Abstract

BackgroundHypertriglyceridemia (HTG) is one of the most common etiologies of acute pancreatitis (AP). Variants in five genes involved in the regulation of plasma lipid metabolism, namely LPL, APOA5, APOC2, GPIHBP1 and LMF1, have been frequently reported to cause or predispose to HTG.MethodsA Han Chinese patient with HTG-induced AP was assessed for genetic variants by Sanger sequencing of the entire coding and flanking sequences of the above five genes.ResultsThe patient was a 32-year-old man with severe obesity (Body Mass Index = 35) and heavy smoking (ten cigarettes per day for more than ten years). At the onset of AP, his serum triglyceride concentration was elevated to 1450.52 mg/dL. We sequenced the entire coding and flanking sequences of the LPL, APOC2, APOA5, GBIHBP1 and LMF1 genes in the patient. We found no putative deleterious variants, with the exception of a novel and heterozygous nonsense variant, c.1024C > T (p.Arg342*; rs776584760), in exon 7 of the LMF1 gene.ConclusionsThis is the first time that a heterozygous LMF1 nonsense variant was found in a HTG-AP patient with severe obesity and heavy smoking, highlighting an important interplay between genetic and lifestyle factors in the etiology of HTG.

Highlights

  • Hypertriglyceridemia (HTG) is one of the most common etiologies of acute pancreatitis (AP)

  • Variants in five genes involved in the regulation of plasma lipid metabolism, namely Lipoprotein lipase (LPL), Apolipoprotein A-V (APOA5), Apolipoprotein C-II (APOC2)

  • Chen et al Lipids in Health and Disease (2019) 18:68 acts as an essential LPL activator [7]), Glycosylphosphatidylinositol-anchored highdensity lipoprotein binding protein 1 (GPIHBP1), and Lipase maturation factor 1 (LMF1), have been frequently reported to cause or predispose to HTG

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Summary

Introduction

Hypertriglyceridemia (HTG) is one of the most common etiologies of acute pancreatitis (AP). Variants in five genes involved in the regulation of plasma lipid metabolism, namely LPL, APOA5, APOC2, GPIHBP1 and LMF1, have been frequently reported to cause or predispose to HTG. HTG-AP is more often associated with greater severity and higher recurrence and complication rates as compared with other etiologies of AP. This is true in patients with primary severe HTG. Chen et al Lipids in Health and Disease (2019) 18:68 acts as an essential LPL activator [7]), GPIHBP1 (encoding glycosylphosphatidylinositol-anchored high density lipoprotein-binding protein 1, which mediates the transmembrane transport and binding of LPL [8]), and LMF1 (encoding lipase maturation factor 1, which is involved in the folding and expression of LPL [9]), have been frequently reported to cause or predispose to HTG. The etiology of HTG in most cases is complex and likely involves gene-gene and/or gene-lifestyle interactions [10]

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