Diacylglycerol oil for apolipoprotein C-II deficiency

Abstract

Sir, Apolipoprotein C-II is a cofactor of lipoprotein lipase (LPL), which hydrolyses triglycerides of chylomicrons and very low-density lipoproteins (VLDLs).1 We report our therapeutic experience with diacylglycerol (DAG) oil, a natural edible oil, in a patient with apolipoprotein C-II deficiency, a rare, autosomal, recessively-inherited disease. A 43-year-old Japanese man presented with hypertriglyceridaemia, chylomicronaemia, hepatosplenomegaly, postprandial epigastric pain, and recurrent attacks of pancreatitis. Fasting serum triglyceride fluctuated from 545 to 2252 mg/dl, even on treatment with fibrate and ethyl icosapentate, indicating refractory hypertriglyceridaemia. On admission, levels of fasting serum total cholesterol, LDL-cholesterol, HDL-cholesterol, triglycerides, plasma glucose, and haemoglobin A1c were 317, 33, 28, 2252, 107 mg/dl and 5.0%, respectively. Serum apolipoprotein …