A 60-Year-Old Woman Comes to the Office for Annual Follow

A 60-year-old woman comes to the office for annual follow up. She has a history of hypertension which is controlled by calcium channel blocker. she states that she increase feeling fatigue and has weight gain recently. Two years ago, her laboratory tests were normal. Blood pressure is 136/97 mmHg. and pulse is 62/ min . BMI is 28 Kg/m2. thyroid gland is mildly enlarged in examination so laboratory tests are done and show elevation TSH and low free T4. High total and LDL cholestrol and increased triglyceride. Which of the following is the most likely underlying mechanism for the elevated cholesterol in this patient?

A) Activation of transcription factor peroxisome proliferator-activated receptor alpha
B) Decreased LDL receptor gene expression
C) Increased lipoprotein lipase gene expression
D) Induction of HMG-CoA reductase
E) Upregulation of LDL receptor degradation