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Hepatic lipase deficiency
Reviewed by Medicinsk Expert•Last updated: 2026-10-22•Condition

Hepatic lipase deficiency

Hepatic lipase deficiency is a disorder that affects the body's ability to break down fats, leading to an imbalance of cholesterol and triglycerides in the blood.

Overview

Hepatic lipase deficiency is a disorder that affects the body's ability to break down fats (lipids). People with this disorder have increased amounts of triglycerides and cholesterol in the blood. These individuals also have increased amounts of molecules known as high-density lipoproteins (HDLs) and decreased amounts of molecules called low-density lipoproteins (LDLs). In people with this deficiency, the LDL molecules are often abnormally large.

Normally, high levels of HDL ("good cholesterol") and low levels of LDL ("bad cholesterol") are protective against the accumulation of fatty deposits on artery walls (atherosclerosis) and heart disease. However, some individuals with hepatic lipase deficiency develop atherosclerosis and heart disease in mid-adulthood, while others do not. It remains unclear whether these individuals have a greater risk of developing these conditions than the general population.

Frequency

Hepatic lipase deficiency is likely a rare disorder; only a few affected families have been reported in the scientific literature.

Causes

Hepatic lipase deficiency is caused by mutations in the LIPC gene. This gene provides instructions for making an enzyme called hepatic lipase. This enzyme is produced by liver cells and released into the bloodstream, where it helps convert very low-density lipoproteins (VLDLs) and intermediate-density lipoproteins (IDLs) to LDLs. The enzyme also assists in transporting HDLs that carry cholesterol and triglycerides from the blood to the liver for redistribution or removal.

LIPC gene mutations prevent the release of hepatic lipase or decrease the enzyme's activity. As a result, VLDLs and IDLs are not efficiently converted into LDLs, and HDLs carrying cholesterol and triglycerides remain in the bloodstream.

Gene Associated with Hepatic Lipase Deficiency

  • LIPC

Inheritance

This condition is inherited in an autosomal recessive pattern, which means both copies of the gene in each cell have mutations. The parents of an individual with an autosomal recessive condition each carry one copy of the mutated gene, but they typically do not show signs and symptoms of the condition.

Frequently Asked Questions

Even though HDL is high, the overall lipid imbalance can still promote atherosclerosis. A heart‑healthy diet low in saturated fat and refined carbohydrates, regular aerobic exercise, and maintaining a healthy weight are first‑line measures. Limiting alcohol and avoiding tobacco are also important because they can worsen triglyceride levels.
The risk is still debated. Some carriers develop premature atherosclerosis, while others remain free of cardiovascular events. Because LDL particles are larger and HDL is high, traditional risk calculators may underestimate risk. It is prudent to monitor coronary risk factors closely (blood pressure, smoking, diabetes) and discuss individualized risk assessment with a cardiologist.
Yes. Hepatic lipase deficiency is inherited in an autosomal recessive pattern, so siblings of an affected individual have a 25 % chance of being homozygous and a 50 % chance of being carriers. Offering lipid screening and, if abnormal, targeted LIPC genetic testing can identify relatives who may benefit from early lifestyle counseling or monitoring.
Diagnosis usually starts with a lipid panel that shows unusually high HDL‑cholesterol, low LDL‑cholesterol, and elevated triglycerides. If the pattern is atypical, clinicians may order specialized lipoprotein subfraction testing or measure hepatic lipase activity directly. Genetic testing for pathogenic variants in the LIPC gene confirms the diagnosis and can be useful for family screening.
Source: MedlinePlus, National Library of Medicine

MedlinePlus brings together authoritative health information from the National Library of Medicine (NLM), the National Institutes of Health (NIH), and other government agencies and health-related organizations.

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