Statins primarily decrease LDL and VLDL cholesterol. Which lipid is increased?

Statins primarily decrease LDL and VLDL cholesterol. Which lipid is increased?

• A. Increase production of LDL
• B. Decrease manufacture of LDL and VLDL cholesterol
• C. Increase production of HDL
• D. Increase triglyceride synthesis

Answer: (B)

Statins inhibit HMG-CoA reductase in the liver, which lowers the liver’s own cholesterol synthesis. When hepatic cholesterol declines, the liver increases LDL receptor activity, pulling more LDL out of the bloodstream, and it also reduces the production of VLDL (which is a precursor to LDL). The overall effect is a decrease in LDL cholesterol and a decrease in VLDL cholesterol. The statement describing a decrease in the manufacture of LDL and VLDL fits this mechanism, so it’s the best description of what statins do. The other options describe increases in LDL production, HDL production, or triglyceride synthesis, which are not how statins primarily act (HDL may rise modestly in some cases, but not as the main, consistent effect, and triglyceride synthesis is not increased by statins).

Statins inhibit HMG-CoA reductase in the liver, which lowers the liver’s own cholesterol synthesis. When hepatic cholesterol declines, the liver increases LDL receptor activity, pulling more LDL out of the bloodstream, and it also reduces the production of VLDL (which is a precursor to LDL). The overall effect is a decrease in LDL cholesterol and a decrease in VLDL cholesterol.

The statement describing a decrease in the manufacture of LDL and VLDL fits this mechanism, so it’s the best description of what statins do. The other options describe increases in LDL production, HDL production, or triglyceride synthesis, which are not how statins primarily act (HDL may rise modestly in some cases, but not as the main, consistent effect, and triglyceride synthesis is not increased by statins).