The clinical approach to the detection of lipodystrophy - an AACE consensus statement

Lipodystrophy is a rare, heterogeneous group of syndromes characterized by the complete or partial loss or absence of subcutaneous adipose tissue (1,2). Lipodystrophy is often, though not always, accompanied by metabolic derangements, including insulin resistance, diabetes mellitus, hepatic steatosis or steatohepatitis, and dyslipidemia (1,2). The metabolic derangements associated with lipodystrophy can be severe and lead to substantial comorbidities, including acute pancreatitis (due to severe hypertriglyceridemia), hepatic cirrhosis, and premature cardiovascular disease (1,2). Other manifestations of metabolic derangements can include polycystic ovarian syndrome, acanthosis nigricans (due to severe insulin resistance), and eruptive xanthomas (due to severe hypertriglyceridemia) (1,2). Lipodystrophy is a condition characterized by regional or total selective loss or absence of subcutaneous fat. This can occur either in the presence or absence of metabolic abnormalities, and with diverse clinical presentations. While generalized forms of lipodystrophy are often diagnosed during childhood or adolescence, some forms of lipodystrophy, particularly FPL, may bear some resemblance to common metabolic disorders managed by adult endocrinologists.