Catabolism of lipoproteins and metabolic syndrome

Metabolic syndrome is very common and is associated with significantly increased risk for both cardiovascular disease and type 2 diabetes. At present, no unifying mechanism can explain it. However, insulin resistance is a key feature of this syndrome, plays a key role in triglyceride metabolism and contributes to dyslipidemia and development of type 2 diabetes. Here, we review the mechanisms involved in the overproduction of large VLDL and their catabolism and finally potential therapeutic targets to provide a more complete approach to treatment of these lipid abnormalities.

Dyslipidemia plays an important role in the development of atherosclerosis and is mainly associated by the hepatic overproduction of large triglyceride-rich VLDL, low levels of HDL cholesterol and high levels of small, dense, LDL cholesterol particles. It is thus of special interest to understand the mechanism involved in the hepatic synthesis of lipoproteins and the degradation of these lipoproteins that depend, to a large extent, on insulin action.

The atherogenic lipid abnormalities observed in the metabolic syndrome may require a combination of drugs such as statins and HDL-raising agents to provide a more complete approach to treating dyslipidemia and reducing cardiovascular risk.