Lipodystrophy
Encyclopedia
Lipodystrophy is a medical condition characterized by abnormal or degenerative conditions of the body's adipose tissue
Adipose tissue
In histology, adipose tissue or body fat or fat depot or just fat is loose connective tissue composed of adipocytes. It is technically composed of roughly only 80% fat; fat in its solitary state exists in the liver and muscles. Adipose tissue is derived from lipoblasts...

. ("Lipo" is Greek
Greek language
Greek is an independent branch of the Indo-European family of languages. Native to the southern Balkans, it has the longest documented history of any Indo-European language, spanning 34 centuries of written records. Its writing system has been the Greek alphabet for the majority of its history;...

 for "fat" and "dystrophy" is Greek for "abnormal or degenerative condition".) A more specific term, lipoatrophy
Lipoatrophy
Lipoatrophy is the term describing the localized loss of fat tissue. This may occur as a result of subcutanous injections of insulin in the treatment of diabetes, from the use of human growth hormone or from subcutanous injections of Copaxone used for the treatment of multiple sclerosis. In the...

 is used when describing the loss of fat from one area (usually the face). This condition is also characterized by a lack of circulating leptin
Leptin
Leptin is a 16 kDa protein hormone that plays a key role in regulating energy intake and energy expenditure, including appetite and metabolism. It is one of the most important adipose derived hormones...

 which may lead to osteosclerosis
Osteosclerosis
Osteosclerosis, an elevation in bone density, is normally detected on an X-ray as an area of whiteness, and is where the bone density has significantly increased...

. It is extremely rare, with only 2000 people on the planet thought to have it.

Types

Lipodystrophy may be divided into the following types:
  • Congential lipodystrophies
  • Congenital generalized lipodystrophy
    Congenital generalized lipodystrophy
    Congenital generalized lipodystrophy is a rare autosomal dominant skin condition, characterized by an extreme paucity of fat in the subcutaneous tissues.-Genetics:-Presentation:...

     (Beradinelli-Seip syndrome)
  • Familial partial lipodystrophy
    Familial partial lipodystrophy
    Familial partial lipodystrophy is an autosomal dominant skin condition characterized by the loss of subcutaneous fat.Type 1 is believed to be underdiagnosed.- References :...

    • Acquired lipodystrophy
  • Acquired partial lipodystrophy (Barraquer-Simons syndrome)
  • Acquired generalized lipodystrophy
    Acquired generalized lipodystrophy
    Acquired generalized lipodystrophy is a rare skin condition that appears during childhood or adolescence, characterized by fat loss affecting large areas of the body, particularly the face, arms, and legs....

  • Centrifugal abdominal lipodystrophy
    Centrifugal abdominal lipodystrophy
    Centrifugal abdominal lipodystrophy is a skin condition characterized by areas of subcutaneous fat loss that slowly enlarge....

     (Lipodystrophia centrifugalis abdominalis infantilis)
  • Lipoatrophia annularis
    Lipoatrophia annularis
    Lipoatrophia annularis is a skin condition affecting primarily women, characterized by the loss of subcutaneous fat in the upper extremity.It is a form of lipodystrophy....

     (Ferreira-Marques lipoatrophia)
  • Localized lipodystrophy
    Localized lipodystrophy
    Localized lipodystrophy is a skin condition characterized by the loss subcutaneous fat localized to sites of insulin injection....

  • HIV-associated lipodystrophy
    HIV-associated lipodystrophy
    HIV-associated lipodystrophy is a condition characterized by loss of subcutaneous fat associated with infection with HIV.-Cause:The exact mechanism of HIV-associated lipodystrophy is not fully elucidated...


Insulin injections

A lipodystrophy can be a lump or small dent in the skin
Skin
-Dermis:The dermis is the layer of skin beneath the epidermis that consists of connective tissue and cushions the body from stress and strain. The dermis is tightly connected to the epidermis by a basement membrane. It also harbors many Mechanoreceptors that provide the sense of touch and heat...

 that forms when a person keeps performing injections
Injection (medicine)
An injection is an infusion method of putting fluid into the body, usually with a hollow needle and a syringe which is pierced through the skin to a sufficient depth for the material to be forced into the body...

 in the same spot. These types of lipodystrophies are harmless. People who want to avoid them can do so by changing (rotating) the places where they perform injections. For people with diabetes
Diabetes mellitus
Diabetes mellitus, often simply referred to as diabetes, is a group of metabolic diseases in which a person has high blood sugar, either because the body does not produce enough insulin, or because cells do not respond to the insulin that is produced...

, using purified insulin
Insulin
Insulin is a hormone central to regulating carbohydrate and fat metabolism in the body. Insulin causes cells in the liver, muscle, and fat tissue to take up glucose from the blood, storing it as glycogen in the liver and muscle....

s may also help.

One of the side-effects of lipodystrophy is the rejection of the injected medication, the slowing down of the absorption of the medication, or trauma that can cause bleeding that, in turn, will reject the medication. In any of these scenarios, the dosage of the medication, such as insulin for diabetics, becomes impossible to gauge correctly and the treatment of the disease for which the medication is administered is impaired thereby allowing the medical condition to worsen.

In some cases, rotation of the injection sites may not be enough to prevent lipodystrophy.

Antiretroviral drugs

Lipodystrophies can be a possible side effect of antiretroviral drug
Antiretroviral drug
Antiretroviral drugs are medications for the treatment of infection by retroviruses, primarily HIV. When several such drugs, typically three or four, are taken in combination, the approach is known as Highly Active Antiretroviral Therapy, or HAART...

s. Other lipodystrophies manifest as lipid
Lipid
Lipids constitute a broad group of naturally occurring molecules that include fats, waxes, sterols, fat-soluble vitamins , monoglycerides, diglycerides, triglycerides, phospholipids, and others...

 redistribution; with excess, or lack of, fat in various regions of the body. These include, but are not limited to, having sunken cheeks and/or "humps" on the back or back of the neck (also referred to as buffalo hump).

Hereditary forms

Lipodystrophy can be caused by metabolic abnormalities due to genetic issues. These are often characterized by insulin resistance
Insulin resistance
Insulin resistance is a physiological condition where the natural hormone insulin becomes less effective at lowering blood sugars. The resulting increase in blood glucose may raise levels outside the normal range and cause adverse health effects, depending on dietary conditions. Certain cell types...

 and are associated with Metabolic Syndrome
Metabolic syndrome
Metabolic syndrome is a combination of medical disorders that, when occurring together, increase the risk of developing cardiovascular disease and diabetes. It affects one in five people in the United States and prevalence increases with age...

.

External links

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