NORTHERN CARIBBEAN UNIVERSITY

College of Natural and Applied Sciences, Allied Health and Nursing

Department of Biology, Chemistry and Environmental Science
BCHM 203: Clinical Biochemistry

Processing of Lipids in the Body

Lipids have very important functions in our bodies:

1. Major source of energy
2. Precursor for hormones
3. Structural integrity of cell membranes

Main lipids in the body include:

1. Fatty acids
2. Triglycerides
3. Phospholipids
4. Cholesterol

Lipids are transported around the body by lipoproteins. Lipoproteins are composed of both
lipids and proteins called apolipoproteins. The important lipoproteins include:

1. Chylomicrons
a. Largest and least dense of the lipoproteins
b. Produced by the intestines
c. Contains apo-48
d. Primarily transport dietary triglycerides to peripheral cells
e. Account for the turbidity of post-prandial plasma
f. Tends to float on top of stored plasma and form a creamy layer, which is the
hallmark of the presence of chylomicrons.

2. Very Low Density Lipoproteins (VLDL)

a. Produced by the liver
b. Primarily transport liver made triglycerides to cells to supply energy or to be
stored as fat.
c. Contains apo B-100, apo E, apo Cs
d. Account for most of the turbidity observed in fasting hyper-lipidemic plasma
specimens. (they typically do not form the creamy layer on top of stored
plasma due to being smaller and more dense)
 e. Excess dietary intake of carbohydrates, saturated fatty acids and trans fatty
acids enhances the hepatic synthesis of triglycerides, which in turn increases
VLDL production.

3. Low Density Lipoproteins (LDL)

a. Rich in cholesterol
b. Deliver cholesterol to peripheral cells and the liver after the triglycerides
have been off-loaded
c. Contains apo B-100 and is more cholesterol rich than other apo B-containing
lipoproteins
d. They are formed as a result of the lipolysis of VLDL.

Important Note: LDL is readily taken up by cells via the LDL receptor in the liver and
peripheral cells. Also, because LDL are significantly smaller than VLDL particles and
chylomicrons, they can diffuse into the extracellular space of blood vessels where they can
be oxidized and taken up by macrophages through various scavenger receptors.
Macrophages that take up too much lipid become filled with intracellular lipid drops and
turn into foam cells, which is the predominant cell type of fatty streaks – an early precursor
of atherosclerotic plaques.

4. High Density Lipoproteins (HDL)

a. Smallest and most dense
b. Typically contain apo A 1
c. Transport excess cholesterol for transport back to the liver

There are four main pathways involved in lipoprotein metabolism

1. The lipid absorption pathway
a. Involves the absorption of products of lipid digestion through the lining of
the intestines and their subsequent packaging into chylomicrons (after being
re-esterified in intestinal cells).

2. The exogenous pathway

a. Involves the transport and delivery of triglycerides and cholesterol to
peripheral and liver cells.

3. The endogenous pathway

a. Involves the transport of liver made triglycerides and cholesterol to
peripheral cells.
4. The reverse cholesterol pathway
a. Involves the transport of excess cholesterol from peripheral cells back to the
liver.
 SUMMARY OF THE PROCESSING OF LIPIDS IN THE BODY

Within the small intestines, complex lipids are broken down to short chain fatty
acids, long chain fatty acids, monoglycerides, diglycerides, glycerol, free
cholesterol.

The short fatty acids, long chain fatty acids, monoglycerides, diglycerides, and
other lipid breakdown products combine with bile salts to form micelles. (the bile
salts are components of bile which are secreted into the small intestines in
response to cholecystokinin)

The micelles make their way to the ileum and make contact with the membrane of
the villi that line the ileum

The short chain fatty acids diffuse
through the membrane and enter
the hepatic portal vein where it is
picked up by albumin and
transported to the liver.
The larger fatty acids, monoglycerides,
diglycerides are re-esterified within the
intestinal cells to form triglycerides and
cholesterol esters. These are then
packaged into chylomicrons which
transport the triglycerides and cholesterol
esters to the cells of the body.

The chylomicrons enter the circulation via the lymphatic ducts. Once they enter the circulation, the
chylomicrons interact with proteoglycans and is acted upon by lipoprotein lipase (LPL) which break
down the triglycerides and cholesterol esters into free fatty acids and glycerol which are then “off-
loaded” at the body cells. Within the body cells, the free fatty acids and cholesterol are re-esterified and
stored as triglycerides. After the action of proteoglycans and LPL, the chylomicron is reduced to
“chylomicron remnants”

The chylomicron remnants are taken up by the liver where enzymes break down the remnants to release
fatty acids, free cholesterol and amino acids. Within the liver, some cholesterol is converted to bile acids,
some is directly excreted into the bile but not all of the excreted bile exits the body. Half is reabsorbed by
the intestines while the remainder is excreted in stool.
POINTS TO NOTE
1. HDL is made in the liver and intestines. They are primarily responsible for
transporting cholesterol back to the liver.

a. The reverse cholesterol pathway is the pathway by which excess cholesterol

from peripheral cells is transported back to the liver. It is mediated by HDL
b. In the liver, cholesterol is either converted to bile acids or secreted directly
into bile

c. About half is excreted with stool while the remainder is reabsorbed by the
intestines

2. VLDL are made within the liver and these carry liver-made triglycerides and
cholesterol esters to adipose tissue and muscle cells.

3. LDL are formed from very low density lipoproteins (VLDL) when they lose
triglycerides by the action of Lipoprotein lipase. This is how it works: LPL breaks
down the triglycerides and cholesterol esters of the VLDL resulting in free fatty
acids and cholesterol and VLDL remnants. The VLDL remnants are then converted
to LDL which is composed of protein and “a lot of” cholesterol.