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LIPID METABOLISM

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Triglycerides and fatty acids are necessary for both energy supply and energy storage, whereas cholesterol is a vital compound required for cell proliferation, cell integrity, synthesis of steroid hormones, and bile acids.

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Highly specialized lipoproteins are responsible for the transport of water-insoluble lipids to different body tissues.1 These contain esterified and unesterified cholesterol, triglycerides (TG), phospholipids, and proteins.2 Lipoprotein-associated proteins, the so-called apolipoproteins (apo), play a central role in lipid metabolism (Tables 22-2 and 22-3). They provide structure for the integrity of the particle (ie, apo B100, apo A-I) and serve as cofactors for enzymes (ie, apo C-II, apo A-I, apo A-IV) or ligands for specific receptors (ie, apo B100, apo E).3,4,5 Descriptions of several mutations and defects of apolipoproteins with major implications for lipid metabolism6,7 have demonstrated the crucial role of these components for lipid and lipoprotein metabolism in humans. The lipid transport system consists of three distinct but interacting pathways: the exogenous, the endogenous, and the reverse lipoprotein pathway.

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Table Graphic Jump Location
TABLE 22-1Recommended Screening Strategies by the AHA and AAP
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Table Graphic Jump Location
TABLE 22-2Apolipoproteins

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