Pathogenesis of atherogenic dyslipidemia

A major component of the insulin resistance syndrome is dyslipidemia. Alterations in serum lipid levels can be worsened by insulin resistance and represent a leading risk factor for the development of atherosclerotic cardiovascular disease. Cardiovascular risk factors, eg, smoking, hypertension, hyperglycemia, and other dyslipidemias, promote premature atherosclerosis when accompanied by some elevation of low-density lipoprotein (LDL). The clustering of many of these risk factors in individual patients is referred to as the metabolic syndrome, which is characterized by abnormally high levels of triglyceride-rich very low-density lipoprotein, low levels of high-density lipoprotein, and increased small LDL particles (the lipid triad), as well as hypertension, glucose intolerance, and a procoagulant state.