Lipodystrophy
Under lipodystrophy refers to a change in the subcutaneous adipose tissue, which may be localized or generalized form. The changes may be reversible depending on the cause.
Forms of lipodystrophy
Lipohypertrophy at insulin therapy
With frequent and repeated injection of insulin to a very limited area of skin it comes through the lipogenetic effect to an increase of adipose tissue. The result is a poorer absorption of insulin and in the further metabolic degradation. The knockout of the injection site leading to a complete recovery.
Lipodystrophiesyndrom antiretroviral therapy
The lipodystrophy is a metabolic syndrome that can occur in HIV -infected patients receiving antiretroviral therapy. Older studies pointed to an occurrence at 30-50 % standing among HAART patients. However, studies of current treatment regimes show a significantly lower occurrence, as in the first-line therapy, the annual incidence of only 5-10% is reported, which seems to progress in subsequent years less. The lipodystrophy is associated with an increase of serum lipids and serum cholesterol as well as a redistribution of adipose tissue, with both atrophic and hypertrophic changes can occur. Sufferers typically develop Fettauszehrungen in the facial area ( lipoatrophy ), and on the extremities; other hand, often results in a " buffalo hump " and a larger fat deposits in the abdominal area ( "spare tire "). In addition, there is a resistance to insulin. The lipodystrophy affects the infected cosmetically strong and increased in yet unknown extent, the risk of HIV, developing diabetes or cardiovascular disease.
Familial lipodystrophy syndromes
There are two very rarely occurring genetic diseases. In type I or Köbberling syndrome, lipodystrophy affects the lower body, while type II or Dunningan syndrome, lipodystrophy relates to the body trunk. In addition, there is a proliferation of fatty tissue on the face and neck, resulting in those affected to a pseudo- cushingoiden appearance. For those affected, typically young women after puberty, there is a hirsutism, the women act muscular due to lack of subcutaneous fat and the resulting protruding muscles and blood vessels. In fact, the body suffers from a pathological, but visceral fat accumulation and located a massive hypertriglyceridemia, which may on the one hand lead to acute pancreatitis and on the other hand, an increased insulin resistance to diabetes mellitus. The therapy consists of the administration of recombinant leptin.