Lipodystrophies are rare, heterogeneous, genetic or acquired, disorders characterised
by varying degrees of body fat loss and associated metabolic complications, including
insulin resistance, dyslipidaemias, hepatic steatosis and predisposition to atherosclerotic
cardiovascular disease (ASCVD). The four main types of lipodystrophy, excluding antiretroviral
therapy-induced lipodystrophy in HIV-infected patients, are congenital generalised
lipodystrophy (CGL), familial partial lipodystrophy (FPLD), acquired generalised lipodystrophy
(AGL) and acquired partial lipodystrophy (APL). This paper reviews the literature
related to the prevalence of dyslipidaemias and ASCVD in patients with lipodystrophies.
Patients with CGL, AGL and FPLD have increased prevalence of dyslipidaemia but those
with APL do not. Patients with CGL as well as AGL present in childhood, and have severe
dyslipidaemias (mainly hypertriglyceridaemia) and early onset diabetes mellitus as
a consequence of extreme fat loss. However, only a few patients with CGL and AGL have
been reported to develop coronary heart disease. In contrast, data from some small
cohorts of FPLD patients reveal increased prevalence of ASCVD especially among women.
Patients with APL have a relatively low prevalence of hypertriglyceridaemia and diabetes
mellitus. Overall, patients with lipodystrophies appear to be at high risk of ASCVD
due to increased prevalence of dyslipidaemia and diabetes and efforts should be made
to manage these metabolic complications aggressively to prevent ASCVD.