Fat metabolism and medication


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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