Lipedema: A Painful Adipose Tissue Disorder

Abstract

Lipedema is a painful fat disease of loose connective tissue usually misdiagnosed as lifestyle-induced obesity that affects ~10% of women of European descent as well as other populations. Lipedema is characterized by symmetric enlargement of the buttocks, hips, and legs due to increased loose connective tissue; arms are also affected in 80% of patients. Lipedema loose connective tissue is characterized by hypertrophic adipocytes, inflammatory cells, and dilated leaky blood and lymphatic vessels. Altered fluid flux through the tissue causes accumulation of fluid, protein, and other constituents in the interstitium resulting in recruitment of inflammatory cells, which in turn stimulates fibrosis and results in difficulty in weight loss. Inflammation and excess interstitial substance may also activate nerve fibers instigating the painful lipedema fat tissue. More research is needed to characterize lipedema loose connective tissue structure in depth, as well as the form and function of blood and lymphatic vessels. Understanding the pathophysiology of the disease will allow healthcare providers to diagnose the disease and develop treatments.

Increase in Leptin and PPAR-γ Gene Expression in Lipedema Adipocytes Differentiated in vitro from Adipose-Derived Stem Cells

“…As lipedema is a chronic, painful fat disorder characterized by a significant expansion of adipose tissue in the lower extremities of the body [5,12], ASCs residing in the adipose niche and stimulated by a plethora of inflammatory and angiogenic factors might contribute to tissue adiposity. ASCs are a heterogeneous population of cells characterized by their ability to adhere to plastic, proliferate in culture, form colonies and differentiate into multiple lineages in vitro and in vivo [35][36][37][38].…”

“…Lipedema is a painful loose connective tissue disorder that affects approximately 11% of adult women in the United States [1,2]. This disorder is characterized by a symmetrical increase of fat deposition in the legs and the arms, sparing the hands and the feet [3][4][5]. The symptoms of lipedema are often confused with obesity, lymphedema, chronic venous insufficiency and other fat disorders [6][7][8][9][10].…”

Upper and Lower Extremity Measurement of Tissue Sodium and Fat Content in Patients with Lipedema

“…Lipedema is an adipose tissue disorder that almost exclusively affects women and that is characterized by excessive subcutaneous adipose tissue (SAT) accumulation. Lipedema is often misdiagnosed as obesity (1,2), a clinical challenge that is receiving increased attention (3,4). Adipose tissue deposition in affected areas is resistant to common diet and exercise treatments (2) and even bariatric surgery (5).…”

Injectable prevascularized mature adipose tissues (iPAT) to achieve long-term survival in soft tissues regeneration

“…The lymphatic system is responsible for the transport of fluid, cells and lipid, helping to coordinate interstitial fluid, lipid homeostasis and immune responses. Lymphatic vasculature has just recently been recognized as a critical modulator of metabolism and obesity in particular, with a strong clinical correlation between lymphatic dysfunction and adipogenesis, leading to adipose tissue inflammation by the recruitment of macrophages and fibrosis formation 61,62 . 61,62 .…”

“…Lymphatic vasculature has just recently been recognized as a critical modulator of metabolism and obesity in particular, with a strong clinical correlation between lymphatic dysfunction and adipogenesis, leading to adipose tissue inflammation by the recruitment of macrophages and fibrosis formation 61,62 . 61,62 . While further studies are needed to better understand the impact of the lymphatic vessels in our study, these results may provide leads for future improvements of adipose graft survival.…”