Low Fasting Serum Triglyceride Level as a Precocious Marker of Autoimmune Disorders

Silvia Iannello, MD, Antonina Cavaleri, MD, Paolina Milazzo, MD, Santi Cantarella, MD, Francesco Belfiore, MD

Disclosures

Medscape General Medicine. 2003;5(3) 

In This Article

Conclusion

Despite the data discussed above, the link between low TG and autoimmune disorder is not clear. Several tissues (adipose tissue, muscle, and lung) are rich in LPL and are the source of postheparin lipase activity, thus contributing to clear serum TG level and to take up FFA from circulating VLDL-TG.[46] It might be postulated that, in autoimmune diseases, an increased content and/or release of LPL by these tissues might lower serum TG concentration and increase FFA level. However, this is a mere hypothesis that needs to be confirmed with further experimental work. The observation that low TG levels are associated with several diverse autoimmune diseases and hyperactive immune response speaks in favor of a pathogenic role of TG lowering.

It could be postulated that low TG level may induce alterations that favor autoimmune processes. On the other hand, it could also be possible that both low TG (and high FFA) and autoimmune disorder are the result of a common unknown etiologic factor, either congenital or acquired.

The present study should be considered as a preliminary clinical observation that requires confirmation in a larger population of patients with autoimmune diseases and further investigation concerning the mechanisms involved (such as evaluation of postheparin plasma LPL activity, plasma lipoprotein status and metabolism, IGF-1 level, and possibly n-3/n-6 ratio in total plasma lipids and phospholipids).

Hypotriglyceridemia (sometimes severe), however, seems to be a precocious and constant marker of autoimmune disease or immune system hyperreactivity (or even of familiarity for autoimmune disorder). In addition, this marker is easy to assay and is very inexpensive. With the assessment of TG value in all patients, it would be possible to detect the subjects with low TG level who are at risk for autoimmunity, dysreactive disorder, initial interstitiopathy (without clear signs of pulmonary disease), or undiscovered/initial other autoimmune disease.

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