and view all the answers

    What is Hypertriglyceridemia a result of?

    <p>Imbalance between synthesis and clearance of VLDL in the circulation</p> Signup and view all the answers

    What is the consequence of elevated levels of LDL in the body?

    <p>Increased risk of cardiovascular disease</p> Signup and view all the answers

    What is the primary difference between Familial Hypercholesterolemia and Hypertriglyceridemia?

    <p>One is caused by LDL receptor defects, the other by VLDL imbalance</p> Signup and view all the answers

    What is responsible for the excessive hepatic synthesis of apo B, leading to increased VLDL secretion and LDL production?

    <p>Combined Hyperlipoproteinemia</p> Signup and view all the answers

    What is the result of excessive hepatic synthesis of apo B in Combined Hyperlipoproteinemia?

    <p>Increased VLDL secretion and LDL production</p> Signup and view all the answers

    What is the characteristic of Familial dysbetalipoproteinemia?

    <p>Accumulation of cholesterol-rich VLDL and chylomicrons remnants</p> Signup and view all the answers

    What is the result of the accumulation of cholesterol-rich VLDL and chylomicrons remnants in Familial dysbetalipoproteinemia?

    <p>Elevated levels of serum total cholesterol and triglycerides</p> Signup and view all the answers

    What is the underlying cause of Combined Hyperlipoproteinemia?

    <p>Excessive hepatic synthesis of apo B</p> Signup and view all the answers

    What is characteristic of Lp(a)?

    <p>It is a variant of LDL with an extra apolipoprotein (a)</p> Signup and view all the answers

    What does apolipoprotein (a) in Lp(a) compete with for binding sites?

    <p>Plasminogen</p> Signup and view all the answers

    What is the effect of Lp(a) on plaque formation?

    <p>It increases plaque formation</p> Signup and view all the answers

    What is the consequence of elevated levels of Lp(a)?

    <p>It increases the risk of cardiovascular disease</p> Signup and view all the answers

    What is the role of apolipoprotein (a) in Lp(a)?

    <p>It competes with plasminogen for fibrin binding sites</p> Signup and view all the answers

    What is hypoalphalipoproteinemia characterized by?

    <p>Isolated decreased in circulating HDL (&lt; 40 mg/dL or 1.0 mmol/L) without hypertriglyceridemia</p> Signup and view all the answers

    What mutations are associated with hypoalphalipoproteinemia?

    <p>Mutations in LCAT, apo A-I and ABCA1 transporter gene</p> Signup and view all the answers

    What is Tangier's disease?

    <p>An extreme form of hypoalphalipoproteinemia</p> Signup and view all the answers

    What is the typical circulating HDL level in hypoalphalipoproteinemia?

    <p>&lt; 40 mg/dL or 1.0 mmol/L</p> Signup and view all the answers

    What is the underlying genetic defect in hypoalphalipoproteinemia?

    <p>All of the above</p> Signup and view all the answers

    What is the normal reference range for triglycerides in the blood?

    <p>&lt; 150 mg/dL</p> Signup and view all the answers

    What is the borderline high for triglyceride reference range?

    <p>150-199 mg/dL</p> Signup and view all the answers

    What is high for triglyceride reference range?

    <p>200-499 mg/dL</p> Signup and view all the answers

    What is the very high reference range for triglyceride levels?

    <p>≥500 mg/dL</p> Signup and view all the answers

    What is the optimal reference range for LDL Cholesterol?

    <p>Less than 100 mg/dL</p> Signup and view all the answers

    What is the near optimal reference range for LDL cholesterol?

    <p>100-129 mg/dl</p> Signup and view all the answers

    What is the borderline high reference range for LDL cholesterol?

    <p>130-159 mg/dl</p> Signup and view all the answers

    What is the high reference range for LDL cholesterol?

    <p>160-189 mg/dL</p> Signup and view all the answers

    What is the very high reference range for LDL cholesterol?

    <p>190 mg/dL or higher</p> Signup and view all the answers

    What is the near protective against heart disease range for HDL cholesterol reference range?

    <p>≥60 mg/dL</p> Signup and view all the answers

    What is the higher the better range for HDL cholesterol reference range?

    <p>40-59 mg/dL</p> Signup and view all the answers

    What is the major risk factor for heart disease range for HDL cholesterol reference range?

    <p>Below 40 mg/dL</p> Signup and view all the answers

    What is the desirable range for total cholesterol reference range?

    <p>below 200 mg/dL</p> Signup and view all the answers

    What is the borderline high range for total cholesterol in the reference range?

    <p>200-239 mg/dL</p> Signup and view all the answers

    What is the high range for total cholesterol reference range?

    <p>≥ 240 mg/dL</p> Signup and view all the answers

    Study Notes

    Lipids

    • Composed mostly of carbon-hydrogen (C-H) bonds
    • Serve as energy storage for excess calories
    • Function as precursors for various biomolecules:
      • Steroid hormones
      • Prostaglandins
      • Leukotrienes
      • Lipoxins

    Fatty Acids

    • Chains of carbon-hydrogen bonds terminating with a carboxyl (-COOH) group
    • In plasma, mostly non-covalently bound to albumin

    Classification of Fatty Acids by Length

    • Fatty acids with 4 to 6 carbon atoms are classified as short-chain fatty acids
    • Medium-chain fatty acids have 8 to 12 carbon atoms
    • Long-chain fatty acids have more than 12 carbon atoms

    Classification of Fatty Acids by Bonding

    • Unesterified fatty acids are bound to albumin
    • Esterified fatty acids are constituents of triglycerides or phospholipids

    Classification of Fatty Acids

    • Classified according to the number of C=C double bonds present
    • Three categories: Saturated, Monounsaturated, and Polyunsaturated

    Saturated Fatty Acids

    • Have no double bonds

    Monounsaturated Fatty Acids

    • Contain one double bond

    Polyunsaturated Fatty Acids

    • Contain 2 or more double bonds

    Triglycerides

    • Composed of 3 fatty acids attached to 1 molecule of glycerol
    • Held together by ester bonds
    • No charged groups, making them water insoluble
    • Classified as neutral lipids

    Phospholipids

    • Consist of 2 fatty acids attached to 1 molecule of glycerol
    • 3rd position contains phospholipid head groups
    • Amphipathic, meaning they have:
      • Hydrophobic (water-repelling) tails
      • Hydrophilic (water-attracting) heads

    Cholesterol

    • Unsaturated steroid alcohol
    • Composed of 4 rings
    • Has a single C-H side chain tail
    • Also an amphipathic lipid

    Classification of Cholesterol

    • Cholesterol exists in two forms: unesterified (free cholesterol) and esterified (cholesteryl ester)
    • Cholesteryl ester is a neutral lipid

    Lipoprotein Characteristics

    • Lipoproteins are typically spherical in shape
    • Lipoproteins range in size from 10-1200 nm
    • Lipoproteins are composed of two main components: lipids and proteins

    Lipoproteins: Chylomicrons

    • Chylomicrons are the largest lipoproteins and have the lowest density.
    • They are formed in the intestines and transport triglycerides after a meal, giving serum a turbid appearance.
    • Due to their low density, chylomicrons will float to the top and form a creamy layer when plasma is stored overnight.
    • Composition of chylomicrons:
      • 86% triglyceride
      • 5% cholesterol
      • 7% phospholipid
      • 2% apolipoprotein
    • Apoproteins present on the surface of chylomicrons:
      • Mainly apoprotein B-48
      • Lesser amounts of apoproteins A-I, C-I, C-II, and C-III

    VLDL Composition and Function

    • VLDL (Very Low-Density Lipoprotein) carries endogenous triglycerides synthesized in the liver.
    • VLDL molecules consist of:
      • 55% triglycerides
      • 19% cholesterol
      • 18% phospholipid
      • 8% apolipoprotein
    • VLDLs have the following apolipoproteins on their surface:
      • Apolipoprotein B-100 (mainly)
      • Apolipoprotein C-I
      • Apolipoprotein C-II
      • Apolipoprotein C-III
      • Apolipoprotein E
    • Normal lipid metabolism: VLDLs are secreted into the blood by the liver for metabolism in peripheral tissues.

    IDL (Intermediate-Density Lipoprotein)

    • A transitional form of lipoprotein formed from VLDL (Very-Low-Density Lipoprotein)
    • Modified in the liver to form LDL (Low-Density Lipoprotein)
    • Carries endogenous triglycerides and cholesterol esters
    • Composed of:
      • 23% triglycerides
      • 38% cholesterol
      • 19% phospholipid
      • 19% apolipoprotein
    • Surface apolipoproteins include:
      • Mainly B-100
      • Some E

    Low-Density Lipoprotein (LDL)

    • LDL is the body's major cholesterol carrier, transporting a large amount of endogenous cholesterol.
    • LDL is commonly known as "bad cholesterol" due to its association with increased risk for atherosclerosis when levels are elevated.
    • LDLs are composed of:
      • 50% cholesterol
      • 22% phospholipids
      • 6% triglycerides
      • 22% protein
    • LDLs have apoprotein B-100 on their surface.

    High-Density Lipoprotein (HDL)

    • Also known as "good cholesterol"
    • Synthesized in the intestine and liver cells
    • HDL molecules are recycled from chylomicron and VLDL molecules
    • Composed of 50% protein, 28% phospholipids, 19% cholesterol, and 3% triglycerides
    • Has apoproteins A-I, mainly, and A-II on its surface

    Lipoprotein (a) [Lp(a)]

    • Primarily composed of cholesterol esters, phospholipids, and apolipoprotein (a) and B-100
    • Elevated levels of Lp(a) are associated with increased risk for: • Coronary heart disease • Myocardial infarction • Cerebrovascular disease

    Lipoprotein Physiology & Metabolism

    • Lipoprotein metabolism involves the transport of lipids in the bloodstream, playing a crucial role in maintaining cellular lipid homeostasis.

    Lipid Absorption

    • Lipid absorption occurs in the small intestine, where dietary fats are broken down into fatty acids and cholesterol.
    • Fatty acids are taken up by enterocytes, re-esterified into triglycerides, and packaged into chylomicrons.
    • Chylomicrons are then transported to the lymphatic system, ultimately entering the bloodstream.

    Endogenous Pathway

    • The endogenous pathway involves the synthesis of lipids in the liver, which are then transported to peripheral tissues.
    • The liver produces very-low-density lipoproteins (VLDLs), which are rich in triglycerides.
    • VLDLs are converted into low-density lipoproteins (LDLs) in the bloodstream, which are then taken up by peripheral tissues.

    Exogenous Pathway

    • The exogenous pathway involves the uptake of dietary lipids from the small intestine, which are then transported to the liver.
    • Chylomicrons are converted into chylomicron remnants in the bloodstream, which are then taken up by the liver.

    Reverse Cholesterol Transport

    • Reverse cholesterol transport is a process by which excess cholesterol from peripheral tissues is transported back to the liver for excretion.
    • High-density lipoproteins (HDLs) play a crucial role in this process, taking up excess cholesterol from peripheral tissues and transporting it to the liver.
    • The liver then excretes the cholesterol into the bile, which is eventually eliminated from the body.

    Lipid Metabolism

    • Lipid metabolism involves releasing fatty acids to cells for energy, then recycling glycerol into triglycerides.
    • Enzymes involved in breaking down triglycerides include lipase, lipoprotein lipase, epinephrine, and cortisol.

    Clinical Significance of Lipids

    • Abnormal lipid metabolism can be due to genetic defects or can be acquired.
    • Abnormal lipid metabolism is associated with an increased risk of coronary heart disease and other disorders.

    ATP III Classification

    • The National Cholesterol Education Program (NCEP) established the Adult Treatment Panel III Classification (ATP III).
    • ATP III sets cutoff values for cholesterol and triglyceride levels based on a 9- to 12-hour fast.

    Blood Disorders

    • Hypoproteinemia: a condition characterized by very low protein levels in the blood
    • Hyperlipoproteinemia: high levels of lipoproteins in the blood
    • Hypercholesterolemia: high cholesterol, characterized by increased levels of cholesterol in the blood
    • Hypertriglyceridemia: high amounts of triglycerides in the blood

    Combined Lipid Disorder

    • Combined hyperlipidemia: elevated levels of fats in the blood, including low-density lipoprotein (LDL) cholesterol ("bad" cholesterol) and triglycerides

    Dyslipidemia

    • Abnormally high levels of lipids (fats) in the blood
    • Typically asymptomatic, but can lead to cardiovascular diseases
    • Can cause coronary artery disease, a common heart condition

    Coronary Artery Disease

    • Occurs when major blood vessels (coronary arteries) struggle to supply enough blood, oxygen, and nutrients to the heart muscle
    • A common heart condition that can lead to cardiovascular disease

    Peripheral Vascular Disease (PVD)

    • A slow and progressive disorder of the blood vessels
    • Caused by narrowing, blockage, or spasms in a blood vessel
    • A type of cardiovascular disease

    Cardiovascular Disease

    • A class of diseases involving the heart or blood vessels
    • May include conditions such as coronary artery disease, peripheral vascular disease, and arteriosclerosis

    Arteriosclerosis

    • Characterized by deposition of esterified cholesterol in the artery wall
    • A type of cardiovascular disease that can lead to narrowing or blockage of blood vessels

    Hypercholesterolemia and Familial Hypercholesterolemia

    • Elevated cholesterol levels are associated with increased LDL (Low-Density Lipoprotein) due to genetic abnormalities.
    • Despite normal intracellular cholesterol levels, individuals with Familial Hypercholesterolemia have a deficiency in active LDL receptors.

    Hypertriglyceridemia

    • Characterized by an imbalance between the synthesis and clearance of VLDL (Very-Low-Density Lipoprotein) in the circulation.
    • Can be caused by familial or hormonal abnormalities.

    Combined Hyperlipoproteinemia

    • Characterized by elevated levels of serum total cholesterol and triglycerides
    • Caused in part by excessive hepatic synthesis of apo B
    • Leads to increased VLDL secretion
    • Results in increased LDL production from VLDL
    • Can be associated with Familial Dysbetalipoproteinemia

    Familial Dysbetalipoproteinemia

    • Caused by accumulation of cholesterol-rich VLDL and chylomicrons remnants

    Lp(a) and its Impact on Plaque Formation

    • Lp(a) is a variant of LDL (low-density lipoprotein) with an additional apolipoprotein (a)
    • Apolipoprotein (a) has a high degree of homology with plasminogen, a coagulation factor
    • Due to this homology, apo(a) competes with plasminogen for binding sites on fibrin
    • This competition leads to increased plaque formation

    Hypoalphalipoproteinemia

    • Characterized by an isolated decrease in circulating high-density lipoprotein (HDL) cholesterol
    • Defined as HDL levels less than 40 mg/dL or 1.0 mmol/L
    • Not associated with hypertriglyceridemia
    • Can result from mutations in genes involved in HDL metabolism
    • Specifically, mutations in LCAT, apo A-I, and ABCA1 transporter genes can cause hypoalphalipoproteinemia

    Tangier's Disease

    • An extreme form of hypoalphalipoproteinemia
    • Caused by mutations in the ABCA1 transporter gene

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    This quiz covers the composition and functions of lipids, including energy storage and hormone production, as well as the structure and properties of fatty acids. Learn about the role of lipids in living cells and their importance in human biology.

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