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      Overproduction of very low-density lipoproteins is the hallmark of the dyslipidemia in the metabolic syndrome.

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          Abstract

          Insulin resistance is a key feature of the metabolic syndrome and often progresses to type 2 diabetes. Both insulin resistance and type 2 diabetes are characterized by dyslipidemia, which is an important and common risk factor for cardiovascular disease. Diabetic dyslipidemia is a cluster of potentially atherogenic lipid and lipoprotein abnormalities that are metabolically interrelated. Recent evidence suggests that a fundamental defect is an overproduction of large very low-density lipoprotein (VLDL) particles, which initiates a sequence of lipoprotein changes, resulting in higher levels of remnant particles, smaller LDL, and lower levels of high-density liporotein (HDL) cholesterol. These atherogenic lipid abnormalities precede the diagnosis of type 2 diabetes by several years, and it is thus important to elucidate the mechanisms involved in the overproduction of large VLDL particles. Here, we review the pathophysiology of VLDL biosynthesis and metabolism in the metabolic syndrome. We also review recent research investigating the relation between hepatic accumulation of lipids and insulin resistance, and sources of fatty acids for liver fat and VLDL biosynthesis. Finally, we briefly discuss current treatments for lipid management of dyslipidemia and potential future therapeutic targets.

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          Author and article information

          Journal
          Arterioscler Thromb Vasc Biol
          Arteriosclerosis, thrombosis, and vascular biology
          Ovid Technologies (Wolters Kluwer Health)
          1524-4636
          1079-5642
          Jul 2008
          : 28
          : 7
          Affiliations
          [1 ] Wallenberg Laboratory, Sahlgrenska University Hospital, 41345 Gothenburg, Sweden. Martin.adiels@wlab.gu.se
          Article
          28/7/1225
          10.1161/ATVBAHA.107.160192
          18565848
          ca6ac3d9-e05d-4745-ad0f-1c01a0ea4f0b

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