De Lipideos | Metabolismo

Dysregulation of these pathways underlies major diseases. results from chronic positive energy balance, with hypertrophied adipocytes becoming insulin-resistant and releasing excess FFAs (lipotoxicity). Atherosclerosis is driven by retention of apoB-containing lipoproteins (LDL) in artery walls, where they become oxidized, triggering inflammation and plaque formation. NAFLD arises from ectopic TAG accumulation in the liver due to increased lipogenesis and reduced VLDL export, often in the context of insulin resistance. The carnitine shuttle defects cause hypoketotic hypoglycemia and cardiomyopathy in infants. Understanding these pathways has led to effective therapies: statins (HMG-CoA reductase inhibitors), fibrates (PPAR-α activators that enhance fatty acid oxidation), and emerging inhibitors of ACC or SCD1 for NAFLD.

Lipid metabolism is exquisitely controlled by hormonal and nutritional signals. Insulin promotes anabolism (lipogenesis, TAG storage) and suppresses catabolism (inhibits HSL, activates ACC). Glucagon and epinephrine do the opposite, activating lipolysis and β-oxidation. The AMPK (AMP-activated protein kinase) system acts as a cellular fuel gauge: low energy (high AMP) activates AMPK, which shuts down energy-consuming anabolic pathways (e.g., ACC, HMG-CoA reductase) and turns on catabolic ones (e.g., fatty acid uptake and oxidation). metabolismo de lipideos

The journey of dietary lipids begins in the gastrointestinal tract. The hydrophobic nature of triglycerides (TAGs), phospholipids, and cholesterol esters necessitates emulsification by bile salts in the small intestine. Pancreatic lipase, along with its cofactor colipase, then cleaves TAGs into free fatty acids (FFAs) and 2-monoacylglycerols. Phospholipase A2 acts on phospholipids, while cholesterol esterase hydrolyzes cholesterol esters. These breakdown products are incorporated into mixed micelles, which diffuse to the enterocyte brush border for absorption. Dysregulation of these pathways underlies major diseases

When energy demands rise or glucose is scarce (e.g., fasting, exercise), fatty acids become the primary fuel. Hormone-sensitive lipase (HSL) in adipose tissue is activated by glucagon and epinephrine, liberating FFAs into the bloodstream. FFAs, bound to serum albumin, are transported to oxidative tissues like heart, skeletal muscle, and liver. NAFLD arises from ectopic TAG accumulation in the

When energy and carbohydrate intake exceed immediate needs, the liver and adipose tissue convert excess acetyl-CoA into fatty acids via . This pathway occurs in the cytoplasm. The key regulated enzyme is acetyl-CoA carboxylase (ACC), which converts acetyl-CoA to malonyl-CoA. ACC is activated by citrate (a sign of abundant energy) and insulin, and inhibited by AMPK (energy stress) and glucagon. The fatty acid synthase (FAS) complex, a large multienzyme protein, then uses NADPH (supplied primarily by the pentose phosphate pathway) to extend the malonyl-CoA-derived two-carbon units into palmitate. Further elongation and desaturation (introducing double bonds via desaturases like SCD1) yield the diverse spectrum of cellular fatty acids.