{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T11:53:25Z","timestamp":1792151605464,"version":"4.4.0"},"reference-count":24,"publisher":"FapUNIFESP (SciELO)","issue":"9","license":[{"start":{"date-parts":[[2026,1,1]],"date-time":"2026-01-01T00:00:00Z","timestamp":1767225600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,1,1]],"date-time":"2026-01-01T00:00:00Z","timestamp":1767225600000},"content-version":"am","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,1,1]],"date-time":"2026-01-01T00:00:00Z","timestamp":1767225600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Rev. Assoc. Med. Bras."],"abstract":"<jats:p>SUMMARY  OBJECTIVE: The aim of this study was to characterize global scientific output on lipedema from 2000 to 2025 and identify emerging thematic trends, with emphasis on the emergence of immunological research.  METHODS: Publications indexed in Google Scholar, PubMed, Crossref, OpenAlex, and Scopus were retrieved using the terms \"lipedema\" OR \"lipoedema.\" Records were deduplicated by normalized title matching and DOI cross-referencing. Bibliometric indicators computed included publication volume, citation metrics, field h-index, exponential growth rate, geographic distribution, author metrics, specialty classification (journal-name keyword matching supplemented by OpenAlex concept tags), and immunological content (regular-expression pattern matching against a predefined term list).  RESULTS: A total of 942 unique publications were identified, accumulating 13,688 citations (field h-index=60; mean 14.5 citations per article; median 2 citations per article). Annual output grew from below 12 per year through 2009 to 145 in 2025, with a doubling time of 3.6 years (R2=0.90; p&lt;0.001). The United States, Germany, and Brazil were the most productive countries. Karen Lynn Herbst (USA) was the most influential researcher (46 papers; h-index=20; 1,586 citations). Lymphology and phlebology formed the dominant classifiable domain (17.1%), with 69.3% of publications spanning multiple disciplines. Publications with immunological content totaled 30 (3.2%), grew from essentially zero before 2019 to 4.8% of annual output in 2025, and received higher mean citations than non-immunological articles (16.6 vs. 14.5).  CONCLUSION: Lipedema research is undergoing rapid exponential expansion driven by growing global recognition of a historically neglected condition. The accelerating immunological trend, with consistently higher citation impact, indicates an accelerating paradigm shift toward chronic adipose tissue inflammation as a unifying pathophysiological framework.<\/jats:p>","DOI":"10.1590\/1806-9282.20260760","type":"journal-article","created":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T11:17:33Z","timestamp":1792149453000},"source":"Crossref","is-referenced-by-count":0,"title":["Lipedema research (2000\u20132025): a global bibliometric analysis with evidence of an emerging immunological paradigm"],"prefix":"10.1590","volume":"72","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4008-4029","authenticated-orcid":false,"given":"Alexandre Campos Moraes","family":"Amato","sequence":"first","affiliation":[{"name":"Amato Duo","place":["S\u00e3o Paulo, SP, Brazil"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5744-476X","authenticated-orcid":false,"given":"Juliana Lelis Spirandeli","family":"Amato","sequence":"additional","affiliation":[{"name":"Amato Duo","place":["S\u00e3o Paulo, SP, Brazil"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3295-1236","authenticated-orcid":false,"given":"Daniel Augusto","family":"Benitti","sequence":"additional","affiliation":[{"name":"Medical Valens Center","place":["S\u00e3o Paulo, SP, Brazil"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"530","published-online":{"date-parts":[[2026]]},"reference":[{"key":"ref1","article-title":"Lipedema prevalence and risk factors in Brazil","volume":"21","author":"Amato ACM","year":"2022","journal-title":"J Vasc Bras"},{"key":"ref2","doi-asserted-by":"crossref","first-page":"184","DOI":"10.1016\/S0025-6196(25)37697-4","article-title":"Lipedema of the legs: a syndrome characterized by fat legs and orthostatic edema","volume":"15","author":"Allen EV","year":"1940","journal-title":"Proc Staff Meet Mayo 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diagnosis and treatment of the disproportional fatty deposition syndrome \u2013 systematic review","volume":"2","author":"Forner-Cordero I","year":"2012","journal-title":"Clin Obes"},{"issue":"22-3","key":"ref7","first-page":"396","article-title":"Lipedema: pathogenesis, diagnosis, and treatment options","volume":"117","author":"Kruppa P","year":"2020","journal-title":"Dtsch Arztebl Int"},{"issue":"10","key":"ref8","doi-asserted-by":"crossref","first-page":"779","DOI":"10.1177\/02683555211015887","article-title":"Standard of care for lipedema in the United States","volume":"36","author":"Herbst KL","year":"2021","journal-title":"Phlebology"},{"issue":"8","key":"ref9","first-page":"1141","article-title":"S2k guideline lipedema","volume":"22","author":"Faerber G","year":"2024","journal-title":"J Dtsch Dermatol Ges"},{"issue":"5","key":"ref10","first-page":"457","article-title":"National survey of patient symptoms and therapies among 707 women with a lipedema diagnosis in the United States","volume":"28","author":"Aday WA","year":"2023","journal-title":"Vasc Med"},{"issue":"3","key":"ref11","doi-asserted-by":"crossref","first-page":"1599","DOI":"10.3390\/ijms25031599","article-title":"Observational study on a large Italian population with lipedema: biochemical and clinical features","volume":"25","author":"Patton L","year":"2024","journal-title":"Int J Mol Sci"},{"key":"ref12","doi-asserted-by":"crossref","first-page":"8747461","DOI":"10.1155\/2019\/8747461","article-title":"Dilated blood and lymphatic microvessels, angiogenesis, increased macrophages, and adipocyte hypertrophy in lipedema thigh skin and fat tissue","volume":"2019","author":"Al-Ghadban S","year":"2019","journal-title":"J Obes"},{"issue":"11","key":"ref13","doi-asserted-by":"crossref","first-page":"2215","DOI":"10.1002\/asi.23329","article-title":"Growth rates of modern science: a bibliometric analysis based on the number of publications and cited references","volume":"66","author":"Bornmann 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hypertrophy, subcutaneous adipose tissue inflammation and interstitial fibrosis","volume":"14","author":"Kruppa P","year":"2023","journal-title":"Front Immunol"},{"key":"ref18","doi-asserted-by":"crossref","first-page":"1004609","DOI":"10.3389\/fimmu.2022.1004609","article-title":"A distinct M2 macrophage infiltrate and transcriptomic profile decisively influence adipocyte differentiation in lipedema","volume":"13","author":"Wolf S","year":"2022","journal-title":"Front Immunol"},{"key":"ref19","doi-asserted-by":"crossref","first-page":"10947","DOI":"10.1038\/s41598-020-67987-3","article-title":"Increased levels of VEGF-C and macrophage infiltration in lipedema patients without corresponding lymphangiogenesis and clinical lymphedema","volume":"10","author":"Felmerer G","year":"2020","journal-title":"Sci Rep"},{"issue":"8","key":"ref20","doi-asserted-by":"crossref","first-page":"7591","DOI":"10.3390\/ijms24087591","article-title":"A comparative analysis to dissect the histological and 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