{"title":"Tirzepatide Therapy in a Patient with Type 2 Diabetes Mellitus, Chylomicronemia, and Heterozygosity for Lipoprotein Lipase Deficiency","authors":"Stephan Paul Babirak MD, PhD","doi":"10.1016/j.aace.2023.05.005","DOIUrl":null,"url":null,"abstract":"<div><h3>Background/Objective</h3><p>A patient with well-controlled type 2 diabetes mellitus (T2DM) and a heterozygote for lipoprotein lipase deficiency (HeLPL) presented with chronic chylomicrons (CMs). Some patients with T2DM can develop CMs due to poor glycemic control or genetic defects that result in a decrease in the lipoprotein lipase (LPL) activity. This study aimed to describe a patient with HeLPL with T2DM and persistent CM on maximal standard lipid-lowering therapy who then used tirzepatide as a novel way to treat CM.</p></div><div><h3>Case Report</h3><p>A patient with well-controlled T2DM with persistent CM and HeLPL was treated with tirzepatide and titrated to 15 mg/week, resulting in resolution of his CM (triglyceride [TG] level, <850 mg/dL) with a 58% reduction in the serum TG level after 2 months and then an 86% reduction after 5 months of therapy. His A1C level and body weight decreased from 6.9% to 6.3% and by 12 lbs in 2 months and then to 5.6% and by 20 lbs after 5 months, respectively.</p></div><div><h3>Discussion</h3><p>The resolution of CM and reduction in the TG level by tirzepatide cannot be solely explained by an improvement in glycemic control or a decrease in body weight but may also be related to other effects of tirzepatide.</p></div><div><h3>Conclusion</h3><p>Tirzepatide caused a significant decrease in the TG level in a patient with CM, T2DM, and HeLPL. The mechanism(s) underlying this effect is not completely understood but warrants further study.</p></div>","PeriodicalId":7051,"journal":{"name":"AACE Clinical Case Reports","volume":"9 4","pages":"Pages 128-130"},"PeriodicalIF":0.0000,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10382611/pdf/","citationCount":"1","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"AACE Clinical Case Reports","FirstCategoryId":"1085","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S2376060523001116","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"Medicine","Score":null,"Total":0}
引用次数: 1
Abstract
Background/Objective
A patient with well-controlled type 2 diabetes mellitus (T2DM) and a heterozygote for lipoprotein lipase deficiency (HeLPL) presented with chronic chylomicrons (CMs). Some patients with T2DM can develop CMs due to poor glycemic control or genetic defects that result in a decrease in the lipoprotein lipase (LPL) activity. This study aimed to describe a patient with HeLPL with T2DM and persistent CM on maximal standard lipid-lowering therapy who then used tirzepatide as a novel way to treat CM.
Case Report
A patient with well-controlled T2DM with persistent CM and HeLPL was treated with tirzepatide and titrated to 15 mg/week, resulting in resolution of his CM (triglyceride [TG] level, <850 mg/dL) with a 58% reduction in the serum TG level after 2 months and then an 86% reduction after 5 months of therapy. His A1C level and body weight decreased from 6.9% to 6.3% and by 12 lbs in 2 months and then to 5.6% and by 20 lbs after 5 months, respectively.
Discussion
The resolution of CM and reduction in the TG level by tirzepatide cannot be solely explained by an improvement in glycemic control or a decrease in body weight but may also be related to other effects of tirzepatide.
Conclusion
Tirzepatide caused a significant decrease in the TG level in a patient with CM, T2DM, and HeLPL. The mechanism(s) underlying this effect is not completely understood but warrants further study.
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