Adipose Tissue Metabolism in Benign Symmetric Lipomatosis

Date: 
01-01-2001

Type 2 benign symmetric lipomatosis (BSL) is characterized by
abnormal growth of adipose tissue in the upper back, deltoid region,
upper arms, hips, and upper thigh region. Studies of lipomatous tissue
in vitro have suggested that defective lipolysis may account for excess
fat accumulation; however, in vivo adipose tissue metabolism has not
been evaluated. We measured systemic adipose tissue lipolysis and
regional adipose tissue fatty acid uptake in a patient with type 2 BSL
scheduled for elective brachioplasty. We found increased, rather than
decreased, rates of systemic free fatty acid release coupled with normal
fatty acid oxidation. The uptake of fatty acids was 19% greater
in deltoid region lipomatous tissue than in abdominal sc fat, whereas
in control studies the relative uptake of fatty acids in deltoid fat
averaged 29% less than that in abdominal fat. Adipocyte size was
smaller than expected in lipomatous tissue. These results suggest
that type 2 BSL is a hyperplastic adipose tissue abnormality that does
not impair systemic lipolysis. The pathophysiology appears similar to
what has been termed hyperplastic obesity. A better understanding
of this condition could lead to insights into the mechanisms of hyperplastic
obesity.

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Authors: 
SØREN NIELSEN, JAMES LEVINE, RICKY CLAY, AND MICHAEL D. JENSEN