Pathophysiological dilemmas of lipedema

Area of Science:

• Endocrinology
• Genetics
• Pathology

Background:

• Lipedema is a frequently underdiagnosed condition predominantly affecting females, often mistaken for obesity.
• Despite clinical diagnostic simplicity, the underlying pathomechanisms of lipedema remain poorly understood, with no existing curative therapies.
• There is a significant need for extensive research into lipedema's etiology and treatment.

Purpose of the Study:

• To review existing literature on lipedema from 1913 to the present.
• To discuss potential pathomechanisms of lipedema based on current knowledge.
• To provide a foundation for future research into lipedema.

Main Methods:

• Comprehensive literature review of articles published between 1913 and the present.
• Analysis and synthesis of findings related to lipedema's potential mechanisms.
• Discussion of reviewed literature in the context of disease pathogenesis.

Main Results:

• Lipedema is hypothesized to be an estrogen-regulated polygenetic disease.
• The condition may involve vasculo- and lymphangiopathy, potentially linked to feminine hormonal changes.
• Neuropathy, possibly due to peripheral nerve inflammation and sympathetic innervation abnormalities involving estrogen, is also implicated.

Conclusions:

• Adipocyte hyperproliferation may be a secondary phenomenon contributing to a vicious cycle in lipedema.
• Estrogen's role is central to the proposed polygenetic and hormonal mechanisms of lipedema.
• The reviewed literature suggests key areas for future research into lipedema's complex pathophysiology.