Dyslipidemia Lipoproteins, Apolipoprotiens, Drugs

Chylomicrons

Formed in intestine

Carries dietary lipids

VLDL

Synthesized in liver

Transports endogenous triglycerides 

IDL

Precursor to LDL

Transient particle from VLDL catabolism 

LDL

VLDL + IDL

Carries cholesterol to peripheral tissues 

HDL

Synthesized in liver + intestine

Reverse cholesterol transport 

Facilitates cholesterol efflux from macrophages

ApoA-I

HDL

Activates LCAT

ApoB-48

Chylomicron assembly + secretion

ApoB-100

Structure for VLDL, IDL, LDL*

Ligand for LDLR (mediates endocytosis)

ApoC-II

Chylomicrons, VLDL

Co-factor for LPL

ApoE

Chylomicrons, VLDL, IDL

Ligand for LRP1

Statins

Inhibits HMG-CoA reductase

Reduce LDL-C + Triglycerides

Increase HDL-C

Ezetimibe

Inhibits NPCL1 protein

Blocks cholesterol absorption

Reduces LDL-C

PCSK9 Inhibitors

Inhibits PCSK9

Increases recycling and availability of LDL receptor 

Decreases LDL-C

Fibrates

Activate PPAR-alpha receptors

Reduce triglycerides

Increase HDL-C

Niacin

Reduces VLDL + LDL

Increases HDL-C

Bile-Acid Sequesterants

Binds bile acids → Excretion in feces

Upregulates LDL receptor 

Lowers LDL-C

Omega-3 Fatty Acids

Reduce VLDL synthesis

Increase fatty acid oxidation 

Lowers triglycerides (small increase in LDL-C)

Bempedoic Acid

Inhibits ATP-citrate lyase (ACL)

Reducing hepatic cholesterol synthesis 

Increasing LDL receptor expression → Reduce LDL-C

Lomitapide

Inhibits microsomal triglyceride transfer protein (MTP)

Reduces VLDL + Chylomicron secretion → Lower LDL-C + Triglycerides