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International Journal of Obesity (2005) Sep 2009Adiposis dolorosa (AD) is a syndrome of obese and non-obese individuals whose hallmark is lipomatosis: unencapsulated painful fatty masses in subcutaneous fat....
BACKGROUND
Adiposis dolorosa (AD) is a syndrome of obese and non-obese individuals whose hallmark is lipomatosis: unencapsulated painful fatty masses in subcutaneous fat. Lipomatosis may contain excess collagen and multi-nucleated giant (MNG) cells. Case reports suggest metabolic defects in AD.
OBJECTIVES
(1) To determine whether women with AD have altered relative resting energy expenditure (REE per total body mass) compared with controls; and (2) to quantitate lipomatosis-associated collagen, MNGs and tissue and blood cytokines that may influence REE.
METHODS
A total of 10 women with AD were compared with age, body mass index, fat and weight-matched control women. Adipose tissue was obtained from five women with AD and five controls and evaluated for collagen and macrophages/MNGs. Fat mass and fat-free mass were identified by dual X-ray absorptiometry. REE was by determined indirect calorimetry and related to mass. Adipokines and cytokines were evaluated in blood and tissue.
RESULTS
Relative REE (REE per total body mass) was lower in women with AD compared with controls (P=0.007). Only lipomatosis (group) and total body mass were significant predictors of REE in forward stepwise regression (P<0.0001). Adipose interleukin (IL)-6 levels were elevated (P=0.03) and connective tissue was increased fourfold in lipomatosis compared with control tissue (P <0.0001). There was no difference in adipose tissue macrophages between groups; 30% of women with AD had MNG cells. Anti-inflammatory IL-13 levels were elevated (P=0.03), and cytokines important in the recruitment of monocytes, Fraktalkine (P=0.04) and macrophage inflammatory protein-1beta (P=0.009), were significantly lower in the blood of women with AD compared with controls.
CONCLUSIONS
The lower relative REE in women with AD compared with controls was associated with increased connective (non-metabolic) tissue in the lipomatosis, and inflammation, although underlying metabolic defects may be important as well. Understanding the pathophysiology and metabolism of lipomatosis in AD may contribute to a better understanding of metabolism in non-lipomatosis obesity.
Topics: Absorptiometry, Photon; Adipokines; Adipose Tissue; Adiposis Dolorosa; Adolescent; Adult; Basal Metabolism; Calorimetry, Indirect; Case-Control Studies; Collagen; Cytokines; Energy Metabolism; Female; Giant Cells; Humans; Inflammation Mediators; Lipomatosis; Middle Aged; Rest; Young Adult
PubMed: 19621017
DOI: 10.1038/ijo.2009.119 -
American Family Physician Mar 2002Lipomas are adipose tumors that are often located in the subcutaneous tissues of the head, neck, shoulders, and back. Lipomas have been identified in all age groups but... (Review)
Review
Lipomas are adipose tumors that are often located in the subcutaneous tissues of the head, neck, shoulders, and back. Lipomas have been identified in all age groups but usually first appear between 40 and 60 years of age. These slow-growing, nearly always benign, tumors usually present as nonpainful, round, mobile masses with a characteristic soft, doughy feel. Rarely, lipomas can be associated with syndromes such as hereditary multiple lipomatosis, adiposis dolorosa, Gardner's syndrome, and Madelung's disease. There are also variants such as angiolipomas, neomorphic lipomas, spindle cell lipomas, and adenolipomas. Most lipomas are best left alone, but rapidly growing or painful lipomas can be treated with a variety of procedures ranging from steroid injections to excision of the tumor. Lipomas must be distinguished from liposarcoma, which can have a similar appearance.
Topics: Adult; Diagnosis, Differential; Female; Humans; Lipoma; Male; Middle Aged; Neoplasms, Adipose Tissue; Postoperative Complications
PubMed: 11898962
DOI: No ID Found -
Journal of Internal Medicine Mar 1998To study the impact of adipose tissue removal by liposuction on factors associated with increased risk of cardiovascular atherosclerotic disease within the coagulation...
OBJECTIVE
To study the impact of adipose tissue removal by liposuction on factors associated with increased risk of cardiovascular atherosclerotic disease within the coagulation and fibrinolytic system and glucose metabolism.
DESIGN, SETTING AND SUBJECTS
Liposuction was performed in 53 patients with Dercum's disease. The levels of fibrinogen, von Willebrand factor antigen (VWF:Ag) and plasminogen activator inhibitor type 1 activity (PAI-1) were measured preoperatively, and 2 weeks, 4 weeks and 3 months postoperatively. In a subsample of 10 patients, insulin sensitivity was determined before and 2-4 weeks after surgery using the 2-h euglycaemic hyperinsulinaemic clamp technique. The study was performed as a single-centre study.
MAIN OUTCOME MEASURE
Fibrinogen, PAI-1 and VWF:Ag levels, and glucose uptake before and after removal of adipose tissue.
RESULTS
Weight reduction was sustained throughout the follow-up period with a mean decrease from 90.7 to 86.6 kg (P < 0.0001). There was a slight increase in levels of coagulation factors 2 and 4 weeks postoperatively, probably in reaction to the surgical trauma. After 3 months the values had returned to preoperative levels except for PAI-1, which still showed a slight increase (P < 0.05). In the subsample of 10 patients, glucose uptake was improved (P < 0.05) from a short-term perspective after surgery.
CONCLUSION
Surgical removal of adipose tissue, without change in lifestyle, does not seem to improve the levels of coagulation and fibrinolytic factors associated with cardiovascular atherosclerotic disease, whereas glucose takeup may be facilitated and insulin sensitivity increases from a short-term perspective.
Topics: Adiposis Dolorosa; Adult; Aged; Arteriosclerosis; Female; Fibrinolysis; Glucose; Hemostasis; Humans; Insulin; Lipectomy; Male; Middle Aged; Risk Factors
PubMed: 9627156
DOI: 10.1046/j.1365-2796.1998.00264.x -
Acta Dermato-venereologica Mar 1996
Topics: Adiposis Dolorosa; Anesthetics, Local; Drug Combinations; Female; Humans; Lidocaine; Lidocaine, Prilocaine Drug Combination; Middle Aged; Pain Measurement; Prilocaine
PubMed: 8740288
DOI: 10.2340/0001555576170171 -
Annals of the Rheumatic Diseases Jun 1990Two patients are presented who had symptomatic relief of juxta-articular adiposis dolorosa of the knees after liposuction. Liposuction is recommended for the treatment...
Two patients are presented who had symptomatic relief of juxta-articular adiposis dolorosa of the knees after liposuction. Liposuction is recommended for the treatment of this condition.
Topics: Adiposis Dolorosa; Aged; Aged, 80 and over; Female; Humans; Knee Joint; Lipectomy
PubMed: 2383065
DOI: 10.1136/ard.49.6.403 -
Annals of the Rheumatic Diseases Oct 1979Juxta-articular adiposis dolorosa may be defined as the localised accumulation of painful fat near joints, most commonly the knee. It exists as a separate entity that...
Juxta-articular adiposis dolorosa may be defined as the localised accumulation of painful fat near joints, most commonly the knee. It exists as a separate entity that must be distinguished from other causes of knee pain. We present 2 patients with this condition and review the literature. Various approaches to therapy are discussed. A classification of painful fat near joints is proposed.
Topics: Adiposis Dolorosa; Female; Humans; Joint Diseases; Knee Joint; Middle Aged
PubMed: 518149
DOI: 10.1136/ard.38.5.479 -
American Journal of Human Genetics Jun 1963
PubMed: 17948485
DOI: No ID Found -
The Indian Medical Gazette Nov 1927
PubMed: 29010813
DOI: No ID Found -
The American Journal of Pathology May 1926
PubMed: 19969701
DOI: No ID Found -
Proceedings of the Royal Society of... 1924
PubMed: 19983505
DOI: No ID Found