From the Guidelines
Lipedema is primarily caused by the accumulation of adipose tissue.
Etiology of Lipedema
The exact mechanism of lipedema is not fully understood, but it is believed to be related to the abnormal growth and accumulation of adipose tissue in the subcutaneous fat layer, particularly in the lower extremities 1.
- Key factors that contribute to the development of lipedema include:
- Genetic predisposition
- Hormonal influences
- Abnormal lymphatic function
- Trauma or injury to the affected area
- Distinguishing lipedema from other conditions, such as lymphedema, is crucial for proper diagnosis and treatment. Lymphedema is characterized by the excessive accumulation of lymphatic fluid, whereas lipedema is primarily caused by the accumulation of adipose tissue 1.
- Other causes of lower extremity edema should be excluded before diagnosing lipedema, including cardiac, hepatic, renal, and thyroid disorders, as well as medications such as calcium channel blockers and NSAIDs 1.
- The diagnosis of lipedema is typically based on clinical presentation, medical history, and physical examination, rather than laboratory tests or imaging studies 1.
From the Research
Etiology of Lipedema
The etiology of lipedema is a complex and multifactorial process that is not yet fully understood. However, several studies have shed light on the potential causes of this condition.
- Lipedema is thought to occur during periods of hormonal fluctuation, such as puberty, pregnancy, or menopause, suggesting a possible role of estrogen in its pathophysiology 2.
- The condition is characterized by bilateral, disproportionate accumulation of subcutaneous adipose tissue predominantly in the lower body, and is often accompanied by chronic pain, swelling, and other discomforts 3.
- Research suggests that lipedema is a distinct condition from obesity and lymphedema, with its own unique morphological and pathophysiological characteristics 3, 4.
Genetic Factors
- Studies have shown that lipedema may have a genetic component, with a positive family history in 60%-80% of cases 5, 4.
- However, the genetic basis of lipedema is still poorly understood, and no single gene has been identified as the primary cause of the condition 5.
- Gene ontology analysis has highlighted vasopressin receptor activity, microfibril binding, and patched binding as statistically significantly overrepresented categories for the set of candidate variants 5.
- The AKR1C1 gene, which codes for a protein involved in steroid hormone metabolism, has been proposed as a potential key gene in lipedema pathogenesis 6.
Hormonal Factors
- Estrogen is thought to play a contributory role in the pathophysiology of lipedema, with dysregulation of adipose tissue accumulation via estrogen signaling potentially leading to increased adipogenesis and adipocyte lipid deposition 2.
- Steroid hormones, including those metabolized by the AKR1C1 protein, may also be involved in the pathogenesis of lipedema 6.