{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T21:41:07Z","timestamp":1791409267787,"version":"4.3.3"},"reference-count":46,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2025,3,12]],"date-time":"2025-03-12T00:00:00Z","timestamp":1741737600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100015913","name":"Institut des Origines de Lyon","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100015913","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Obesity"],"published-print":{"date-parts":[[2025,4]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>This study aimed to evaluate adipose tissue of lipedema patients.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Gluteo\u2010femoral (affected area) and interscapular (nonaffected area) adipose tissue from 10 lean patients affected by lipedema stage 1 to 2 was studied and compared with tissue from 10 patients with obesity and 12 lean patients.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The main features were alterations of capillaries with wall thickening (<jats:italic>p<\/jats:italic> \u2264\u20090.0001), endothelial and pericyte hyperplasia (<jats:italic>p<\/jats:italic> =\u20090.03 and <jats:italic>p<\/jats:italic> =\u20090.004), hypodense areas in basal membrane, and endothelial degeneration with exfoliation of degenerated cells into the capillary lumen. Adipocytes were larger (hypertrophic) in affected (<jats:italic>P<\/jats:italic> \u2264\u20090.0001) and nonaffected (<jats:italic>p<\/jats:italic> =\u20090.0003) areas compared with those with obesity and who were lean (both <jats:italic>p<\/jats:italic> \u2264\u20090.0001). Frequently the cytoplasm of adipocytes contained massive deposition of calcium crystals as revealed by Von Kossa staining (<jats:italic>p<\/jats:italic> =\u20090.023) and electron microscopy. CD68 immunoreactive macrophages were more abundant in affected areas (<jats:italic>p<\/jats:italic> =\u20090.005), and their number was similar to that found in fat from patients with obesity (<jats:italic>p<\/jats:italic> =\u20090.17). Despite adipocyte hypertrophy and inflammation, lack of the healthy marker perilipin\u20101 and the presence of crown\u2010like structures were only rarely seen, while they were quite frequent in patients with obesity.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Our data support the idea that cell alterations happen in the early stages of adipocyte development (endothelium\/pericyte) in the adipose organ of women affected by lipedema.<\/jats:p><\/jats:sec>","DOI":"10.1002\/oby.24244","type":"journal-article","created":{"date-parts":[[2025,3,13]],"date-time":"2025-03-13T01:39:04Z","timestamp":1741829944000},"page":"695-708","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":24,"title":["Endothelial cell alterations in capillaries of adipose tissue from patients affected by lipedema"],"prefix":"10.1002","volume":"33","author":[{"given":"Sandro","family":"Michelini","sequence":"first","affiliation":[{"name":"Vascular Diagnostics and Rehabilitation Service Marino Hospital  Rome Italy"},{"name":"Physical Medicine and Rehabilitation San Giovanni Battista Hospital  Rome Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stefania","family":"Greco","sequence":"additional","affiliation":[{"name":"Department of Experimental and Clinical Medicine, Center of Obesity Universit\u00e0 Politecnica delle Marche (Polytechnic University of Marche)  Ancona Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicola","family":"Vaia","sequence":"additional","affiliation":[{"name":"Plastic, Reconstructive and Aesthetic Surgery European Hospital  Rome Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Valeria","family":"Puleo","sequence":"additional","affiliation":[{"name":"Department of Science and Public Health Catholic University Policlinico Gemelli  Rome Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pamela","family":"Pellegrino","sequence":"additional","affiliation":[{"name":"Department of Experimental and Clinical Medicine, Center of Obesity Universit\u00e0 Politecnica delle Marche (Polytechnic University of Marche)  Ancona Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Angelica","family":"Di Vincenzo","sequence":"additional","affiliation":[{"name":"Department of Experimental and Clinical Medicine, Center of Obesity Universit\u00e0 Politecnica delle Marche (Polytechnic University of Marche)  Ancona Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Serena","family":"Michelini","sequence":"additional","affiliation":[{"name":"Physical Medicine and Rehabilitation San Giovanni Battista Hospital  Rome Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karen L.","family":"Herbst","sequence":"additional","affiliation":[{"name":"The Roxbury Institute  Tucson Arizona USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gaia","family":"Goteri","sequence":"additional","affiliation":[{"name":"Department of Biomedical Sciences and Public Health, Section of Pathological Anatomy and Histopathology Universit\u00e0 Politecnica delle Marche (Polytechnic University of Marche)  Ancona Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tonia","family":"Luca","sequence":"additional","affiliation":[{"name":"Department of Medical, Surgical Sciences and Advanced Technologies \"G.F. 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Ingrassia\" University of Catania  Catania Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Antonio","family":"Giordano","sequence":"additional","affiliation":[{"name":"Department of Experimental and Clinical Medicine, Center of Obesity Universit\u00e0 Politecnica delle Marche (Polytechnic University of Marche)  Ancona Italy"},{"name":"Istituto di Ricovero e Cura a Carattere Scientifico (Scientific Institute for Research, Hospitalization and Health Care), Istituto Nazionale di Ricovero e Cura per Anziani (National Institute of Hospitalization and Care for the Elderly) (IRCCS\/INRCA)  Ancona Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4400-3786","authenticated-orcid":false,"given":"Pasquapina","family":"Ciarmela","sequence":"additional","affiliation":[{"name":"Department of Experimental and Clinical Medicine, Center of Obesity Universit\u00e0 Politecnica delle Marche (Polytechnic University of Marche)  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