Don't know if anyone can explain this but I am trying to understand nephrotic syndrome. If you have decreased albumin, why would the liver increase cholesterol synthesis?
I remember that it has something to do with VLDL. There's increased VLDL synthesis by the liver when the oncotic pressure is low. I don't think the exact mechanism is known. There's also decreased clearance of VLDL for some reason. Since VLDL can be converted to LDL, the patient is at risk for hyperlipidemia. Someone who's done Medicine more recently will probably have a better answer for you.