Question
A 36-year-old male has orange-yellow discoloration of his palmar creases and small clusters of yellow papules on his elbows, knees and buttocks. Laboratory evaluation suggests a lack of ApoE3 and ApoE4 in his circulating lipoproteins. Which of the following is most likely impaired in this patient:
| A. |
Chylomicron secretion by the intestine
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| B. |
Chylomicron remnant uptake by liver cells
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| C. |
LDL particle uptake by extrahepatic cells
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| D. |
Lipoprotein lipase activation
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Show Answer
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Correct Answer � B
Explanation
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Ans. B. Chylomicron remnant uptake by liver cells
Explanation: Familial dysbetalipoproteinemia (type Ill hyperlipoproteinemia) is characterized clinically by xanthomas and premature coronary and peripheral vascular disease. The primary defects in familial dysbetalipoproteinemia are in ApoE3 and ApoE4, apolipoproteins found on chylomicrons and VLDL that are responsible for binding hepatic apolipoprotein receptors. Without ApoE3 and ApoE4, the liver cannot efficiently remove chylomicrons and VLDL remnants from the circulation, causing their accumulation in the serum and resultant elevations in cholesterol and triglyceride levels.
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