Perilipin-null mice eat more food than wild-type mice, but gain 1/3 less fat than wild-type mice on the same diet; perilipin-null mice are thinner, with more lean muscle mass. Perilipin-null mice also exhibit enhanced leptin production and a greater tendency to develop insulin resistance than wild-type mice. Even though perilipin-null mice present less fat mass and a higher insulin resistance, they do not show signs of a whole lipodystrophic phenotype.
In humans, studies suggest that a deficiency of PLIN1 causes lipodystrophic syndromes, which disables the optimal accumulation of triglycerides in adipocytes that derives in an abnormal deposition of lipids in tissues such as skeletal muscle and liver. The storage of lipids in the liver leads to insulin resistance and hypertriglyceridemia. Affected patients are characterized by a subcutaneous fat with smaller than normal adipocytes, macrophage infiltration and fibrosis.
These findings affirm a new primary form of inherited lipodystrophy and emphasize on the severe metabolic consequences of a defect in the formation of lipid droplets in adipose tissue.
In particular, variants 13041A>G and 14995A>T have been associated with increased risk of obesity in women and 11482G>A has been associated with decreased perilipin expression and increased lipolysis in women.