Laboratory results for a patient with uncontrolled type 1 diabetes reveal hyperglycemia (634 mg/dL) and hypertriglyceridemia (498 mg/dL). Which of the following represents the most likely cause of the hypertriglyceridemia in this patient?
A) absence of hormone-sensitive lipase
B) decreased lipoprotein lipase activity
C) deficiency in apoprotein C-II
D) deficiency in LDL receptors
E) increased hepatic triglyceride synthesis

Question

Quizplus · Accepted Answer

In uncontrolled type 1 diabetes, insulin deficiency leads to decreased activity of lipoprotein lipase, an enzyme that breaks down triglycerides in chylomicrons and VLDL. This results in hypertriglyceridemia.  The triglyceride components of VLDL and chylomicron are hydrolyzed to free fatty acids and glycerol in the capillaries of tissues such as liver, adipose tissue, and skeletal muscle by the actions of lipoprotein lipase (LPL) and hepatic triglyceride lipase (HTGL, also called hepatic lipase, HL). Insulin exerts numerous effects on overall metabolic homeostasis. One of the effects of insulin, which relates to the symptoms in this patient, is the regulation of the expression of LPL on the surface of endothelial cells. Since type 1 diabetics do not synthesize insulin, they do not properly regulate the level of LPL, which contributes to hypertriglyceridemia in these individuals.

Laboratory Results for a Patient with Uncontrolled Type 1 Diabetes