By Thomas Wright MD FACPh FACP and Karen Herbst MD PhD
Lipedema is a genetically transmitted, loose connective tissue disease of subcutaneous fat tissue. There are many differences in the subcutaneous tissue in women with lipedema compared to women without lipedema; these include increased sodium content, increased tissue edema, adipose tissue hypertrophy, increased cellular inflammation, microvascular dilation, and different gene expression.1 While these differences are becoming more known, what is often focused on, especially by the media, is abnormal adipose tissue, more colloquially known as “abnormal fat.”
How Is Lipedema Fat and Metabolism Different?
Compared to body mass index (BMI) matched controls, individuals with lipedema are more insulin sensitive as measured by glucose tolerance tests (GTT) and euglycemic insulin clamp glucose sensitivity. Fat in the distribution of lipedema is called gynoid fat and is considered cardio-protective when compared with the central android fat of lifestyle-induced obesity.
Lipedema fat is relatively resistant to weight loss. Women with lipedema have a greater percentage of body fat compared to BMI-matched controls. With 10% body weight loss, the percentage of body fat does not change significantly when measured by dual absorption x-ray (Dexa).
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