Adipokines and the insulin resistance syndrome in familial partial lipodystrophy caused by a mutation in lamin A/C

Aims/hypothesis: Familial partial lipodystrophy (FPLD) and obesity are both associated with increased risks of type 2 diabetes and cardiovascular disease. Although adipokines have been implicated, few data exist in subjects with FPLD; therefore we investigated a family with FPLD due to a lamin A/C mutation in order to determine how abnormalities of the plasma adipokine profile relate to insulin resistance and the metabolic syndrome. Methods: Plasma levels of adiponectin, leptin, resistin, IL-1 beta, IL-6 and TNF-alpha in 30 subjects (ten patients, 20 controls) were correlated with indices of metabolic syndrome. Results: Compared with controls, FPLD patients had significantly lower plasma levels of adiponectin (3.7 +/- 1.0 in FDLP cases vs 7.1 +/- 0.72 mu g/ml in controls, p=0.02), leptin (1.23 +/- 0.4 vs 9.0 +/- 1.3 ng/ml, p=0.002) and IL-6 (0.59 +/- 0.12 vs 1.04 +/- 0.17 pg/ml, p=0.047) and elevated TNF-alpha (34.8 +/- 8.1 vs 13.7 +/- 2.7 pg/ml, p=0.028), whereas IL-1 beta and resistin were unchanged. In both groups, adiponectin levels were inversely correlated with body fat mass (controls, r=-0.44, p=0.036; FDLP, r=-0.67, p=0.025), insulin resistance (controls, r=-0.62, p=0.003; FDLP, r=-0.70, p=0.025) and other features of the metabolic syndrome. TNF-alpha concentrations were positively related to fat mass (controls, r=0.68, p=0.001; FDLP, r=0.64, p=0.048) and insulin resistance (controls, r=0.86, p=0.001; FDLP, r=0.75, p=0.013). IL-6, IL-1 beta and resistin did not demonstrate any correlations with the metabolic syndrome in either group. Conclusions/interpretation: Low adiponectin and leptin and high TNF-alpha were identified as the major plasma adipokine abnormalities in FPLD, consistent with the hypothesis that low adiponectin and high TNF-alpha production may be mechanistically related, and perhaps responsible for the development of insulin resistance and cardiovascular disease in FPLD.