Background: GPIHBP1 binds lipoprotein lipase (LPL) and transports it to the capillary lumen. Results: A GPIHBP1 missense mutation (S107C) leads to the formation of GPIHBP1 multimers that cannot bind LPL. Conclusion: An extra cysteine leads to GPIHBP1 multimerization, defective LPL binding, and hypertriglyceridemia. Significance: This study identifies a novel mechanism by which GPIHBP1 mutations interfere with LPL binding and cause hypertriglyceridemia.

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