From the Research
Etiology of Lipedema
The etiology of lipedema is not yet fully understood, but several studies have investigated its potential causes.
- Lipedema is thought to occur during periods of hormonal fluctuation, such as puberty, pregnancy, or menopause 1.
- Estrogen is believed 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 1.
- Genetic factors may also contribute to the development of lipedema, with some studies suggesting that it may be an inherited condition with autosomal dominant inheritance or X-linked dominant inheritance 2, 3.
- However, a study of 31 individuals from 9 lipedema families found no individual genes that contained likely disease-causing variants across all participating families, suggesting genetic heterogeneity in the etiology of lipedema 2.
Potential Mechanisms
Several potential mechanisms have been proposed to contribute to the development of lipedema, including:
- Altered adipocyte estrogen receptor distribution and subsequent metabolic signaling 1.
- Increased release of adipocyte-produced steroidogenic enzymes leading to increased paracrine estrogen release 1.
- Vasopressin receptor activity, microfibril binding, and patched binding may also be involved in the etiology of lipedema, as these categories were found to be statistically significantly overrepresented in a gene ontology analysis of candidate variants 2.
Clinical Characteristics
Lipedema is characterized by:
- Bilateral and disproportionate accumulation of subcutaneous adipose tissue in the lower body 1, 4.
- Chronic pain, swelling, and other discomforts due to the expansion of subcutaneous adipose tissue 4.
- Easy bruising and pain in affected areas 5, 3.
- A classic "column leg" appearance in later stages, with masses of nodular fat 5.