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2012 ; 97
(7
): E1266-75
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Mutations in the ANGPTL3 gene and familial combined hypolipidemia: a clinical and
biochemical characterization
#MMPMID22659251
Minicocci I
; Montali A
; Robciuc MR
; Quagliarini F
; Censi V
; Labbadia G
; Gabiati C
; Pigna G
; Sepe ML
; Pannozzo F
; Lütjohann D
; Fazio S
; Jauhiainen M
; Ehnholm C
; Arca M
J Clin Endocrinol Metab
2012[Jul]; 97
(7
): E1266-75
PMID22659251
show ga
CONTEXT: Familial combined hypolipidemia causes a global reduction of plasma
lipoproteins. Its clinical correlates and metabolic implications have not been
well defined. OBJECTIVE: The objective of the study was to investigate the
genetic, clinical, and metabolic characteristics of a cohort of subjects with
familial combined hypolipidemia. DESIGN: The design of the study included
candidate gene screening and the comparison of the clinical and metabolic
characteristics between carrier and noncarrier individuals. SETTING: The study
was conducted in a general community. SUBJECTS: Participants in the study
included individuals belonging to nine families with familial combined
hypolipidemia identified in a small town (Campodimele) as well as from other 352
subjects living in the same community. MAIN OUTCOMES MEASURES: Serum
concentrations of lipoproteins, Angiopoietin-like 3 (Angptl3) proteins, and
noncholesterol sterols were measured. RESULTS: The ANGPTL3 S17X mutation was
found in all probands, 20 affected family members, and 32 individuals of the
community. Two additional frame shift mutations, FsE96del and FsS122, were also
identified in two hypocholesterolemic individuals. Homozygotes for the ANGPTL3
S17X mutation had no circulating Angptl3 and a marked reduction of all plasma
lipids (P < 0.001). Heterozygotes had 42% reduction in Angptl3 level compared
with noncarriers (P < 0.0001) but a significant reduction of only total
cholesterol and high-density lipoprotein cholesterol. No differences were
observed in the plasma noncholesterol sterols between carriers and noncarriers.
No association between familial combined hypolipidemia and the risk of hepatic or
cardiovascular diseases were detected. CONCLUSIONS: Familial combined
hypolipidemia segregates as a recessive trait so that apolipoprotein B- and
apolipoprotein A-I-containing lipoproteins are comprehensively affected only by
the total deficiency of Angptl3. Familial combined hypolipidemia does not perturb
whole-body cholesterol homeostasis and is not associated with adverse clinical
sequelae.