Adipose tissue biology and effect of weight loss in women with lipedema

IF 6.2 1区医学 Q1 ENDOCRINOLOGY & METABOLISM

Diabetes Pub Date : 2024-12-09 DOI:10.2337/db24-0890

Vincenza Cifarelli, Gordon I. Smith, Silvia Gonzalez-Nieves, Dmitri Samovski, Hector H. Palacios, Jun Yoshino, Richard I. Stein, Anja Fuchs, Thomas F. Wright, Samuel Klein

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Abstract

Lipedema is a lipodystrophic disease that is typically characterized by a marked increase in lower-body subcutaneous adipose tissue that is purported to have increased inflammation and fibrosis, impaired microvascular/lymphatic circulation and to be resistant to reduction by weight loss therapy. However, these outcomes have not been adequately studied. We evaluated body composition, insulin sensitivity, metabolic health and adipose tissue biology in women with obesity and lipedema (Obese-LIP) before and after moderate (~9%) diet-induced weight loss. At baseline, people with Obese-LIP had ~23% greater leg fat mass, ~11% lower android-to-gynoid ratio and ~48% greater insulin sensitivity (all P<0.05) than women matched on age, BMI and whole-body adiposity. In Obese-LIP, macrophage content and expression of genes involved in inflammation and fibrosis were greater, whereas lymph/angiogenesis-related genes were lower in thigh than abdominal subcutaneous adipose tissue. Weight loss improved insulin sensitivity and decreased total fat mass, with similar relative reductions in abdominal and leg fat masses, but without changes in markers of inflammation and fibrosis. These results demonstrate that affected adipose tissue in women with lipedema is characterized by increased inflammation and fibrogenesis, and alterations in lymphatic and vascular biology. Moderate diet-induced weight loss improves metabolic function and decreases lower-body adipose tissue mass.

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脂肪组织生物学和脂肪水肿妇女减肥的影响

脂肪水肿是一种脂肪营养不良疾病，其典型特征是下体皮下脂肪组织显著增加，据称会增加炎症和纤维化，微血管/淋巴循环受损，并且对减肥疗法的减少有抵抗力。然而，这些结果还没有得到充分的研究。我们评估了患有肥胖和脂水肿（obesity - lip）的女性在中度（~9%）饮食诱导减肥前后的身体组成、胰岛素敏感性、代谢健康和脂肪组织生物学。在基线时，与年龄、体重指数和全身肥胖程度相匹配的女性相比，患有obesity - lip的女性腿部脂肪量增加了约23%，男性与女性的比例降低了约11%，胰岛素敏感性增加了约48% （p < 0.05）。在obesity - lip中，与炎症和纤维化相关的巨噬细胞含量和基因表达更高，而大腿中与淋巴/血管生成相关的基因低于腹部皮下脂肪组织。减肥改善了胰岛素敏感性，减少了总脂肪量，腹部和腿部脂肪量也有类似的相对减少，但炎症和纤维化标志物没有变化。这些结果表明，脂肪水肿妇女的脂肪组织受影响的特点是炎症和纤维生成增加，以及淋巴和血管生物学的改变。适度饮食引起的体重减轻可改善代谢功能并减少下半身脂肪组织质量。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Diabetes 医学-内分泌学与代谢

CiteScore

12.50

自引率

2.60%

发文量

1968

审稿时长

1 months

期刊介绍： Diabetes is a scientific journal that publishes original research exploring the physiological and pathophysiological aspects of diabetes mellitus. We encourage submissions of manuscripts pertaining to laboratory, animal, or human research, covering a wide range of topics. Our primary focus is on investigative reports investigating various aspects such as the development and progression of diabetes, along with its associated complications. We also welcome studies delving into normal and pathological pancreatic islet function and intermediary metabolism, as well as exploring the mechanisms of drug and hormone action from a pharmacological perspective. Additionally, we encourage submissions that delve into the biochemical and molecular aspects of both normal and abnormal biological processes. However, it is important to note that we do not publish studies relating to diabetes education or the application of accepted therapeutic and diagnostic approaches to patients with diabetes mellitus. Our aim is to provide a platform for research that contributes to advancing our understanding of the underlying mechanisms and processes of diabetes.