Acquired partial lipodystrophy is associated with increased risk for developing metabolic abnormalities.

Abstract

OBJECTIVE:

Acquired partial lipodystrophy (APL) is a rare disorder characterized by progressive selective fat loss. In previous studies, metabolic abnormalities were reported to be relatively rare in APL, whilst they were quite common in other types of lipodystrophy syndromes.

METHODS:

In this nationwide cohort study, we evaluated 21 Turkish patients with APL who were enrolled in a prospective follow-up protocol. Subjects were investigated for metabolic abnormalities. Fat distribution was assessed by whole body MRI. Hepatic steatosis was evaluated by ultrasound, MRI and MR spectroscopy. Patients with diabetes underwent a mix meal stimulated C-peptide/insulin test to investigate pancreatic beta cell functions. Leptin and adiponectin levels were measured.

RESULTS:

Fifteen individuals (71.4%) had at least one metabolic abnormality. Six patients (28.6%) had diabetes, 12 (57.1%) hypertrigylceridemia, 10 (47.6%) low HDL cholesterol, and 11 (52.4%) hepatic steatosis. Steatohepatitis was further confirmed in 2 patients with liver biopsy. Anti-GAD was negative in all APL patients with diabetes. APL patients with diabetes had lower leptin and adiponectin levels compared to patients with type 2 diabetes and healthy controls. However, contrary to what we observed in patients with congenital generalized lipodystrophy (CGL), we did not detect consistently very low leptin levels in APL patients. The mix meal test suggested that APL patients with diabetes had a significant amount of functional pancreatic beta cells, and their diabetes was apparently associated with insulin resistance.

CONCLUSIONS:

Our results show that APL is associated with increased risk for developing metabolic abnormalities. We suggest that close long-term follow-up is required to identify and manage metabolic abnormalities in APL.

• Authors: Baris Akinci, Fatos Dilan Koseoglu, Huseyin Onay, Sevgi Yavuz, Canan Altay, Ilgin Yildirim Simsir, Secil Ozisik, Leyla Demir, Meltem Korkut, Nusret Yilmaz, Samim Ozen, Gulcin Akinci, Tahir Atik, Mehmet Calan, Mustafa Secil, Abdurrahman Comlekci, Tevfik Demir
• Journal: Metabolism: clinical and experimental (Metabolism) Vol. 64 Issue 9 Pg. 1086-95 (Sep 2015) ISSN: 1532-8600 [Electronic] United States
• PMID: 26139569 (Publication Type: Journal Article)
• Copyright: Copyright © 2015 Elsevier Inc. All rights reserved.

Chemical References

• Adiponectin
• Leptin

Topics

• Adiponectin (blood)
• Adolescent
• Adult
• Aged
• Cohort Studies
• Diabetes Complications (epidemiology, etiology)
• Fatty Liver (etiology)
• Female
• Follow-Up Studies
• Humans
• Leptin (blood)
• Lipodystrophy (complications, epidemiology)
• Magnetic Resonance Imaging
• Male
• Metabolic Diseases (epidemiology, etiology)
• Middle Aged
• Prospective Studies
• Registries
• Risk
• Turkey (epidemiology)
• Young Adult