A recently published article in Obesity[1] has highlighted significant changes in the adipose tissue of patients with lipedema.
The study demonstrated that in lipedema, some endothelial cells move to the periphery of the vessel wall, transforming into pericytes. These pericytes subsequently differentiate into preadipocytes and then adipocytes, reaching volumes up to twice those of adipocytes in healthy or obese individuals.
In simpler terms, these changes mainly involve alterations in the cells lining the blood capillaries, known as endothelial cells, and pericytes, the supportive cells of capillaries. Such changes include marked thickening of capillary walls, proliferation of endothelial cells and pericytes, fragile areas of basement membrane, and cellular degeneration phenomena leading to cells detaching and falling into the capillary lumen.
It was also observed that adipocytes, the cells responsible for storing fat in the body, are significantly larger in lipedema-affected areas compared to those in obese patients or lean individuals. Another notable finding was the frequent presence of calcium crystals within adipocytes, identified using advanced microscopy techniques and specialized laboratory staining methods.
From an inflammatory perspective, lipedema-affected adipose tissue shows a substantial presence of macrophages—immune cells involved in inflammatory processes. However, the so-called “crown-like structures,” typical inflammatory features commonly observed in obese patients, are relatively rare in lipedema.
These findings suggest new directions in understanding this pathology, highlighting that endothelial cells and pericytes might play a central role in the development of lipedema. The proliferation of these cells in capillaries could serve as an early indicator of the disease, opening possibilities for developing innovative diagnostic tools based on specific vascular markers.
The study compared biopsies from areas typically affected by lipedema, such as the gluteo-femoral region, with body areas generally unaffected, like the interscapular region. Samples from 10 lean lipedema patients were analyzed and compared to those from 10 obese patients and 12 healthy controls. The analyses were conducted using advanced microscopy techniques and specific histological methods.
In conclusion, this research offers significant insights for improving the diagnosis and treatment of lipedema, emphasizing the importance of analyzing vascular alterations to develop targeted therapies in the future.
[1] by Sandro Michelini | Stefania Greco | Nicola Vaia | Valeria Puleo | Pamela Pellegrino | Karen L. Herbst | Antonio Giordano | Angelica Di Vincenzo | Serena Michelini | Gaia Goteri | Tonia Luca | Sergio Castorina | Pasquapina Ciarmela | Saverio Cinti
Obesity - 2025 - Michelini - Endothelial cell alterations in capillaries of adipose tissue from patients affected by (1)
