Adipose Tissue Hypertrophy, An Aberrant Biochemical Profile and Distinct Gene Expression in Lipedema

Felmerer, Gunther; Stylianaki, Aikaterini; Hägerling, René; Wang, Anna; Ströbel, Philipp; Hollmén, Maija; Lindenblatt, Nicole; Gousopoulos, Epameinondas

doi:10.1016/j.jss.2020.03.055

Cited by 60 publications

(121 citation statements)

References 33 publications

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“…32 Lipedema tissue has an enlarged extracellular matrix where proteoglycans reside. 2,33 In support, multiple proteoglycans are upregulated in excess adipose tissue in individuals with obesity. 34 These data suggest an increase in proteoglycanbound fluid in lipedema tissue.…”

Section: (A)mentioning

confidence: 99%

Standard of care for lipedema in the United States

et al. 2021

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Background Lipedema is a loose connective tissue disease predominantly in women identified by increased nodular and fibrotic adipose tissue on the buttocks, hips and limbs that develops at times of hormone, weight and shape change including puberty, pregnancy, and menopause. Lipedema tissue may be very painful and can severely impair mobility. Non-lipedema obesity, lymphedema, venous disease, and hypermobile joints are comorbidities. Lipedema tissue is difficult to reduce by diet, exercise, or bariatric surgery. Methods This paper is a consensus guideline on lipedema written by a US committee following the Delphi Method. Consensus statements are rated for strength using the GRADE system. Results Eighty-five consensus statements outline lipedema pathophysiology, and medical, surgical, vascular, and other therapeutic recommendations. Future research topics are suggested. Conclusion These guidelines improve the understanding of the loose connective tissue disease, lipedema, to advance our understanding towards early diagnosis, treatments, and ultimately a cure for affected individuals.

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Section: (A)mentioning

confidence: 99%

Standard of care for lipedema in the United States

et al. 2021

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“…This distribution of fat is not associated with metabolic disease, including cardiovascular disease, hypertension, and diabetes [ 15 ]. A better definition of obesity is the Obesity Medicine Association’s definition: a chronic, relapsing, multifactorial, neurobehavioral disease, wherein an increase in body fat promotes adipose tissue dysfunction and abnormal fat mass physical forces, resulting in adverse metabolic, biomechanical, and psychosocial health consequences [ 17 ]. Lipedema tissue contains hypertrophic adipocytes, similar to non-lipedema obesity, and is associated with lymphedema, similar to non-lipedema obesity [ 7 ].…”

Section: Discussionmentioning

confidence: 99%

A 41-Year-Old Woman with Excessive Fat of the Lower Body Since Puberty with Progression to Swollen Ankles and Feet Despite Caloric Restriction, Due to Lipedema and Protein-Calorie Malnutrition: A Case of Stage 3 Lipedema

Wright¹,

Herbst²

2021

Am J Case Rep

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Patient: Female, 41-year-old Final Diagnosis: Malnutrition Symptoms: Leg edema • weakness Medication: — Clinical Procedure: Lymphatic mapping Specialty: Dermatology • Endocrinology and Metabolic • Surgery Objective: Rare co-existance of disease or pathology Background: Lipedema is a common condition that presents as excessive fat deposition in the extremities, initially sparing the trunk, ankles, and feet, and is found mainly in women, usually occurring after puberty or pregnancy. Lipedema can progress to include lipo-lymphedema of the ankles and feet. This report is of a 41-year old woman with Stage 3 lipedema and lipo-lymphedema with excessive fat of the lower body since puberty, with progression to swollen ankles and feet despite dietary caloric restriction. Case Report: A 41-year-old woman noticed increased fat in her legs since age 12. Her weight and leg size increased until age 21, when she reached a maximum weight of 165 kg, and underwent a Roux-En-Y gastric bypass. Over 12 months, she lost 74.8 kg. Her trunk significantly reduced in weight, but her legs did not. Fifteen years later, during recovery from hysterectomy surgery, she became progressively weaker and swollen over her entire body. Laboratory test results showed hypoalbuminemia (2.0 g/dL), lymphopenia, and hypolipoproteinemia. She was diagnosed with protein and calorie malnutrition with marked gut edema requiring prolonged parenteral nutrition. After restoration of normal protein, her health returned and her pitting edema resolved, but her extremities remained enlarged. She was subsequently diagnosed with lipedema. Conclusions: This report demonstrates that early and correct diagnosis of lipedema is important, as women who believe the condition is due to obesity may suffer the consequences of calorie or protein-calorie deficiency in an attempt to lose weight.

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“…In der kürzlich veröffentlichten Arbeit von Felmerer, Hägerling und Gousopoulos bei reinen Lipödem-Patientinnen konnten lediglich vergrößerte Adipozyten ("increased adipocyte size") festgestellt werden. Obwohl in dieser histopathologischen Untersuchung das von Hägerling entwickelte VIPAR-Verfahren der 3D-Rekonstruktion verwendet wurde, gab es keinen Hinweis auf veränderte Lymph-oder Blutgefäße bei Lipödem-Patientinnen [13].…”

Section: Zuunclassified

“…Bereits ältere klinische Studien mittels indirekter Lymphografie und Lymphszintigrafie haben gezeigt, dass der Lymphtransport vom subepidermalen Kompartiment beim Lipödem eben nicht eingeschränkt ist [38][39][40]. Auch neue Untersuchungen mit modernsten histopathologischen Untersuchungsmethoden brachten keinen Hinweis auf veränderte Lymphgefäße bei Lipödem-Patientinnen [13].…”

Section: Zu B Manual Lymphtherapy and Compressionunclassified

Erwiderung auf den Leserbrief zu Lipoedema – myths and facts Part 1 and 5. European Best Practice of Lipoedema – Summary of the European Lipoedema Consensus, Phlebologie 2020; 49: 31–49

Bertsch

Erbacher

2020

Phlebologie

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Adipose Tissue Hypertrophy, An Aberrant Biochemical Profile and Distinct Gene Expression in Lipedema

Cited by 60 publications

References 33 publications

Standard of care for lipedema in the United States

Standard of care for lipedema in the United States

A 41-Year-Old Woman with Excessive Fat of the Lower Body Since Puberty with Progression to Swollen Ankles and Feet Despite Caloric Restriction, Due to Lipedema and Protein-Calorie Malnutrition: A Case of Stage 3 Lipedema

Erwiderung auf den Leserbrief zu Lipoedema – myths and facts Part 1 and 5. European Best Practice of Lipoedema – Summary of the European Lipoedema Consensus, Phlebologie 2020; 49: 31–49

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