TY - JOUR
T1 - Clinical features and management of non-HIV-related lipodystrophy in children
T2 - A systematic review
AU - Gupta, Nidhi
AU - Asi, Noor
AU - Farah, Wigdan
AU - Almasri, Jehad
AU - Barrionuevo, Patricia
AU - Alsawas, Mouaz
AU - Wang, Zhen
AU - Haymond, Morey W.
AU - Brown, Rebecca J.
AU - Murad, M. Hassan
N1 - Publisher Copyright:
© 2017 by the Endocrine Society.
PY - 2017/2/1
Y1 - 2017/2/1
N2 - Context: Lipodystrophy syndromes are characterized by generalized or partial absence of adipose tissue. Objective: We conducted a systematic review to synthesize data on clinical and metabolic features of lipodystrophy (age at onset,<, 18 years). Data Source: Sources included Medline, Embase, Cochrane Library, Scopus and Non-Indexed Citations from inception through January 2016. Study Selection: Search terms included lipodystrophy, and age 0 to 18 years. Patients with unambiguous diagnosis of lipodystrophy were included. Lipodystrophy secondary to HIV treatment was excluded. Data Synthesis: We identified 1141 patients from 351 studies. Generalized fat loss involving face, neck, abdomen, thorax, and upper and lower limbs was explicitly reported in 65% to 93% of patients with congenital generalized lipodystrophy (CGL) and acquired generalized lipodystrophy (AGL). In familial partial lipodystrophy (FPL), fat loss occurred from upper and lower limbs, with sparing of face and neck. In acquired partial lipodystrophy (APL), upper limbs were involved while lower limbs were spared. Other features were prominent musculature, acromegaloid, acanthosis nigricans and hepatosplenomegaly. Diabetes mellitus was diagnosed in 48% (n = 222) of patients with CGL (mean age at onset, 5.3 years). Hypertriglyceridemia was observed in CGL, AGL and FPL. Multiple interventions were used, with most patients receiving ≥ 3 interventions and being ≥ 18 years of age at the initiation of interventions. Conclusions: To our knowledge, this is the largest reported pooled database describing lipodystrophy patients with age at onset,18 years.Wehave suggested core and supportive clinical features and summarized data on available interventions, outcomes and mortality.
AB - Context: Lipodystrophy syndromes are characterized by generalized or partial absence of adipose tissue. Objective: We conducted a systematic review to synthesize data on clinical and metabolic features of lipodystrophy (age at onset,<, 18 years). Data Source: Sources included Medline, Embase, Cochrane Library, Scopus and Non-Indexed Citations from inception through January 2016. Study Selection: Search terms included lipodystrophy, and age 0 to 18 years. Patients with unambiguous diagnosis of lipodystrophy were included. Lipodystrophy secondary to HIV treatment was excluded. Data Synthesis: We identified 1141 patients from 351 studies. Generalized fat loss involving face, neck, abdomen, thorax, and upper and lower limbs was explicitly reported in 65% to 93% of patients with congenital generalized lipodystrophy (CGL) and acquired generalized lipodystrophy (AGL). In familial partial lipodystrophy (FPL), fat loss occurred from upper and lower limbs, with sparing of face and neck. In acquired partial lipodystrophy (APL), upper limbs were involved while lower limbs were spared. Other features were prominent musculature, acromegaloid, acanthosis nigricans and hepatosplenomegaly. Diabetes mellitus was diagnosed in 48% (n = 222) of patients with CGL (mean age at onset, 5.3 years). Hypertriglyceridemia was observed in CGL, AGL and FPL. Multiple interventions were used, with most patients receiving ≥ 3 interventions and being ≥ 18 years of age at the initiation of interventions. Conclusions: To our knowledge, this is the largest reported pooled database describing lipodystrophy patients with age at onset,18 years.Wehave suggested core and supportive clinical features and summarized data on available interventions, outcomes and mortality.
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U2 - 10.1210/jc.2016-2271
DO - 10.1210/jc.2016-2271
M3 - Review article
C2 - 27967300
AN - SCOPUS:85012098055
SN - 0021-972X
VL - 102
SP - 363
EP - 374
JO - Journal of Clinical Endocrinology and Metabolism
JF - Journal of Clinical Endocrinology and Metabolism
IS - 2
ER -