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Reference Guide
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LIPG
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LIPG

Lipase is an enzyme that catalyzes the breakdown of fats into fatty acids and glycerol, essential for fat digestion and absorption. 

Found in various tissues such as the liver, stomach, fat cells, blood vessels, and small intestine, lipases play crucial roles in lipid metabolism, cholesterol transport, cell signaling, and inflammation. 

The LIPG gene encodes endothelial lipase (EL), which primarily functions as a phospholipase with some triglyceride lipase activity, efficiently hydrolyzing high-density lipoproteins (HDL). 

This enzyme plays a crucial role in lipid metabolism and vascular biology, and is highly expressed in various tissues, including the liver and lungs. 

EL is involved in inflammatory responses and atherosclerosis, and recent studies suggest its potential role in cancer progression, making it a target for future therapies.

What is Lipase? [25.] 

Lipase is an enzyme that catalyzes the hydrolysis of fats (lipids), facilitating the breakdown of triglycerides into fatty acids and glycerol. This process is essential for the digestion and absorption of dietary fats as well as fat-soluble vitamins.

Lipases are also involved in cholesterol metabolism and are targeted by certain medications like orlistat, fibrates, and niacin to treat conditions related to fat digestion and cholesterol levels.

Locations of Lipase [25.] 

Lipases are found in various tissues, including the liver (hepatic lipase), stomach (gastric lipase), fat cells (hormone-sensitive lipase), blood vessels (lipoprotein lipase), and the small intestine (pancreatic lipase). 

Functions of Lipase

Functions of lipase may vary slightly depending on the type of lipase concerned. 

General functions of lipase include:

  • Fat digestion: it catalyzes the breakdown of triglycerides into fatty acids and glycerol [6., 29.] 
  • Lipid metabolism: helps in the processing and transport of dietary lipids [6., 29.] 
  • Cell signaling: some lipases are involved in cell signaling pathways [6.] 
  • Inflammation: certain lipases play a role in inflammatory processes [3., 9.] 
  • Cholesterol transport: Lipoprotein lipase (LPL) plays a critical role in cholesterol metabolism by hydrolyzing triglycerides (TG) in lipoprotein particles, converting them into free fatty acids and glycerol. This process facilitates the uptake of these fatty acids into peripheral tissues for energy storage and consumption. [16., 29.] 

What Does the Enzyme Lipase G, Endothelial Lipase Do? [15., 22., 23.]

The LIPG gene encodes endothelial lipase (EL), a protein with significant phospholipase and some triglyceride lipase activities, primarily hydrolyzing high-density lipoproteins (HDL). 

It is part of the triglyceride lipase family, characterized by a lid region that provides substrate specificity. 

Endothelial lipase is synthesized in endothelial cells. [15.] 

EL is secreted and highly expressed in the liver, placenta, lungs, thyroid, kidneys, and other tissues but not in the heart, brain, or muscles. It binds heparin, forms homodimers, and is inhibited by serum. [14.] 

EL is crucial in lipid metabolism, vascular biology, inflammatory responses, and may contribute to cancer progression. [14.] 

LIPG Deficiency Disorders

Lipase Deficiency, Combined

Combined lipase deficiency is a rare genetic disorder caused by mutations in the LMF1 gene, leading to deficiencies in lipoprotein lipase (LPL) and hepatic triglyceride lipase (HTGL). It is also associated with alterations in the LIPG gene. [10., 20.] 

This results in hypertriglyceridemia, chylomicronemia, and decreased overall lipase activity. Affected individuals often experience repeated episodes of pancreatitis, tuberous xanthomas, and lipodystrophy. [20.]

The condition is inherited in an autosomal recessive manner and is linked to chromosome 16p13.3.

Cardiovascular Disease Risk [8.] 

Variants in the LIPG gene, responsible for endothelial lipase, are associated with hyperalphalipoproteinemia, characterized by high HDL-C levels. 

However, high HDL-C due to LIPG variants may not provide protection against atherosclerotic cardiovascular disease (ASCVD). 

In a South African cohort, seven known and two novel LIPG variants were identified, affecting HDL-C concentration but not correlating with reduced ASCVD risk. [8.]

This study highlights that current risk models may be unsuitable for patients with hyperalphalipoproteinemia due to endothelial lipase deficiency. [8.] 

What is a SNP?

A SNP, or single nucleotide polymorphism, refers to a variation at a single position in a gene along its DNA sequence.  A gene encodes a protein, so an alteration in that gene programs the production of an altered protein.  

As a type of protein with great functionality in human health, alterations in genes for enzymes may confer a difference in function of that enzyme.  The function of that enzyme may be increased or decreased, depending on the altered protein produced.  

SNPs are the most common type of genetic variation in humans and can occur throughout the genome, influencing traits, susceptibility to diseases, and response to medications.

The completion of the Human Genome Project has significantly expanded opportunities for genetic testing by providing a comprehensive map of the human genome that facilitates the identification of genetic variations associated with various health conditions, including identifying SNPs that may cause alterations in protein structure and function.  

Genetic testing for SNPs enables the identification of alterations in genes, shedding light on their implications in health and disease susceptibility.

Laboratory Testing for LIPG

Genetic testing for single nucleotide polymorphisms (SNPs) typically involves obtaining a sample of DNA which can be extracted from blood, saliva, or cheek swabs. 

The sample may be taken in a lab, in the case of a blood sample.  Alternatively, a saliva or cheek swab sample may be taken from the comfort of home.  

Test Preparation

Prior to undergoing genetic testing, it's important to consult with a healthcare provider or genetic counselor to understand the purpose, potential outcomes, and implications of the test.  This consultation may involve discussing medical history, family history, and any specific concerns or questions. 

Additionally, individuals may be advised to refrain from eating, drinking, or chewing gum for a short period before providing a sample to ensure the accuracy of the test results.  Following sample collection, the DNA is processed in a laboratory where it undergoes analysis to identify specific genetic variations or SNPs. 

Once the testing is complete, individuals will typically receive their results along with interpretation and recommendations from a healthcare professional. 

It's crucial to approach genetic testing with proper understanding and consideration of its implications for one's health and well-being.

Patient-Centric Approaches

A patient-centered approach to SNP genetic testing emphasizes individualized medicine, tailoring healthcare decisions and interventions based on an individual's unique genetic makeup.

When that is combined with the individual’s health status and health history, preferences, and values, a truly individualized plan for care is possible. 

By integrating SNP testing into clinical practice, healthcare providers can offer personalized risk assessment, disease prevention strategies, and treatment plans that optimize patient outcomes and well-being. 

Genetic testing empowers a deeper understanding of genetic factors contributing to disease susceptibility, drug response variability, and overall health, empowering patients to actively participate in their care decisions. 

Furthermore, individualized medicine recognizes the importance of considering socioeconomic, cultural, and environmental factors alongside genetic information to deliver holistic and culturally sensitive care that aligns with patients' goals and preferences. 

Through collaborative decision-making and shared decision-making processes, patients and providers can make informed choices about SNP testing, treatment options, and lifestyle modifications, promoting patient autonomy, engagement, and satisfaction in their healthcare journey.

Genetic Panels and Combinations

Integrating multiple biomarkers into panels or combinations enhances the predictive power and clinical utility of pharmacogenomic testing. Biomarker panels comprising a variety of transporter proteins and enzymes including drug metabolizing enzymes offer comprehensive insights into individual drug response variability and treatment outcomes. 

Combining genetic SNP testing associated with drug transport, metabolism, and pharmacodynamics enables personalized medicine approaches tailored to individual patient characteristics and genetic profiles.

Order Genetic Testing

Click here to compare genetic test panels and order genetic testing for health-related SNPs. 

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See References

[1.] 1.001404: Lipase | Labcorp. www.labcorp.com. https://www.labcorp.com/tests/001404/lipase

[2.] Alvarez E, Persaud R, Soniega-Sherwood J, Rattray J, Richman M. Critical Illness Causing Marked Hyperlipasemia. The American Journal of Medicine. 2019;132(4):e540-e541. doi:https://doi.org/10.1016/j.amjmed.2018.12.006

[3.] Badellino KO, Wolfe ML, Reilly MP, Rader DJ. Endothelial Lipase Is Increased In Vivo by Inflammation in Humans. Circulation. 2008;117(5):678-685. doi:https://doi.org/10.1161/circulationaha.107.70734

[4.] Bernstein DL, Hülkova H, Bialer MG, Desnick RJ. Cholesteryl ester storage disease: Review of the findings in 135 reported patients with an underdiagnosed disease. Journal of Hepatology. 2013;58(6):1230-1243. doi:https://doi.org/10.1016/j.jhep.2013.02.014

[5.] Cao, H., Hegele, R.A. DNA polymorphisms of lipase related genes. J Hum Genet 48, 443–446 (2003). https://doi.org/10.1007/s10038-003-0051-1

[6.] Cerk IK, Wechselberger L, Oberer M. Adipose Triglyceride Lipase Regulation: An Overview. Curr Protein Pept Sci. 2018;19(2):221-233. doi: 10.2174/1389203718666170918160110. PMID: 28925902; PMCID: PMC7613786.

[7.] Chaffin, Hally M. MD; Trivedi, Shubham BS; Singh, Vijay P. MBBS, MD. S119 Prognostic Value of Elevated Lipase in Pancreatitis versus Non Pancreatitis Hyperlipasemia (NPHL) due to Non-Malignant Causes. The American Journal of Gastroenterology 117(10S):p e86, October 2022. | DOI: 10.14309/01.ajg.0000857116.42140.fb 

[8.] Cole J, Diane Mary Blackhurst, Anna G, Bharati Dhanluxmi Ratanjee, Benjamin R, Adrian David Marais. Atherosclerotic cardiovascular disease in hyperalphalipoproteinemia due to LIPG variants. Journal of clinical lipidology. 2021;15(1):142-150.e2. doi:https://doi.org/10.1016/j.jacl.2020.12.007

[9.] de Oliveira C, Khatua B, Noel P, Kostenko S, Bag A, Balakrishnan B, Patel KS, Guerra AA, Martinez MN, Trivedi S, McCullough A, Lam-Himlin DM, Navina S, Faigel DO, Fukami N, Pannala R, Phillips AE, Papachristou GI, Kershaw EE, Lowe ME, Singh VP. Pancreatic triglyceride lipase mediates lipotoxic systemic inflammation. J Clin Invest. 2020 Apr 1;130(4):1931-1947. doi: 10.1172/JCI132767. PMID: 31917686; PMCID: PMC7108918.

[10.] DISEASES - LIPG. Jensenlab.org. Published 2024. Accessed July 23, 2024. https://diseases.jensenlab.org/Entity?documents=10&type1=9606&id1=ENSP00000261292&type2=-26&id2=DOID:0111422

[11.] Don’t test for amylase in cases of suspected acute pancreatitis. Instead, test for lipase. www.aafp.org. https://www.aafp.org/pubs/afp/collections/choosing-wisely/317.html

[12.] George J, Gnanamoorthy K, Suthakaran PK, Baliga KV. Hyperlipasemia Sans Pancreatitis: A Case Series. Cureus. 2023 Oct 27;15(10):e47781. doi: 10.7759/cureus.47781. PMID: 38021537; PMCID: PMC10679796.

[13.] Goldberg IJ, Eckel RH, Abumrad NA. Regulation of fatty acid uptake into tissues: lipoprotein lipase- and CD36-mediated pathways. J Lipid Res. 2009 Apr;50 Suppl(Suppl):S86-90. doi: 10.1194/jlr.R800085-JLR200. Epub 2008 Nov 24. PMID: 19033209; PMCID: PMC2674753.

[14.] Hong, C., Deng, R., Wang, P. et al. LIPG: an inflammation and cancer modulator. Cancer Gene Ther 28, 27–32 (2021). https://doi.org/10.1038/s41417-020-0188-5

[15.] Human Gene LIPG (ENST00000261292.9) from GENCODE V46. genome.ucsc.edu. Accessed July 23, 2024. https://genome.ucsc.edu/cgi-bin/hgGene?db=hg38&hgg_chrom=chr18&hgg_end=49599185&hgg_gene=ENST00000261292.9&hgg_start=49561479&hgg_type=knownGene

[16.] Joon Ho Moon, Kim K, Sung Hee Choi. Lipoprotein Lipase: Is It a Magic Target for the Treatment of Hypertriglyceridemia. 2022;37(4):575-586. doi:https://doi.org/10.3803/enm.2022.402

[17.] Junglee D, Penketh A, Katrak A, Hodson ME, Batten JC, Dandona P. Serum pancreatic lipase activity in cystic fibrosis. Br Med J. 1983 May 28;286(6379):1693-4. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1548188/pdf/bmjcred00555-0017.pdf

[18.] Kobayashi J, Miyashita K, Nakajima K, Mabuchi H. Hepatic Lipase: a Comprehensive View of its Role on Plasma Lipid and Lipoprotein Metabolism. Journal of Atherosclerosis and Thrombosis. 2015;22(10):1001-1011. doi:https://doi.org/10.5551/jat.31617

[19.] Lim SY, Steiner JM, Cridge H. Lipases: it’s not just pancreatic lipase! American Journal of Veterinary Research. 2022;83(8):ajvr.22.03.0048. doi:https://doi.org/10.2460/ajvr.22.03.0048

[20.] Lipase Deficiency, Combined (CLD). Malacards. The Human Disease Database. https://www.malacards.org/card/lipase_deficiency_combined_2

[21.] Lipase Tests: MedlinePlus Medical Test. medlineplus.gov. https://medlineplus.gov/lab-tests/lipase-tests/#:~:text=A%20very%20high%20level%20of

‌[22.] LIPG lipase G, endothelial type [Homo sapiens (human)] - Gene - NCBI. www.ncbi.nlm.nih.gov. Accessed July 23, 2024. https://www.ncbi.nlm.nih.gov/gene/9388

[23.] LIPG protein expression summary - The Human Protein Atlas. www.proteinatlas.org. Accessed July 23, 2024. https://www.proteinatlas.org/ENSG00000101670-LIPG

[24.] Nichols J. Lipase in the Diagnosis of Acute Pancreatitis.; 2021. https://documents.cap.org/documents/LipaseAcutePancreatitis_FullModule.pdf

‌[25.] Pirahanchi Y, Sharma S. Biochemistry, Lipase. [Updated 2023 Jun 26]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK537346/

[26.] Piseddu, I., Vielhauer, J. & Mayerle, J. Genetic Testing in Acute and Chronic Pancreatitis. Curr Treat Options Gastro 20, 429–444 (2022). https://doi.org/10.1007/s11938-022-00383-0

[27.] PMC E. Europe PMC. europepmc.org. Accessed July 22, 2024. https://europepmc.org/article/NBK/nbk305870#__NBK305870_dtls__

[28.] Ravi, Anupama MD*; Obideen, Kamil MD; Goldstein, Marney MD. Not All Hyperlipasemia Is Pancreatitis: 198. American Journal of Gastroenterology 103():p S77, September 2008. 

[29.] Santamarina-Fojo S, González-NavarroH, Freeman L, Wagner E, Nong Z. Hepatic Lipase, Lipoprotein Metabolism, and Atherogenesis. Arteriosclerosis, Thrombosis, and Vascular Biology. 2004;24(10):1750-1754. doi:https://doi.org/10.1161/01.atv.0000140818.00570.2d

[30.] Zhu G, Fang Q, Zhu F, Huang D, Yang C. Structure and Function of Pancreatic Lipase-Related Protein 2 and Its Relationship With Pathological States. Front Genet. 2021 Jul 5;12:693538. doi: 10.3389/fgene.2021.693538. PMID: 34290745; PMCID: PMC8287333.

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