Alternatively, decreased LDL-C levels may be the result of lower LDL precursor and hepatic VLDL particle secretion rates, suggesting that ANGPTL3 may effectively reduce serum LDL-C levels in patients with homozygous familial hypercholesterolemia with a complete LDL receptor-mediated LDL-C uptake deficiency [31]. This evidence concerns the gene ANGPTL3 and familial hypercholesterolemia.