title: Homozygous LIPE mutation in siblings with multiple symmetric lipomatosis, partial lipodystrophy, and myopathy.
abstract: Despite considerable progress in identifying causal genes for lipodystrophy syndromes, the molecular basis of some peculiar adipose tissue disorders remains obscure. In an Israeli-Arab pedigree with a novel autosomal recessive, multiple symmetric lipomatosis (MSL), partial lipodystrophy and myopathy, we conducted exome sequencing of two affected siblings to identify the disease-causing mutation. The 41-year-old female proband and her 36-year-old brother reported marked accumulation of subcutaneous fat in the face, neck, axillae, and trunk but loss of subcutaneous fat from the lower extremities and progressive distal symmetric myopathy during adulthood. They had increased serum creatine kinase levels, hypertriglyceridemia and low levels of high-density lipoprotein cholesterol. Exome sequencing identified a novel homozygous NC_000019.9:g.42906092C>A variant on chromosome 19, leading to a NM_005357.3:c.3103G>T nucleotide change in coding DNA and corresponding p.(Glu1035*) protein change in hormone sensitive lipase (LIPE) gene as the disease-causing variant. Sanger sequencing further confirmed the segregation of the mutation in the family. Hormone sensitive lipase is the predominant regulator of lipolysis from adipocytes, releasing free fatty acids from stored triglycerides. The homozygous null LIPE mutation could result in marked inhibition of lipolysis from some adipose tissue depots and thus may induce an extremely rare phenotype of MSL and partial lipodystrophy in adulthood associated with complications of insulin resistance, such as diabetes, hypertriglyceridemia and hepatic steatosis. © 2016 Wiley Periodicals, Inc.
authors.affiliation: Institute of Diabetes Endocrinology and Metabolism, Rambam Health Campus, Haifa, Israel.
authors.forename: Sagit
authors.initials: S
authors.lastname: Zolotov
authors.affiliation: Department of Clinical Sciences and McDermott Center for Human Growth and Development, UT Southwestern Medical Center, Dallas, Texas.
authors.forename: Chao
authors.initials: C
authors.lastname: Xing
authors.affiliation: Institute of Diabetes Endocrinology and Metabolism, Rambam Health Campus, Haifa, Israel.
authors.forename: Riad
authors.initials: R
authors.lastname: Mahamid
authors.affiliation: The Institute of Human Genetics, Bnai-Zion Medical Center, Haifa, Israel.
authors.forename: Adel
authors.initials: A
authors.lastname: Shalata
authors.affiliation: Department of Endocrinology, Bnai-Zion Medical Center, Haifa, Israel.
authors.forename: Mohammed
authors.initials: M
authors.lastname: Sheikh-Ahmad
authors.affiliation: Division of Nutrition and Metabolic Diseases, Department of Internal Medicine and the Center for Human Nutrition, UT Southwestern Medical Center, Dallas, Texas.
authors.forename: Abhimanyu
authors.initials: A
authors.lastname: Garg
mesh_terms: D000328:Adult; D000368:Aged; D015415:Biomarkers; D004252:DNA Mutational Analysis; D059472:Exome; D005260:Female; D056726:Genetic Association Studies; D005838:Genotype; D006720:Homozygote; D006801:Humans; D008060:Lipodystrophy / Q000175:diagnosis / Q000235:genetics* / Q000378:metabolism; D008069:Lipomatosis, Multiple Symmetrical / Q000175:diagnosis / Q000235:genetics* / Q000378:metabolism; D008297:Male; D008875:Middle Aged; D009135:Muscular Diseases / Q000175:diagnosis / Q000235:genetics* / Q000378:metabolism; D009154:Mutation; D010375:Pedigree; D010641:Phenotype; D035781:Siblings; D002787:Sterol Esterase / Q000235:genetics*; D055815:Young Adult
chemical_list: D015415:Biomarkers; D002787:Sterol Esterase
keywords: hormone sensitive lipase; insulin resistance; lipodystrophy; multiple symmetric lipomatosis; myopathy