Pandzic Jaksic V, Sucic M
Division of Endocrinology, Diabetes and Metabolic Diseases, Department of Internal Medicine, University Hospital Dubrava, Av. Gojka Suska 6, Zagreb, Croatia.
Med Hypotheses. 2008;71(1):99-101. doi: 10.1016/j.mehy.2008.01.028. Epub 2008 Mar 25.
Multiple symmetric lipomatosis (MSL) is characterized by subcutaneous accumulation of nonencapsulated adipose tissue. In type 2 MSL accumulation occurs on proximal limbs, upper back and hips. This sometimes unrecognized disease is similar to an exaggerated female fat distribution and can be confused with simple obesity. Obesity is a heterogeneous disorder and we suppose that type 2 MSL might have a place on the edge of the obesity spectrum. Several contemporary concepts about adipose tissue could be recognized in the model of MSL. Changes in fat distribution among different depots of adipose tissue in obesity have emerged as origin of its metabolic complications. Decreased insulin resistance and raised adiponectin have been found in MSL just as in some other conditions with accumulation of the subcutaneous adipose tissue (SAT). In that context, MSL may present as a model for possible favourable metabolic impact of SAT depots. Adipogenesis in MSL is not a consequence of energy excess but it is an active hyperplastic proliferation of SAT. This kind of behaviour of some adipocytes in several subcutaneous areas in MSL suggests that the energy unrelated adipogenesis could contribute to the expansion of at least a part of SAT depot in obesity in general. Contrary to current concept that the signals for adipogenesis are dependent only on the energy equation, allowing this additional mechanism would imply a new approach to issues of obesity, foremost to differentiate its particular types for which these concepts may be relevant.
多发性对称性脂肪瘤病（MSL）的特征是皮下出现无包膜的脂肪组织堆积。在2型MSL中，堆积发生在四肢近端、上背部和臀部。这种有时未被识别的疾病类似于女性夸张的脂肪分布，可能会与单纯性肥胖相混淆。肥胖是一种异质性疾病，我们认为2型MSL可能处于肥胖谱系的边缘位置。在MSL模型中可以识别出几种当代关于脂肪组织的概念。肥胖时不同脂肪储存部位之间脂肪分布的变化已成为其代谢并发症的根源。在MSL中发现胰岛素抵抗降低和脂联素升高，就像在其他一些皮下脂肪组织（SAT）堆积的情况中一样。在这种情况下，MSL可能作为SAT储存部位可能具有有利代谢影响的一个模型。MSL中的脂肪生成不是能量过剩的结果，而是SAT的一种活跃的增生性增殖。MSL中几个皮下区域的一些脂肪细胞的这种行为表明，与能量无关的脂肪生成可能总体上有助于肥胖中至少一部分SAT储存部位的扩张。与目前认为脂肪生成信号仅取决于能量平衡的概念相反，允许这种额外的机制将意味着对肥胖问题有一种新的方法，首先是区分这些概念可能相关的肥胖的特定类型。
