In a patient with nephrotic syndrome, which of the following is true regarding plasma cholesterol levels?
(1) Plasma cholesterol levels are decreased due to increased LDL receptors in the liver.
(2) Plasma cholesterol levels are increased due to the loss of cholesterol in urine.
(3) Plasma cholesterol levels are normal as the condition is unrelated to lipid metabolism.
(4) Plasma cholesterol levels are decreased due to increased hepatic synthesis of bile salts.
📝 Explanation:
Nephrotic syndrome is associated with hyperlipidemia, particularly increased levels of LDL and cholesterol. The underlying mechanism involves the loss of albumin in the urine, which leads to hypoalbuminemia. This causes an increased synthesis of very low-density lipoproteins (VLDL) by the liver to compensate for the loss of oncotic pressure. Additionally, the loss of proteins that normally bind to cholesterol in the blood, such as lipoproteins, results in decreased clearance of LDL.