Genetic and clinical characteristics of patients with lipoprotein lipase deficiency from Slovenia and PakistanAin, Quratul (Avtor) Cevc, Matija (Avtor) Marusic, Tatiana (Avtor) Šikonja, Jaka (Avtor) Sadiq, Fouzia (Avtor) Šuštar, Urša (Avtor) Mlinarič, Matej (Avtor) Kovač, Jernej (Avtor) Batool, Hijab (Avtor) Khan, Iqbal Mohammad (Avtor) Trebušak Podkrajšek, Katarina (Avtor) Jenko Bizjan, Barbara (Avtor) Battelino, Tadej (Avtor) Fras, Zlatko (Avtor) Grošelj, Urh (Avtor) LPLcase serieshypertriglyceridemialipoprotein lipaselipoprotein lipase deficiencypancreatitisIntroduction: Hypertriglyceridemia (HTG) is a complex disorder caused by genetic and environmental factors that frequently results from loss-of-function variants in the gene encoding lipoprotein lipase (LPL). Heterozygous patients have a range of symptoms, while homozygous LPL deficiency presents with severe symptoms including acute pancreatitis, xanthomas, and lipemia retinalis. Methods: We described the clinical characteristics of three Slovenian patients (an 8-year-old female, an 18-year-old man, and a 57-year-old female) and one Pakistani patient (a 59-year-old male) with LPL deficiency. We performed next-generation sequencing (NGS) targeting all coding exons and intron-exon boundaries of the LPL gene, and Sanger sequencing for variant confirmation. In addition, we performed a systematic literature review of all cases with three identified variants and described their clinical characteristics. Results: Two Slovenian patients with a heterozygous pathogenic variant NM_000237.3:c.984G>T (p.Met328Ile) were diagnosed within the first three years of life and had triglyceride (TG) values of 16 and 20 mmol/L. An asymptomatic Pakistani patient with TG values of 36.8 mmol/L until the age of 44 years, was identified as heterozygous for a pathogenic variant NM_000237.3:c.724G>A (p.Asp242Asn). His TG levels dropped to 12.7 mmol/L on dietary modifications and by using fibrates. A Slovenian patient who first suffered from pancreatitis at the age of 18 years with a TG value of 34 mmol/L was found to be homozygous for NM_000237.3:c.337T>C (p.Trp113Arg). Conclusions: Patients with LPL deficiency had high TG levels at diagnosis. Homozygous patients had worse outcomes. Good diet and medication compliance can reduce severity.20242026-06-08 12:18:27Neznano29843sl