Question:
Which of the following is NOT a predisposing factor for atherosclerotic plaque formation?
Which of the following is NOT a predisposing factor for atherosclerotic plaque formation?
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Three relate to lipids, endothelium or oxidation; the protease inhibitor is the odd one out.
Updated On: Jun 24, 2026
- ApoE
- Alpha 2-macroglobulin
- Oxidised LDL
- Increased homocysteine
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The Correct Option is B
Solution and Explanation
Step 1: Atherogenesis is driven by endothelial injury, lipid accumulation, oxidative modification of lipoproteins, and chronic inflammation in the arterial wall.
Step 2: Oxidised LDL is central to plaque formation; it is taken up by macrophages via scavenger receptors to form foam cells and is directly proatherogenic.
Step 3: Increased homocysteine (hyperhomocysteinemia) causes endothelial damage and promotes thrombosis and atherosclerosis, so it is a recognised risk factor.
Step 4: ApoE polymorphisms influence lipoprotein clearance; certain isoforms (for example ApoE4) are linked to higher cholesterol and increased atherosclerotic and vascular risk, so ApoE is associated with predisposition.
Step 5: Alpha 2-macroglobulin is a broad-spectrum protease inhibitor that clears proteases and cytokines; it is not an established predisposing factor for atherosclerotic plaque formation.
Conclusion: The factor that does not predispose to atherosclerosis is alpha 2-macroglobulin, so the answer is option 2.
Step 2: Oxidised LDL is central to plaque formation; it is taken up by macrophages via scavenger receptors to form foam cells and is directly proatherogenic.
Step 3: Increased homocysteine (hyperhomocysteinemia) causes endothelial damage and promotes thrombosis and atherosclerosis, so it is a recognised risk factor.
Step 4: ApoE polymorphisms influence lipoprotein clearance; certain isoforms (for example ApoE4) are linked to higher cholesterol and increased atherosclerotic and vascular risk, so ApoE is associated with predisposition.
Step 5: Alpha 2-macroglobulin is a broad-spectrum protease inhibitor that clears proteases and cytokines; it is not an established predisposing factor for atherosclerotic plaque formation.
Conclusion: The factor that does not predispose to atherosclerosis is alpha 2-macroglobulin, so the answer is option 2.
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