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家族性乳糜微粒血症综合征:一种罕见但严重的常染色体隐性遗传病,其特征为难治性高甘油三酯血症和反复发作的胰腺炎。

Familial chylomicronemia syndrome: A rare but devastating autosomal recessive disorder characterized by refractory hypertriglyceridemia and recurrent pancreatitis.

机构信息

Division of Cardiology, Advocate Heart Institute at Advocate Lutheran General, Hospital, 1775 Dempster St., Parkside B-01, Park Ridge, IL 60068, USA.

Division of Cardiology, Advocate Heart Institute at Advocate Lutheran General, Hospital, 1775 Dempster St., Parkside B-01, Park Ridge, IL 60068, USA.

出版信息

Trends Cardiovasc Med. 2020 Feb;30(2):80-85. doi: 10.1016/j.tcm.2019.03.001. Epub 2019 Mar 19.

Abstract

Familial Chylomicronemia Syndrome (FCS) is a rare autosomal recessive lipid disorder characterized by severe hypertriglyceridemia and recurrent pancreatitis. Because the disorder is often misdiagnosed or not diagnosed and because traditional triglyceride lowering medications are often ineffective, the disease leads to a tremendous physical, social and emotional burden on afflicted patients and their caretakers. Mutations in 5 different genes have been implicated in the development of FCS, all of which have an effect on the activity of lipoprotein lipase. Lipoprotein lipase(LPL) is responsible for removing triglycerides from chylomicrons and other triglyceride rich lipoproteins in the circulation, breaking them down into free fatty acids for use as energy. Patients with FCS have loss of function of their LPL leading to severely elevated chylomicrons in the circulation and hence, severe hypertriglyceridemia. The principle treatment for FCS is to reduce chylomicron formation in the gut by placing the patient on an extremely low fat diet. New medications in development hold significant promise for improving the quality of life for FCS patients.

摘要

家族性乳糜微粒血症综合征(FCS)是一种罕见的常染色体隐性脂质代谢紊乱,其特征为严重的高甘油三酯血症和复发性胰腺炎。由于该疾病经常被误诊或漏诊,并且传统的降低甘油三酯的药物通常无效,因此该疾病给受影响的患者及其护理人员带来了巨大的身体、社会和情感负担。已有 5 种不同的基因突变与 FCS 的发展有关,这些突变都对脂蛋白脂肪酶的活性有影响。脂蛋白脂肪酶(LPL)负责从乳糜微粒和循环中的其他富含甘油三酯的脂蛋白中去除甘油三酯,将其分解为游离脂肪酸以供能量使用。FCS 患者的 LPL 功能丧失,导致循环中乳糜微粒严重升高,从而导致严重的高甘油三酯血症。FCS 的主要治疗方法是通过让患者采用极低脂肪饮食来减少肠道中乳糜微粒的形成。正在开发中的新型药物有望显著改善 FCS 患者的生活质量。

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