Bone Density in Patients With Berardinelli-Seip Congenital Lipodystrophy Is Higher in Trabecular Sites and in Type 2 Patients

J Clin Densitom. 2018 Jan-Mar;21(1):61-67. doi: 10.1016/j.jocd.2016.10.002. Epub 2016 Nov 25.

Abstract

Berardinelli-Seip congenital lipodystrophy (BSCL) is a rare autosomal recessive syndrome characterized by a difficulty storing lipid in adipocytes, low body fat, hypoleptinemia, and hyperinsulinemia. We report here laboratory, bone mineral density (BMD), and bone mineral content findings of 21 patients (24.1 ± 8.4 yr old, 14 females, 18 diabetics, 5.3% total body fat) with BSCL. The mean leptin was very low (0.91 ± 0.42 ng/mL), and the mean values of the Z-scores for all studied sites were positive, except for the 33% radius (Z-score -0.5 standard deviation [SD]). Twelve patients (57.1%) had a BMD Z-score higher than +2.5 SD in at least 1 site. There was no significant difference in the Z-scores between males and females. None of type 1 (AGPAT2) patients had Z-scores higher than +2.5 SD, and these patients had a smaller Z-score of BMD total body (0.26 SD vs 1.90 SD, p = 0.022) and of bone mineral content (1.59 SD vs 3.3 SD, p = 0.032) than type 2 (seipin) patients. Insulin, as well as HOMAIR (homeostasis model assessment), correlated positively with the BMD of all sites, except for the 33% radius. Z-Scores on this site (33% radius) were the smallest of all. More than half of our patients with BSCL have BMD Z-scores higher than +2.5 SD on at least 1 site, and this increase is more pronounced in the trabecular sites and in type 2 patients.

Keywords: Bone mass; density; insulin; leptin; lipodystrophy.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Acyltransferases / genetics
  • Adolescent
  • Adult
  • Bone Density*
  • Cancellous Bone / diagnostic imaging*
  • Cancellous Bone / physiopathology
  • Female
  • Femur Head / diagnostic imaging
  • Femur Neck / diagnostic imaging
  • GTP-Binding Protein gamma Subunits / genetics
  • Homeostasis
  • Humans
  • Insulin / blood*
  • Insulin Resistance
  • Leptin / blood*
  • Lipodystrophy, Congenital Generalized / diagnostic imaging*
  • Lipodystrophy, Congenital Generalized / genetics
  • Lipodystrophy, Congenital Generalized / physiopathology*
  • Lumbar Vertebrae / diagnostic imaging
  • Male
  • Radius / diagnostic imaging
  • Young Adult

Substances

  • BSCL2 protein, human
  • GTP-Binding Protein gamma Subunits
  • Insulin
  • Leptin
  • Acyltransferases
  • 2-acylglycerophosphate acyltransferase