{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,19]],"date-time":"2026-02-19T00:19:06Z","timestamp":1771460346640,"version":"3.50.1"},"reference-count":15,"publisher":"American Diabetes Association","issue":"10","license":[{"start":{"date-parts":[[2018,9,20]],"date-time":"2018-09-20T00:00:00Z","timestamp":1537401600000},"content-version":"vor","delay-in-days":9,"URL":"http:\/\/www.diabetesjournals.org\/content\/license"}],"funder":[{"DOI":"10.13039\/100000062","name":"NIH","doi-asserted-by":"publisher","award":["R01-DK-088114"],"award-info":[{"award-number":["R01-DK-088114"]}],"id":[{"id":"10.13039\/100000062","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000062","name":"NIH","doi-asserted-by":"publisher","award":["P30-DK-089503"],"award-info":[{"award-number":["P30-DK-089503"]}],"id":[{"id":"10.13039\/100000062","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000062","name":"NIH","doi-asserted-by":"publisher","award":["P30-DK-034933"],"award-info":[{"award-number":["P30-DK-034933"]}],"id":[{"id":"10.13039\/100000062","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["diabetesjournals.org"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2018,10,1]]},"abstract":"<jats:sec>\n                  <jats:title>OBJECTIVE<\/jats:title>\n                  <jats:p>Lipodystrophy syndromes are a heterogeneous group of disorders associated with selective absence of fat. Currently, the diagnosis is established only clinically.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>RESEARCH DESIGN AND METHODS<\/jats:title>\n                  <jats:p>We developed a new method from DXA scans called a \u201cfat shadow,\u201d which is a color-coded representation highlighting only the fat tissue. We conducted a blinded retrospective validation study to assess its usefulness for the diagnosis of lipodystrophy syndromes.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>RESULTS<\/jats:title>\n                  <jats:p>We evaluated the fat shadows from 16 patients (11 female and 5 male) with generalized lipodystrophy (GL), 57 (50 female and 7 male) with familial partial lipodystrophy (FPLD), 2 (1 female and 1 male) with acquired partial lipodystrophy, and 126 (90 female and 36 male) control subjects. FPLD was differentiated from control subjects with 85% sensitivity and 96% specificity (95% CIs 72\u201393 and 91\u201399, respectively). GL was differentiated from nonobese control subjects with 100% sensitivity and specificity (95% CIs 79\u2013100 and 92\u2013100, respectively).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>CONCLUSIONS<\/jats:title>\n                  <jats:p>Fat shadows provided sufficient qualitative information to infer clinical phenotype and differentiate these patients from appropriate control subjects. We propose that this method could be used to support the diagnosis.<\/jats:p>\n               <\/jats:sec>","DOI":"10.2337\/dc18-0978","type":"journal-article","created":{"date-parts":[[2018,9,20]],"date-time":"2018-09-20T19:25:42Z","timestamp":1537471542000},"page":"2255-2258","update-policy":"https:\/\/doi.org\/10.2337\/ada-journal-policies","source":"Crossref","is-referenced-by-count":37,"title":["\u201cFat Shadows\u201d From DXA for the Qualitative Assessment of Lipodystrophy: When a Picture Is Worth a Thousand Numbers"],"prefix":"10.2337","volume":"41","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4026-5049","authenticated-orcid":false,"given":"Rasimcan","family":"Meral","sequence":"first","affiliation":[{"name":"Division of Metabolism, Endocrinology and Diabetes, Department of Internal Medicine, University of Michigan Medical School, Ann Arbor, MI"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Benjamin J.","family":"Ryan","sequence":"additional","affiliation":[{"name":"Substrate Metabolism Laboratory, School of Kinesiology, University of Michigan, Ann Arbor, MI"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Noemi","family":"Malandrino","sequence":"additional","affiliation":[{"name":"Diabetes, Endocrinology, and Obesity Branch, National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Bethesda, MD"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Abdelwahab","family":"Jalal","sequence":"additional","affiliation":[{"name":"Division of Metabolism, Endocrinology and Diabetes, Department of Internal Medicine, University of Michigan Medical School, Ann Arbor, MI"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Adam H.","family":"Neidert","sequence":"additional","affiliation":[{"name":"Division of Metabolism, Endocrinology and Diabetes, Department of Internal Medicine, University of Michigan Medical School, Ann Arbor, MI"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ranganath","family":"Muniyappa","sequence":"additional","affiliation":[{"name":"Diabetes, Endocrinology, and Obesity Branch, National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Bethesda, MD"},{"name":"Inter-Institute Endocrinology Training Program, National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Bethesda, MD"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bar\u0131\u015f","family":"Ak\u0131nc\u0131","sequence":"additional","affiliation":[{"name":"Division of Endocrinology, Dokuz Eyl\u00fcl University, Izmir, Turkey"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jeffrey F.","family":"Horowitz","sequence":"additional","affiliation":[{"name":"Substrate Metabolism Laboratory, School of Kinesiology, University of Michigan, Ann Arbor, MI"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rebecca J.","family":"Brown","sequence":"additional","affiliation":[{"name":"Diabetes, Endocrinology, and Obesity Branch, National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Bethesda, MD"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9171-1144","authenticated-orcid":false,"given":"Elif A.","family":"Oral","sequence":"additional","affiliation":[{"name":"Division of Metabolism, Endocrinology and Diabetes, Department of Internal Medicine, University of Michigan Medical School, Ann Arbor, MI"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1167","published-online":{"date-parts":[[2018,9,11]]},"reference":[{"key":"2022031301240650700_B1","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1159\/000316893","article-title":"Human lipodystrophies: genetic and acquired diseases of adipose 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