Lipodystrophy

Lipodystrophie
Classification and external resources
Specialty endocrinology
ICD-10 E88.1
ICD-9-CM 272.6
DiseasesDB 30066
eMedicine med/1307 med/3523
MeSH D008060

Lipodystrophy is a disorder in which the body is unable to produce fat.[1][2]The medical condition is characterized by abnormal or degenerative conditions of the body's adipose tissue. ("Lipo" is Greek for "fat", and "dystrophy" is Greek for "abnormal or degenerative condition".) A more specific term, lipoatrophy, 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 which may lead to osteosclerosis.

Types

Lipodystrophy can be divided into the following types:[3]:495–7

Insulin injections

A lipodystrophy can be a lump or small dent in the skin that forms when a person performs injections repeatedly in the same spot. These types of lipodystrophies are harmless and can be avoided by changing (rotating) the locations of injections. For those with diabetes, using purified insulins 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 drugs. Other lipodystrophies manifest as lipid 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)[4] which also exhibits due to excess cortisol. Lipoatrophy is most commonly seen in patients treated with thymidine analogue nucleoside reverse transcriptase inhibitors [5] like zidovudine (AZT) and stavudine (d4T).[6]

Hereditary forms

Lipodystrophy can be caused by metabolic abnormalities due to genetic issues. These are often characterized by insulin resistance and are associated with metabolic syndrome.

See also

References

  1. ↑ Lipodystrophy paper by Karen Reue
  2. ↑ UCLA/VA Researchers discover fat gene
  3. ↑ James, William D.; Berger, Timothy G.; et al. (2006). Andrews' Diseases of the Skin: clinical Dermatology. Saunders Elsevier. ISBN 0-7216-2921-0.
  4. ↑ Physical and Biochemical Changes in HIV Disease Eric S. Daar, M.D. MedicineNet, Accessed 22 September 2007
  5. ↑ Carr A, Workman C, Smith DE, Hoy J, Hudson J, Doong N, Martin A, Amin J, Freund J, Law M, Cooper DA, Mitochondrial Toxicity (MITOX) Study, Group (Jul 10, 2002). "Abacavir substitution for nucleoside analogs in patients with HIV lipoatrophy: a randomized trial.". JAMA: the Journal of the American Medical Association. 288 (2): 207–15. PMID 12095385. doi:10.1001/jama.288.2.207.
  6. ↑ John, M; McKinnon, EJ; James, IR; Nolan, DA; Herrmann, SE; Moore, CB; White, AJ; Mallal, SA (May 1, 2003). "Randomized, controlled, 48-week study of switching stavudine and/or protease inhibitors to combivir/abacavir to prevent or reverse lipoatrophy in HIV-infected patients.". Journal of acquired immune deficiency syndromes (1999). 33 (1): 29–33. PMID 12792352. doi:10.1097/00126334-200305010-00005.
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