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Apolipoprotein C-III levels remain unaltered following leptin replacement in lipodystrophy
In patients with lipodystrophy, leptin replacement is not sufficient to affect elevated apolipoprotein C-III plasma levels.
Further, hypertriglyceridemia of lipodystrophy may be caused in part by elevated apolipoprotein C-III, researchers wrote.
Rebecca J. Brown, MD, MHSc, clinical research scholar at the National Institute of Diabetes and Digestive and Kidney Diseases, and colleagues compared serum apolipoprotein C-III concentrations from 60 adult patients with generalized or partial lipodystrophy unrelated to HIV vs. 54 healthy age-, sex-, race- and ethnicity-matched controls with a BMI greater than 25 kg/m2. All participants underwent baseline anthropometric measures and routine laboratory tests for fasting lipids, insulin, leptin, HbA1c and general chemistry.
Rebecca J. Brown
Fifty-four of the 60 lipodystrophy patients were treated with self-administered subcutaneous metereleptin injections in doses ranging from 0.04 to 0.16 mg per kg body weight per day for 6 to 12 months.
The researchers found that the lipodystrophy group had significantly elevated apolipoprotein C-III levels (23.9 mg/dL) vs. controls (14.9 mg/dL; P < .0001). This disparity persisted after adjustment for use of individual medications and retained borderline significance when all medication was considered in a single model (P = .05).
A strong positive correlation was seen between apolipoprotein C-III and triglyceride levels in both lipodystrophy patients (P < .0001) and controls (P<.0001).
While apolipoprotein C-III decreased after 6 to 12 months of metreleptin treatment, this change was not statistically significant. A post-hoc subgroup analysis of patients with lower post-leptin replacement triglyceride levels (n = 40) revealed significantly lower apolipoprotein C-III levels after metereleptin (P = .01).
“Hypertriglyceridemia in patients with lipodystrophy appears to be related to both hypoleptinemia and elevated circulating levels of apolipoprotein CIII,” Brown told Endocrine Today. “In patients who do not have adequate triglyceride lowering with metreleptin, or are not candidates for metreleptin, apolipoprotein CIII lowering might be a potential therapeutic strategy to reduce triglycerides.” – by Jennifer Byrne
Disclosure: Brown reports no relevant financial disclosures. Please see the full study for a list of all other authors’ relevant financial disclosures.