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  • CN376065 has been replaced by C5882745, showing C5882745

Lipodystrophy, congenital generalized, type 5(CGL5)

MedGen UID:
1847991
Concept ID:
C5882745
Disease or Syndrome
Synonym: CGL5
 
Gene (location): PCYT1A (3q29)
 
Monarch Initiative: MONDO:0958023
OMIM®: 620680

Definition

Congenital generalized lipodystrophy type 5 (CGL5) is an autosomal recessive metabolic disorder characterized by childhood onset of lipodystrophy, severe nonalcoholic fatty liver disease, dyslipidemia, hypertriglyceridemia, low HDL, and insulin-resistant diabetes mellitus. Affected individuals also have short stature (Payne et al., 2014). For a discussion of genetic heterogeneity of congenital generalized lipodystrophy, see CGL1 (608594). [from OMIM]

Clinical features

From HPO
Short stature
MedGen UID:
87607
Concept ID:
C0349588
Finding
A height below that which is expected according to age and gender norms. Although there is no universally accepted definition of short stature, many refer to "short stature" as height more than 2 standard deviations below the mean for age and gender (or below the 3rd percentile for age and gender dependent norms).
Decreased body fat percentage
MedGen UID:
1723230
Concept ID:
C5421709
Finding
The percentage of fat as a part of total body weight below the norm, usually defined as less than 14% for females and less than 8% for males.
Hepatic steatosis
MedGen UID:
398225
Concept ID:
C2711227
Disease or Syndrome
Steatosis is a term used to denote lipid accumulation within hepatocytes.
Lipodystrophy
MedGen UID:
6111
Concept ID:
C0023787
Disease or Syndrome
Degenerative changes of the fat tissue.
Loss of subcutaneous adipose tissue in limbs
MedGen UID:
325248
Concept ID:
C1837764
Finding
Loss (disappearance) of previously present subcutaneous fat tissue in arm or leg.
Type 2 diabetes mellitus
MedGen UID:
41523
Concept ID:
C0011860
Disease or Syndrome
Type 2 diabetes mellitus is distinct from maturity-onset diabetes of the young (see 606391) in that it is polygenic, characterized by gene-gene and gene-environment interactions with onset in adulthood, usually at age 40 to 60 but occasionally in adolescence if a person is obese. The pedigrees are rarely multigenerational. The penetrance is variable, possibly 10 to 40% (Fajans et al., 2001). Persons with type 2 diabetes usually have an obese body habitus and manifestations of the so-called metabolic syndrome (see 605552), which is characterized by diabetes, insulin resistance, hypertension, and hypertriglyceridemia. Genetic Heterogeneity of Susceptibility to Type 2 Diabetes Susceptibility to T2D1 (601283) is conferred by variation in the calpain-10 gene (CAPN10; 605286) on chromosome 2q37. The T2D2 locus (601407) on chromosome 12q was found in a Finnish population. The T2D3 locus (603694) maps to chromosome 20. The T2D4 locus (608036) maps to chromosome 5q34-q35. Susceptibility to T2D5 (616087) is conferred by variation in the TBC1D4 gene (612465) on chromosome 13q22. A mutation has been observed in hepatocyte nuclear factor-4-alpha (HNF4A; 600281.0004) in a French family with NIDDM of late onset. Mutations in the NEUROD1 gene (601724) on chromosome 2q32 were found to cause type 2 diabetes mellitus in 2 families. Mutation in the GLUT2 glucose transporter was associated with NIDDM in 1 patient (138160.0001). Mutation in the MAPK8IP1 gene, which encodes the islet-brain-1 protein, was found in a family with type 2 diabetes in individuals in 4 successive generations (604641.0001). Polymorphism in the KCNJ11 gene (600937.0014) confers susceptibility. In French white families, Vionnet et al. (2000) found evidence for a susceptibility locus for type 2 diabetes on 3q27-qter. They confirmed the diabetes susceptibility locus on 1q21-q24 reported by Elbein et al. (1999) in whites and by Hanson et al. (1998) in Pima Indians. A mutation in the GPD2 gene (138430.0001) on chromosome 2q24.1, encoding mitochondrial glycerophosphate dehydrogenase, was found in a patient with type 2 diabetes mellitus and in his glucose-intolerant half sister. Mutations in the PAX4 gene (167413) have been identified in patients with type 2 diabetes. Triggs-Raine et al. (2002) stated that in the Oji-Cree, a gly319-to-ser change in HNF1-alpha (142410.0008) behaves as a susceptibility allele for type 2 diabetes. Mutation in the HNF1B gene (189907.0007) was found in 2 Japanese patients with typical late-onset type 2 diabetes. Mutations in the IRS1 gene (147545) have been found in patients with type 2 diabetes. A missense mutation in the AKT2 gene (164731.0001) caused autosomal dominant type 2 diabetes in 1 family. A (single-nucleotide polymorphism) SNP in the 3-prime untranslated region of the resistin gene (605565.0001) was associated with susceptibility to diabetes and to insulin resistance-related hypertension in Chinese subjects. Susceptibility to insulin resistance has been associated with polymorphism in the TCF1 (142410.0011), PPP1R3A (600917.0001), PTPN1 (176885.0001), ENPP1 (173335.0006), IRS1 (147545.0002), and EPHX2 (132811.0001) genes. The K121Q polymorphism of ENPP1 (173335.0006) is associated with susceptibility to type 2 diabetes; a haplotype defined by 3 SNPs of this gene, including K121Q, is associated with obesity, glucose intolerance, and type 2 diabetes. A SNP in the promoter region of the hepatic lipase gene (151670.0004) predicts conversion from impaired glucose tolerance to type 2 diabetes. Variants of transcription factor 7-like-2 (TCF7L2; 602228.0001), located on 10q, have also been found to confer risk of type 2 diabetes. A common sequence variant, rs10811661, on chromosome 9p21 near the CDKN2A (600160) and CDKN2B (600431) genes has been associated with risk of type 2 diabetes. Variation in the PPARG gene (601487) has been associated with risk of type 2 diabetes. A promoter polymorphism in the IL6 gene (147620) is associated with susceptibility to NIDDM. Variation in the KCNJ15 gene (602106) has been associated with T2D in lean Asians. Variation in the SLC30A8 gene (611145) has been associated with susceptibility to T2D. Variation in the HMGA1 gene (600701.0001) is associated with an increased risk of type 2 diabetes. Mutation in the MTNR1B gene (600804) is associated with susceptibility to type 2 diabetes. Protection Against Type 2 Diabetes Mellitus Protein-truncating variants in the SLC30A8 (611145) have been associated with a reduced risk for T2D.
Hyperglycemia
MedGen UID:
5689
Concept ID:
C0020456
Disease or Syndrome
An increased concentration of glucose in the blood.
Insulin resistance
MedGen UID:
43904
Concept ID:
C0021655
Pathologic Function
Increased resistance towards insulin, that is, diminished effectiveness of insulin in reducing blood glucose levels.
Decreased HDL cholesterol concentration
MedGen UID:
57731
Concept ID:
C0151691
Finding
An decreased concentration of high-density lipoprotein cholesterol in the blood.
Hypertriglyceridemia
MedGen UID:
167238
Concept ID:
C0813230
Finding
An abnormal increase in the level of triglycerides in the blood.
Elevated circulating hepatic transaminase concentration
MedGen UID:
338525
Concept ID:
C1848701
Finding
Elevations of the levels of SGOT and SGPT in the serum. SGOT (serum glutamic oxaloacetic transaminase) and SGPT (serum glutamic pyruvic transaminase) are transaminases primarily found in the liver and heart and are released into the bloodstream as the result of liver or heart damage. SGOT and SGPT are used clinically mainly as markers of liver damage.
Hyperinsulinemia
MedGen UID:
43779
Concept ID:
C0020459
Disease or Syndrome
An increased concentration of insulin in the blood.
Decreased adiponectin level
MedGen UID:
892903
Concept ID:
C4073127
Finding
A reduced circulating concentration of adiponectin, a 30-kDa complement C1-related protein that is the most abundant secreted protein expressed in adipose tissue.

Professional guidelines

PubMed

Araujo-Vilar D, Sánchez-Iglesias S, Guillín-Amarelle C, Castro A, Lage M, Pazos M, Rial JM, Blasco J, Guillén-Navarro E, Domingo-Jiménez R, del Campo MR, González-Méndez B, Casanueva FF
Endocrine 2015 May;49(1):139-47. Epub 2014 Nov 4 doi: 10.1007/s12020-014-0450-4. PMID: 25367549Free PMC Article

Recent clinical studies

Etiology

Yildirim Simsir I, Tuysuz B, Ozbek MN, Tanrikulu S, Celik Guler M, Karhan AN, Denkboy Ongen Y, Gunes N, Soyaltin UE, Altay C, Nur B, Ozalkak S, Akgun Dogan O, Dursun F, Pekkolay Z, Eren MA, Usta Y, Ozisik S, Ozgen Saydam B, Adiyaman SC, Unal MC, Gungor Semiz G, Turan I, Eren E, Kayserili H, Jeru I, Vigouroux C, Atik T, Onay H, Ozen S, Arioglu Oral E, Akinci B
Diabetes Obes Metab 2023 Jul;25(7):1950-1963. Epub 2023 Apr 11 doi: 10.1111/dom.15061. PMID: 36946378
Lima GEDCP, Fernandes VO, Montenegro APDR, Carvalho AB, Karbage LBAS, Aguiar LB, Macedo MSR, Ferreira LAA, Montenegro Júnior RM
Arch Endocrinol Metab 2019 Feb;63(1):79-83. doi: 10.20945/2359-3997000000096. PMID: 30864635Free PMC Article
Çelo E, Kalari B, Toti F
Georgian Med News 2018 Apr;(277):27-31. PMID: 29745909
Araujo-Vilar D, Sánchez-Iglesias S, Guillín-Amarelle C, Castro A, Lage M, Pazos M, Rial JM, Blasco J, Guillén-Navarro E, Domingo-Jiménez R, del Campo MR, González-Méndez B, Casanueva FF
Endocrine 2015 May;49(1):139-47. Epub 2014 Nov 4 doi: 10.1007/s12020-014-0450-4. PMID: 25367549Free PMC Article
Nishiyama A, Yagi M, Awano H, Okizuka Y, Maeda T, Yoshida S, Takeshima Y, Matsuo M
Pediatr Int 2009 Dec;51(6):775-9. Epub 2009 Mar 31 doi: 10.1111/j.1442-200X.2009.02863.x. PMID: 19438831

Diagnosis

Yildirim Simsir I, Tuysuz B, Ozbek MN, Tanrikulu S, Celik Guler M, Karhan AN, Denkboy Ongen Y, Gunes N, Soyaltin UE, Altay C, Nur B, Ozalkak S, Akgun Dogan O, Dursun F, Pekkolay Z, Eren MA, Usta Y, Ozisik S, Ozgen Saydam B, Adiyaman SC, Unal MC, Gungor Semiz G, Turan I, Eren E, Kayserili H, Jeru I, Vigouroux C, Atik T, Onay H, Ozen S, Arioglu Oral E, Akinci B
Diabetes Obes Metab 2023 Jul;25(7):1950-1963. Epub 2023 Apr 11 doi: 10.1111/dom.15061. PMID: 36946378
Costa S, Sampaio L, Berta Sousa A, Xing C, Agarwal AK, Garg A
J Clin Endocrinol Metab 2022 Aug 18;107(9):2433-2438. doi: 10.1210/clinem/dgac406. PMID: 35857714Free PMC Article
Craveiro Sarmento AS, Ferreira LC, Lima JG, de Azevedo Medeiros LB, Barbosa Cunha PT, Agnez-Lima LF, Galvão Ururahy MA, de Melo Campos JTA
Mutat Res Rev Mutat Res 2019 Jul-Sep;781:30-52. Epub 2019 Mar 23 doi: 10.1016/j.mrrev.2019.03.005. PMID: 31416577
Ponte CMM, Fernandes VO, Gurgel MHC, Vasconcelos ITGF, Karbage LBAS, Liberato CBR, Negrato CA, Gomes MB, Montenegro APDR, Montenegro Júnior RM
BMC Cardiovasc Disord 2018 Jan 12;18(1):6. doi: 10.1186/s12872-017-0738-4. PMID: 29329523Free PMC Article
Rahman OU, Khawar N, Khan MA, Ahmed J, Khattak K, Al-Aama JY, Naeem M, Jelani M
Diagn Pathol 2013 May 9;8:78. doi: 10.1186/1746-1596-8-78. PMID: 23659685Free PMC Article

Therapy

Brener A, Zeitlin L, Wilnai Y, Birk OS, Rosenfeld T, Chorna E, Lebenthal Y
Acta Diabetol 2022 May;59(5):711-719. Epub 2022 Feb 8 doi: 10.1007/s00592-022-01854-7. PMID: 35137278
Fukaishi T, Minami I, Masuda S, Miyachi Y, Tsujimoto K, Izumiyama H, Hashimoto K, Yoshida M, Takahashi S, Kashimada K, Morio T, Kosaki K, Maezawa Y, Yokote K, Yoshimoto T, Yamada T
Endocr J 2020 Feb 28;67(2):211-218. Epub 2019 Nov 8 doi: 10.1507/endocrj.EJ19-0226. PMID: 31708526
Çelo E, Kalari B, Toti F
Georgian Med News 2018 Apr;(277):27-31. PMID: 29745909
Araujo-Vilar D, Sánchez-Iglesias S, Guillín-Amarelle C, Castro A, Lage M, Pazos M, Rial JM, Blasco J, Guillén-Navarro E, Domingo-Jiménez R, del Campo MR, González-Méndez B, Casanueva FF
Endocrine 2015 May;49(1):139-47. Epub 2014 Nov 4 doi: 10.1007/s12020-014-0450-4. PMID: 25367549Free PMC Article
Park JY, Chong AY, Cochran EK, Kleiner DE, Haller MJ, Schatz DA, Gorden P
J Clin Endocrinol Metab 2008 Jan;93(1):26-31. Epub 2007 Oct 16 doi: 10.1210/jc.2007-1856. PMID: 17940115Free PMC Article

Prognosis

Brener A, Zeitlin L, Wilnai Y, Birk OS, Rosenfeld T, Chorna E, Lebenthal Y
Acta Diabetol 2022 May;59(5):711-719. Epub 2022 Feb 8 doi: 10.1007/s00592-022-01854-7. PMID: 35137278
Araujo-Vilar D, Sánchez-Iglesias S, Guillín-Amarelle C, Castro A, Lage M, Pazos M, Rial JM, Blasco J, Guillén-Navarro E, Domingo-Jiménez R, del Campo MR, González-Méndez B, Casanueva FF
Endocrine 2015 May;49(1):139-47. Epub 2014 Nov 4 doi: 10.1007/s12020-014-0450-4. PMID: 25367549Free PMC Article
Nishiyama A, Yagi M, Awano H, Okizuka Y, Maeda T, Yoshida S, Takeshima Y, Matsuo M
Pediatr Int 2009 Dec;51(6):775-9. Epub 2009 Mar 31 doi: 10.1111/j.1442-200X.2009.02863.x. PMID: 19438831
Park JY, Chong AY, Cochran EK, Kleiner DE, Haller MJ, Schatz DA, Gorden P
J Clin Endocrinol Metab 2008 Jan;93(1):26-31. Epub 2007 Oct 16 doi: 10.1210/jc.2007-1856. PMID: 17940115Free PMC Article
Jin J, Cao L, Zhao Z, Shen S, Kiess W, Zhi D, Ye R, Cheng R, Chen L, Yang Y, Luo F
Eur J Endocrinol 2007 Dec;157(6):783-7. doi: 10.1530/EJE-07-0393. PMID: 18057387

Clinical prediction guides

Okawa MC, Tuska RM, Lightbourne M, Abel BS, Walter M, Dai Y, Cochran E, Brown RJ
J Clin Endocrinol Metab 2023 Dec 21;109(1):e96-e106. doi: 10.1210/clinem/dgad491. PMID: 37595266Free PMC Article
Lima GEDCP, Fernandes VO, Montenegro APDR, Carvalho AB, Karbage LBAS, Aguiar LB, Macedo MSR, Ferreira LAA, Montenegro Júnior RM
Arch Endocrinol Metab 2019 Feb;63(1):79-83. doi: 10.20945/2359-3997000000096. PMID: 30864635Free PMC Article
Ponte CMM, Fernandes VO, Gurgel MHC, Vasconcelos ITGF, Karbage LBAS, Liberato CBR, Negrato CA, Gomes MB, Montenegro APDR, Montenegro Júnior RM
BMC Cardiovasc Disord 2018 Jan 12;18(1):6. doi: 10.1186/s12872-017-0738-4. PMID: 29329523Free PMC Article
Lima JG, Nobrega LHC, Lima NN, Dos Santos MCF, Baracho MFP, Bandeira F, Capistrano L, Freire Neto FP, Jeronimo SMB
J Clin Densitom 2018 Jan-Mar;21(1):61-67. Epub 2016 Nov 25 doi: 10.1016/j.jocd.2016.10.002. PMID: 27894728
Faria CA, Moraes RS, Sobral-Filho DC, Rego AG, Baracho MF, Egito ES, Brandão-Neto J
Europace 2009 Jun;11(6):763-9. Epub 2009 Apr 17 doi: 10.1093/europace/eup095. PMID: 19376819

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