Lipid and Metabolism Associates

About This Program

Treating the Full Range of Lipid Metabolism Disorders

When Mason Freeman, MD, founded the Lipid and Metabolism Associates, Mass General’s lipid clinic, 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.

Today our clinic continues to serve as a valuable medical resource in the community, providing advanced diagnostics and therapies for people with common and rare lipid disorders.

The most common 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
• High levels of LDL and triglycerides: A combination that can expose patients to multiple health risks

Causes of common lipid disorders include lifestyle behaviors (e.g. improper diet, lack of adequate exercise) and illnesses such as diabetes, hypothyroidism, kidney disease and liver disease. Additionally, common forms of these disorders may affect patients who have received organ transplants or take certain medications.

Our experience includes treating the full range of rare lipid disorders, many of which are genetically based, such as:

• Familial hypercholesterolemia: Very high LDL levels that expose patients to the risk of premature arteriosclerosis and other heart diseases
• Hyperbetalipoproteinemia: Extremely high levels of LDL and beta-lipoproteins in the blood that can cause premature heart disease
• Tangier disease: Very low levels of high-density cholesterol (HDL), so-called “good” cholesterol, which lead to various heart diseases
• Extremely high levels of triglycerides: A genetic condition that increases the risk of heart disease and pancreatitis and is commonly present in patients with diabetes

What to Expect

Lipid and Metabolism Associates, our lipid clinic, is located in Suite 730 of the Wang Ambulatory Center at Mass General’s main campus in downtown Boston. Appointments are available on Wednesdays from 9:00 am-noon.

Before your first appointment, please ask your referring physician to send us your medical records and, if applicable, 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 images or a blood test.

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

Treatment and Advanced Therapy for Lipid Disorders

For common lipid disorders, such as high levels of low-density cholesterol (LDL) and/or triglycerides, our treatment approach typically begins with a thorough understanding of the roles lifestyle and family history play in the development of the disorder. Depending on your condition, we may recommend lifestyle modifications (e.g. dietary changes or an exercise plan) and, if appropriate, medications.

Statins are the medications most often prescribed for patients with high levels of LDL. Many patients are referred to us because they don’t respond to statins or experience side effects they find intolerable. Others have lipid disorders that are not primarily caused by high LDL levels, for which statins may be ineffective. Our physicians, whose research focuses on developing new therapies, are experts in prescribing medications that replace or work along with statins to produce the best outcomes for these patients.

When persistently high levels of LDL fail to respond to medications and lifestyle changes, we may recommend an advanced therapy called LDL apheresis. This treatment, which is managed by our colleagues at the Mass General Heart Center, is a dialysis-like procedure that can reduce LDL levels by as much as 70 percent.

Groundbreaking Research into Lipid Disorders

Clinical Activities

The Lipid and Metabolism Associates has patients with disorders affecting their blood cholesterol and triglyceride levels are diagnosed and treated. The unit participates in clinical trials of novel lipid-lowering agents, and performs studies on the genetics of lipid disorders.

Research

Following a longstanding tradition of Mass General’s Endocrine Unit, our specialists pursue a dual mission: to diagnose and treat patients and to study lipid disorders in our Lipid Metabolism Laboratory. By deepening their knowledge of lipid metabolism at the cellular level, our physician-scientists help improve diagnostics and treatments for rare and complicated lipid disorders.

The research activities of the Lipid and Metabolism Associates are centered on cholesterol trafficking in and out of cells and the proteins that control this movement. NIH funded studies support current investigations into the biology of the ABCA family of lipid transporters, scavenger receptors, and inflammatory signaling pathways that play a role in atherosclerosis and Alzheimer's disease.

Our team’s investigations also are instrumental in developing promising new therapies. In addition to managing our research program, Dr. Freeman works closely with the Mass General Center for Computational and Integrative Biology (CCIB). This center focuses on translating basic-science research into targeted therapies for metabolic disorders, such as diabetes, which increase a patient’s risk of developing atherosclerosis (blocked arteries).CCIBhas developed a new program in Translational Medicine, headed by Mason Freeman MD, which is designed to take novel therapeutic molecules generated in either the CCIB laboratories or elsewhere in academia or industry and move those treatments into first-in-man therapeutic trials.

Our Fellows

• Regine Boutin, MD
• Kristine Gu, MD
• Kathryn Nagel, MD, MPH
• Seth Tobolsky, MD