Fat metabolism and medication

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Statins inhibit the enzyme HMG CoA reductase, preventing hepatic cholesterol synthesis.

Ezetimibe reduces cholesterol absorption.

Bile acid sequestrants such as cholestyramine, colesevelam and colestipol prevent bile acid re-uptake from the terminal ileum and promote cholesterol excretion.

Fibrates activate the PPAR-alpha receptor, resulting in reduced triglyceride formation and increased HDL-C levels.
The effect of fibrates on the metabolism of triglyceride-rich lipoproteins is due to a peroxisome proliferator activating receptor (PPAR)-alpha-dependent stimulation of lipoprotein lipase and of apolipoprotein (apo)A-V. They also inhibit apoC-III expression, and increase plasma high density lipoprotein (HDL)-cholesterol due to overexpression of apoA-I and apoA-II.

Omega-3 fatty acids increase peroxisomal beta-oxidation of fatty acids in the liver, reducing triglyceride synthesis.





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