Question

Dyslipidaemia with raised triglyceride and low HDL cholesterol is seen in all of the following EXCEPT

• A. Uncontrolled diabetes mellitus
• B. Hypertensive on Beta blocker Therapy
• C. Regular alcohol consumption
• D. Obesity with BMI more than 30

Hint:

Think about which of these actually raises HDL rather than lowering it.

Answer 1

The Correct Option is C

The question asks which of four situations does not fit the raised triglyceride, low HDL pattern that is typical of insulin resistance.

1. Uncontrolled diabetes mellitus: poor insulin action lets the liver push out more VLDL, raising triglyceride, while HDL production falls. This fits the pattern.
2. Hypertensive on Beta blocker therapy: non-selective beta blockers are known to push triglyceride up and HDL down as a metabolic side effect. This fits too.
3. Regular alcohol consumption: alcohol taken regularly raises HDL cholesterol by boosting Apo A1 production. Even though heavy drinking can raise triglyceride, the HDL side of the pattern, being low, does not hold, since alcohol raises rather than lowers HDL.
4. Obesity with BMI more than 30: excess fat tissue drives insulin resistance, more free fatty acids reaching the liver, higher triglyceride and lower HDL. This fits the pattern.

Three of the four, diabetes, beta blockers and obesity, genuinely give high triglyceride with low HDL. Alcohol breaks the pattern because it raises HDL instead of lowering it.

Let's summarize:

• High triglyceride with low HDL is the signature of insulin resistance, seen in diabetes, obesity and beta blocker use.
• Alcohol is well known to raise HDL cholesterol, so it does not belong with the other three.

So regular alcohol consumption is the condition that does not fit, making it the correct exception.