title: Lipoatrophic diabetes in an elderly woman: clinical course and serum adipocytokine concentrations.
abstract: Generalized lipodystrophy is a rare disorder of adipose tissue, whose etiology remains unknown. Pathophysiology of this disorder is characterized by generalized loss of body fat associated with an infrequent form of diabetes mellitus (lipoatrophic diabetes). Main features of this form of diabetes mellitus are the severe insulin resistance and the absence of ketoacidosis. Lipodystrophy can be congenital or acquired. In the acquired form, metabolic disturbances usually begin in the first years of life and the response to conventional treatment is very poor. Some alterations in serum adipocytokines have been described in this disease. We report the case of a 74-year-old woman with acquired generalized lipodystrophy who presented with low-normal serum concentrations of leptin, low adiponectin and resistin levels, and high serum levels of TNF alpha. Patient was initially treated with fenofibrate, metformin and high doses of subcutaneous insulin achieving an adequate metabolic control. During this period, serum adipocytokines were periodically measured. We comment on the different etiopathogenic mechanisms and the therapeutic modalities of this rare syndrome.
authors.affiliation: Department of Endocrinology, Hospital General, Ctra Avila s/n, 40002-Segovia, Spain.
authors.forename: Pedro
authors.initials: P
authors.lastname: Iglesias
authors.forename: Pilar
authors.initials: P
authors.lastname: Alvarez Fidalgo
authors.forename: Rosa
authors.initials: R
authors.lastname: Codoceo
authors.forename: Juan J
authors.initials: JJ
authors.lastname: Díez
mesh_terms: D052242:Adiponectin; D000368:Aged; D001786:Blood Glucose / Q000032:analysis; D016207:Cytokines / Q000097:blood*; D003923:Diabetes Mellitus, Lipoatrophic / Q000097:blood / Q000175:diagnosis* / Q000188:drug therapy; D003924:Diabetes Mellitus, Type 2 / Q000150:complications; D005260:Female; D011345:Fenofibrate / Q000627:therapeutic use; D006729:Hormones, Ectopic / Q000097:blood; D006801:Humans; D007328:Insulin / Q000008:administration & dosage; D036341:Intercellular Signaling Peptides and Proteins / Q000097:blood; D020738:Leptin / Q000097:blood; D008687:Metformin / Q000627:therapeutic use; D052243:Resistin; D014409:Tumor Necrosis Factor-alpha / Q000032:analysis; D015431:Weight Loss
chemical_list: D052242:Adiponectin; D001786:Blood Glucose; D016207:Cytokines; D006729:Hormones, Ectopic; D007328:Insulin; D036341:Intercellular Signaling Peptides and Proteins; D020738:Leptin; C499624:RETN protein, human; D052243:Resistin; D014409:Tumor Necrosis Factor-alpha; D008687:Metformin; D011345:Fenofibrate