The Balance Between Hormone Sensitive Lipase and Postheparin Lipoprotein Lipase
A struggle is waged between hormone sensitive lipase (activated by catecholamines and Cortisol) and postheparin lipoprotein lipase (activated by testosterone). Under normal conditions there is a balance between these two lipases. During stress the activity of hormone sensitive lipase rises, causing a shift towards anaerobic metabolism, which means increased plasma glucose, FFA, and acetyl CoA. Due to lack of oxaloacetic acid, acetyl CoA cannot enter the Krebs cycle, but is synthesized to cholesterol. A rise in cholesterol is, therefore, a sign of the anaerobic metabolism leading to CVD. This is in accordance with what is said elsewhere in this book that there is a continuous struggle between testosterone and cortisol, and the state of this struggle is reflected in the level of cholesterol.