Lipid and Metabolism Associates

About This Program

Treating the Full Range of Lipid and Metabolism Disorders

When Mason Freeman, MD founded the Lipid and Metabolism Associates in 1985, it was one of the few treatment centers in New England devoted to the care of patients with lipid metabolism disorders. Since these disorders can cause heart attacks, strokes and other serious but common vascular diseases, the clinic quickly became a high referral center. Referring physicians throughout New England rely on us because our clinicians have devoted their careers to diagnosing, treating and studying these disorders, from the common to the rare.

Since its initial inception, our clinic continues to focus on treating patients with lipid disorders, and has since further expanded to become a premier center for patients with various common and rare metabolic disorders including lipodystrophy.

Examples of conditions we treat include:

• High levels of low-density cholesterol (LDL): “Bad” cholesterol, which can lead to heart disease and stroke
• High levels of triglycerides: Fatty substances in the blood that can cause heart disease, stroke and pancreatic disease
• Other lipid disorders
• Lipodystrophy: A lack of fat in certain areas of the body causing diabetes, fatty liver disease, high triglycerides, and heart disease

What to Expect

Lipid and Metabolism Associates is located in Suite 430 of the 50 Staniford Street Building in downtown Boston.

Before your first appointment, please ask your referring physician to send us your medical records and, if applicable, blood test results or images (e.g. X-rays or CT scans). During your initial appointment, your physician will perform a physical evaluation and may order additional tests.

Based on the findings, your physician will diagnose your symptoms and develop a personalized treatment program to address your condition.

Treatment of Lipid and Metabolism Disorders

We take a broad multi-disciplinary approach to the treatment of lipid and metabolism disorders in our practice that incorporates the latest scientific evidence and medical therapies as well as an emphasis on lifestyle with a dedicated nutritionist serving our practice. We will develop a personalized treatment plan that takes into consideration your unique values, genetic risk factors, and lifestyle.

Research into Lipid and Metabolism Disorders 

Following a longstanding tradition of Massachusetts General Hospital’s Division of Endocrinology, our specialists pursue a dual mission: to diagnose and treat patients with lipid and metabolism disorders and to learn from our patients about how we can advance our knowledge of the biology and treatment of these conditions. 

Ongoing research studies within Lipid and Metabolism Associates are described below. Your doctor will let you know if these studies are right for you. 

MGH Lipid and Metabolic Disorders Biorepository

In many cases, the pathogenesis, natural history, and optimal treatment for patients with lipid and metabolic disorders, including lipodystrophy and lipedema, is not well understood. To fill these gaps in knowledge, we seek to capitalize on the breadth of our clinical experience by building a biorepository of detailed phenotypic data and biospecimens. This observational study follows the health of select patients with lipid or metabolic disorders over time. Participants may be evaluated up to every 6 months for a maximum of 10 years. Data to be collected include anthropometrics, vital signs, and body composition as measured by dual-energy x-ray absorptiometry. Blood specimens will be collected for the completion of exploratory analyses, which may include genetic testing. Through these efforts, we hope to establish a mechanism by which to optimize the clinical care that we provide to our patients and to more broadly advance medical knowledge. 

PI: Lindsay Fourman (LFourman@partners.org) 

Study Coordinator: Sam Russo (srusso4@mgh.harvard.edu) 

A 12-Month Randomized, Multicenter, Double-Blind, Placebo-Controlled Phase 3 Study to Evaluate the Safety and Efficacy of Daily Subcutaneous Metreleptin Treatment in Subjects with Partial Lipodystrophy 

Lipodystrophy (LD) is a rare, heterogeneous group of syndromes characterized by a complete or partial loss or absence of subcutaneous adipose tissue (fat). Because of the loss of adipose tissue, levels of the adipocyte-secreted hormone leptin in patients with LD are very low. This disrupts the body’s system for regulating energy use and storage. Metabolic abnormalities often occur with LD, including insulin resistance with resultant hyperinsulinemia and diabetes; hepatic steatosis or steatohepatitis; and dyslipidemia with severe hypertriglyceridemia. This study focuses on patients with familial partial LD (FPLD). Individuals with FPLD often have reduced subcutaneous fat in the arms and legs, while the trunk regions may or may not have loss of fat. FPLD may run in families or be attributed to a specific genetic mutation. To help people with FPLD, we are exploring treating FPLD with metreleptin, which is a recombinant human leptin analog that is indicated as a replacement therapy to treat the complications of leptin deficiency. Metreleptin has been approved by the Food and Drug Administration (FDA) for treating patients with generalized LD who have complete loss of fat. While it is approved in the EU for both patients with generalized LD and FPLD, the use of metreleptin in patients with FPLD has not yet been approved by the FDA. This study will be conducted as a randomized, double-blind, placebo-controlled study and will provide useful efficacy and safety information for the use of metreleptin in patients with FPLD. 

PI: Lindsay Fourman (LFourman@partners.org) 

Study Coordinator: Sam Russo (srusso4@mgh.harvard.edu) 

Featured Publications

Shook LL, Fourman LT, Edlow AG. Immune Responses to SARS-CoV-2 in Pregnancy: Implications for the Health of the Next Generation. J Immunol. 2022 Oct 15; 209(8):1465-1473. PMID: 36192115; PMCID: PMC9536183.

Fourman LT, Grinspoon SK. Approach to the Patient With Lipodystrophy. J Clin Endocrinol Metab. 2022 05 17; 107(6):1714-1726. PMID: 35137140; PMCID: PMC9113814.

Fourman LT, Mueller SB, Boutin A, Zheng I, Pan CS, Gerard ME, Stanley TL, Roberts DJ. Placental Vascular Abnormalities in Association With Prenatal and Long-Term Health Characteristics Among HIV-Exposed Uninfected Adolescents and Young Adults. J Acquir Immune Defic Syndr. 2021 09 01; 88(1):103-109. PMID: 34034303; PMCID: PMC8373807.

Fourman LT, Stanley TL, Billingsley JM, Sui SJH, Feldpausch MN, Boutin A, Zheng I, McClure CM, Corey KE, Torriani M, Kleiner DE, Hadigan CM, Chung RT, Grinspoon SK. Delineating tesamorelin response pathways in HIV-associated NAFLD using a targeted proteomic and transcriptomic approach. Sci Rep. 2021 05 18; 11(1):10485. PMID: 34006921; PMCID: PMC8131688.

deFilippi C, Toribio M, Wong LP, Sadreyev R, Grundberg I, Fitch KV, Zanni MV, Lo J, Sponseller CA, Sprecher E, Rashidi N, Thompson MA, Cagliero D, Aberg JA, Braun LR, Stanley TL, Lee H, Grinspoon SK. Differential Plasma Protein Regulation and Statin Effects in Human Immunodeficiency Virus (HIV)-Infected and Non-HIV-Infected Patients Utilizing a Proteomics Approach. J Infect Dis. 2020 08 17; 222(6):929-939. PMID: 32310273; PMCID: PMC7430172.

Toribio M, Fitch KV, Stone L, Zanni MV, Lo J, de Filippi C, Sponseller CA, Lee H, Grundberg I, Thompson MA, Aberg JA, Grinspoon SK. Assessing statin effects on cardiovascular pathways in HIV using a novel proteomics approach: Analysis of data from INTREPID, a randomized controlled trial. EBioMedicine. 2018 Sep; 35:58-66. PMID: 30174281.

Toribio M, Park MH, Zanni MV, Robbins GK, Burdo TH, Williams KC, Feldpausch MN, Stone L, Melbourne K, Grinspoon SK, Fitzgerald ML. HDL Cholesterol Efflux Capacity in Newly Diagnosed HIV and Effects of Antiretroviral Therapy. J Clin Endocrinol Metab. 2017 11 01; 102(11):4250-4259. PMID: 28945911; PMCID: PMC5673269.

Fitch KV, McCallum SA, Erlandson KM, Overton ET, Zanni MV, Fichtenbaum C, Aberg JA, Fulda ES, Kileel EM, Moran LE, Bloomfield GS, Novak RM, Pérez-Frontera S, Abrams-Downey A, Pierone G, Kumarasamy N, Ruxrungtham K, Mngqibisa R, Douglas PS, Ribaudo HJ, Grinspoon SK. Diet in a global cohort of adults with HIV at low-to-moderate traditional cardiovascular disease risk. AIDS. 2022 Nov 15; 36(14):1997-2003. PMID: 35876637; PMCID: PMC9612704.

Lo J, Lu MT, Ihenachor EJ, Wei J, Looby SE, Fitch KV, Oh J, Zimmerman CO, Hwang J, Abbara S, Plutzky J, Robbins G, Tawakol A, Hoffmann U, Grinspoon SK. Effects of statin therapy on coronary artery plaque volume and high-risk plaque morphology in HIV-infected patients with subclinical atherosclerosis: a randomised, double-blind, placebo-controlled trial. Lancet HIV. 2015 Feb; 2(2):e52-63. PMID: 26424461; PMCID: PMC4820828.

Bogorodskaya M, Fitch KV, Lu M, Torriani M, Zanni MV, Looby SE, Iyengar S, Triant VA, Grinspoon SK, Srinivasa S, Lo J. Measures of Adipose Tissue Redistribution and Atherosclerotic Coronary Plaque in HIV. Obesity (Silver Spring). 2020 04; 28(4):749-755. PMID: 32086864.

Kileel EM, Lo J, Malvestutto C, Fitch KV, Zanni MV, Fichtenbaum CJ, Overton ET, Okeke NL, Kumar P, Joao E, Aberg JA, Martinez E, Currier JS, Douglas PS, Ribaudo HJ, Grinspoon SK. Assessment of Obesity and Cardiometabolic Status by Integrase Inhibitor Use in REPRIEVE: A Propensity-Weighted Analysis of a Multinational Primary Cardiovascular Prevention Cohort of People With Human Immunodeficiency Virus. Open Forum Infect Dis. 2021 Dec; 8(12):ofab537. PMID: 34888395; PMCID: PMC8651160.

Registered Dietitian

Reem Jabr, MA, RDN, LDN
Registered Dietitian Nutritionist

Nurses

Barbara Chase, RN
Ellen L. Miceli, RN, BSN

Clinic Practice Manager

William McLaughlin III

Patient Services Coordinator

Carmen Villanueva