TABLE 1.

Treatment Considerations in Lipodystrophy

• Diagnosis can lead to major anxiety for patients and their families. • Cosmetic surgery to address fat loss can be considered with caution. • Dietary considerations: high-carbohydrate, low-fat diet  ○ Improves marked chylomicronemia but may increase VLDL cholesterol   ■ Fibric acid agents and peroxisome proliferator–activated receptor agents may be helpful but are untested   ■ Fish oil supplementation should be considered • There are special cardiovascular concerns with CGL4 because of arrhythmia risk:  ○ Avoid strenguous exercise  ○ Possible role for β-blockers  ○ Electrophysiology consultation should be given strong consideration • Newest consideration: metreleptin  ○ Leads to improved metabolic parameters  ○ Glucose, triglyercides, fatty organ disease