Premature and severe cardiovascular disease in a Mexican male with markedly low high-density-lipoprotein-cholesterol levels and a mutation in the lecithin:cholesterol acyltransferase gene: a family study.
Epidemiological and clinical studies have shown that a low plasma high‑density lipoprotein cholesterol (HDL-C) level is a strong predictor of cardiovascular disease (CVD). Lecithin:cholesterol acyltransferase (LCAT) is a key enzyme in the formation, maturation and function of HDL. Therefore impaired LCAT function may enhance atherosclerosis because of defective cholesterol transport. In this study, we examined a 34-year old LCAT‑deficient patient and eight first-degree family members. There was a strong family history for CVD and type 2 diabetes mellitus (DM2). The proband was found homozygous for a previously reported LCAT gene mutation (Thr37Met). A sister and two sons of the proband were heterozygous for the same mutation. The proband had DM2 and showed severe multivessel coronary artery disease, corneal opacification and extremely low HDL-C levels. Large HDL particles were absent while small HDL particles were increased. The HDL of the patient had a reduced ability to promote cell cholesterol efflux, and the low‑density lipoproteins (LDL) were more susceptible to oxidation. Among his family members, two heterozygotes and one non-carrier had early carotid or coronary atherosclerosis. In conclusion, as the increased LDL oxidability and structural and functional abnormalities of HDL particles have been reported in patients with obesity and diabetes, the results suggested that the adverse coronary risk profile, and not being LCAT deficient, may be responsible for the CVD found in our proband, and for the early atherosclerosis observed in the two heterozygotes and in the wild‑type family members.
Department of Endocrinology, National Institute of Cardiology ̔Ignacio Chávez̓ (INCICH), Tlalpan, Mexico City 14080, Mexico.
Rosalinda
R
Posadas-Sánchez
Department of Endocrinology, National Institute of Cardiology ̔Ignacio Chávez̓ (INCICH), Tlalpan, Mexico City 14080, Mexico.
Carlos
C
Posadas-Romero
Department of Endocrinology, National Institute of Cardiology ̔Ignacio Chávez̓ (INCICH), Tlalpan, Mexico City 14080, Mexico.
Wendy Angélica
WA
Ocampo-Arcos
Laboratory of Genomics of Cardiovascular Disease, National Institute of Genomic Medicine (INMEGEN), Tlalpan, Mexico City 14610, Mexico.
María Teresa
MT
Villarreal-Molina
Department of Molecular Biology, National Institute of Cardiology ̔Ignacio Chávez̓ (INCICH), Tlalpan, Mexico City 14080, Mexico.
Gilberto
G
Vargas-Alarcón
Laboratory of Genomics of Cardiovascular Disease, National Institute of Genomic Medicine (INMEGEN), Tlalpan, Mexico City 14610, Mexico.
Erika
E
Antúnez-Argüelles
Department of Endocrinology, National Institute of Cardiology ̔Ignacio Chávez̓ (INCICH), Tlalpan, Mexico City 14080, Mexico.
Enrique
E
Mendoza-Pérez
Department of Endocrinology, National Institute of Cardiology ̔Ignacio Chávez̓ (INCICH), Tlalpan, Mexico City 14080, Mexico.
Guillermo
G
Cardoso-Saldaña
Department of Endocrinology, National Institute of Cardiology ̔Ignacio Chávez̓ (INCICH), Tlalpan, Mexico City 14080, Mexico.
Rocío
R
Martínez-Alvarado
Department of Endocrinology, National Institute of Cardiology ̔Ignacio Chávez̓ (INCICH), Tlalpan, Mexico City 14080, Mexico.
Aída
A
Medina-Urrutia
Department of Endocrinology, National Institute of Cardiology ̔Ignacio Chávez̓ (INCICH), Tlalpan, Mexico City 14080, Mexico.
Esteban
E
Jorge-Galarza
D000328:Adult; D002318:Cardiovascular Diseases / Q000175:diagnosis* / Q000235:genetics*; D008076:Cholesterol, HDL / Q000097:blood* / Q000235:genetics*; D020022:Genetic Predisposition to Disease; D006801:Humans; D008297:Male; D009154:Mutation; D007862:Phosphatidylcholine-Sterol O-Acyltransferase / Q000235:genetics*
D008076:Cholesterol, HDL; D007862:Phosphatidylcholine-Sterol O-Acyltransferase