Letter to the editor from Akinci and Oral: “Evaluating the therapeutic impact of tirzepatide in people with partial lipodystrophy”

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ID: 329446
2026
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Abstract
We read with great interest the recent article by Mandour et al. The study addresses an important therapeutic question in a clinically challenging group of disorders and provides valuable real-world data on tirzepatide use in lipodystrophy (1). We wish to raise one point that we believe requires further clarification, relating to the interpretation of the subgroup described as “familial partial lipodystrophy (FPLD)1-like.” In the study, this category is defined as participants with clinically detected limb lipodystrophy and preserved or increased central adiposity. These individuals are further characterized by selective paucity of upper and lower limb adipose tissue, central adiposity, insulin resistance, and metabolic disease. However, it remains unclear whether all such individuals truly represent a typical FPLD phenotype or whether this group includes a broader and more heterogeneous population. This may cover entities such as partial lipodystrophy of the limbs (2, 3) or a “lipodystrophy-like” phenotype described previously by others (4, 5). As most participants fell within the FPLD1-like category, this distinction is critical for interpretation of the overall findings and limits conclusions regarding generalizability, particularly to genetically confirmed forms such as FPLD2 or FPLD3, which were underrepresented.
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Authors Barış Akıncı, Elif Arioglu Oral
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Journal the journal of clinical endocrinology & metabolism
Year 2026
DOI
10.1210/clinem/dgag362
URL
https://doi.org/10.1210/clinem/dgag362
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