Maternally inherited diabetes and deafness coexists with lipoprotein lipase gene mutation-associated severe hyperlipidemia that was resistant to fenofibrate and atorvastatin, but sensitive to bezafibrate: A case report

J Diabetes Investig. 2022 Feb;13(2):397-401. doi: 10.1111/jdi.13651. Epub 2021 Sep 22.


Maternally inherited diabetes and deafness is a rare genetic disease mainly caused by a point mutation in mitochondrial deoxyribonucleic acid. Lipoprotein lipase gene mutations are associated with familial dyslipidemias, which are difficult to manage. We reported for the first time a case that had both maternally inherited diabetes and severe hyperlipidemia caused by lipoprotein lipase gene mutation (C.347(exon3)G>C) that was resistant to fenofibrate and atorvastatin. We were able to manage the patient's hyperlipidemia with bezafibrate, and her diabetes was well controlled with insulin. In conclusion, genetic testing is helpful in identifying rare and interesting cases when clinicians suspect inheritable diseases. Additionally, when one fibrate drug is ineffective in treating hyperlipidemia, it might be worthwhile trying another fibrate.

Keywords: Hypertriglyceridemia; Lipoprotein lipase; Maternally inherited diabetes and deafness.

Publication types

  • Case Reports

MeSH terms

  • Atorvastatin / therapeutic use
  • Bezafibrate / therapeutic use
  • Deafness
  • Diabetes Mellitus, Type 2* / complications
  • Diabetes Mellitus, Type 2* / drug therapy
  • Diabetes Mellitus, Type 2* / genetics
  • Female
  • Fenofibrate* / therapeutic use
  • Humans
  • Hyperlipidemias* / complications
  • Hyperlipidemias* / drug therapy
  • Hyperlipidemias* / genetics
  • Lipoprotein Lipase / genetics*
  • Mitochondrial Diseases
  • Mutation


  • Atorvastatin
  • LPL protein, human
  • Lipoprotein Lipase
  • Fenofibrate
  • Bezafibrate

Supplementary concepts

  • Noninsulin-dependent diabetes mellitus with deafness