{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,19]],"date-time":"2026-01-19T21:40:44Z","timestamp":1768858844125,"version":"3.49.0"},"reference-count":39,"publisher":"MDPI AG","issue":"1","license":[{"start":{"date-parts":[[2026,1,17]],"date-time":"2026-01-17T00:00:00Z","timestamp":1768608000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Life"],"abstract":"<jats:p>Lipodystrophy is a rare group of metabolic disorders characterized by the abnormal distribution of body fat, which can lead to various metabolic complications due to the body\u2019s inability to adequately process carbohydrates and fat. We report the case of a female, aged 53 years, who was admitted as an outpatient for progressive weight loss of the upper part of the body (face, neck, arms, and chest), dyspeptic complaints, fatigue, mild insomnia, and anxious behavior. Her medical history was characterized by the presence of dyslipidemia, hypertension, and a minor stroke episode. However, she denied any family-relevant medical history. Although the clinical perspective suggested a possible late onset of partial acquired lipodystrophy, due to the imaging exam that revealed an enlarged liver with inhomogeneous structure with multiple nodular lesions, scattered over both lobes, a lot of lab work-ups and complementary studies were performed. Eventually, a liver biopsy was performed by a laparoscopic approach during cholecystectomy, the histology consistent with metabolic disease-associated steatohepatitis (MASH). In conclusion, given their heterogeneity and rarity, lipodystrophies may be either overlooked or misdiagnosed for other entities. Barraquer\u2013Simons syndrome (BSS) may be associated with liver disease, including cirrhosis and liver failure. Liver lipodystrophy in BSS may sometimes feature steatosis with a focal, multi-nodular aspect, multiplying the diagnostic burden. Liver lipodystrophy may manifest as asymptomatic fat accumulation but may progress to severe conditions, representing one of the major causes of mortality in BSS, apart from the cardio-vascular comorbidities. Given the potential of severe outcomes, it is mandatory to correctly assess the stage of liver disease since the first diagnosis.<\/jats:p>","DOI":"10.3390\/life16010156","type":"journal-article","created":{"date-parts":[[2026,1,19]],"date-time":"2026-01-19T08:23:56Z","timestamp":1768811036000},"page":"156","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Liver Lipodystrophy in Barraquer\u2013Simons Syndrome: How Much Should We Worry About?"],"prefix":"10.3390","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9622-6618","authenticated-orcid":false,"given":"Doina","family":"Georgescu","sequence":"first","affiliation":[{"name":"Department of Internal Medicine I, Center of Advanced Research in Cardiovascular Diseases and Hemostaseology, University of Medicine and Pharmacy Victor Babes, 2 Eftimie Murgu Plaza, 300041 Timisoara, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Daniel Florin","family":"Lighezan","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine I, Center of Advanced Research in Cardiovascular Diseases and Hemostaseology, University of Medicine and Pharmacy Victor Babes, 2 Eftimie Murgu Plaza, 300041 Timisoara, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7476-6584","authenticated-orcid":false,"given":"Roxana","family":"Buzas","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine I, Center of Advanced Research in Cardiovascular Diseases and Hemostaseology, University of Medicine and Pharmacy Victor Babes, 2 Eftimie Murgu Plaza, 300041 Timisoara, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Paul Gabriel","family":"Ciubotaru","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine I, Center of Advanced Research in Cardiovascular Diseases and Hemostaseology, University of Medicine and Pharmacy Victor Babes, 2 Eftimie Murgu Plaza, 300041 Timisoara, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1293-7664","authenticated-orcid":false,"given":"Oana Elena","family":"\u021aunea","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine I, Center of Advanced Research in Cardiovascular Diseases and Hemostaseology, University of Medicine and Pharmacy Victor Babes, 2 Eftimie Murgu Plaza, 300041 Timisoara, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ioana","family":"Suceava","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine I, Center of Advanced Research in Cardiovascular Diseases and Hemostaseology, University of Medicine and Pharmacy Victor Babes, 2 Eftimie Murgu Plaza, 300041 Timisoara, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Teodora Anca","family":"Albu","sequence":"additional","affiliation":[{"name":"Department of Physics, West University of Timisoara, 4 Vasile Parvan Blvd, 300223 Timisoara, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0898-795X","authenticated-orcid":false,"given":"Aura","family":"Jurescu","sequence":"additional","affiliation":[{"name":"Department of Morphopathology, Microscopic Morphology, University of Medicine and Pharmacy Victor Babes, 2 Eftimie Murgu Plaza, 300041 Timisoara, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mihai","family":"Ioni\u021b\u0103","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine I, Center of Advanced Research in Cardiovascular Diseases and Hemostaseology, University of Medicine and Pharmacy Victor Babes, 2 Eftimie Murgu Plaza, 300041 Timisoara, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6288-3601","authenticated-orcid":false,"given":"Daniela","family":"Reisz","sequence":"additional","affiliation":[{"name":"Department of Neurosciences, University of Medicine and Pharmacy Victor Babes, 2 Eftimie Murgu Plaza, 300041 Timisoara, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2026,1,17]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"109","DOI":"10.1016\/j.metabol.2017.04.010","article-title":"Clinical presentations, metabolic abnormalities, and end-organ complications in patients with familial partial lipodystrophy","volume":"72","author":"Akinci","year":"2017","journal-title":"Metabolism"},{"key":"ref_2","doi-asserted-by":"crossref","unstructured":"Oliveira, J., Freitas, P., Lau, E., and Carvalho, D. (2016). Barraquer-Simons syndrome: A rare form of acquired lipodystrophy. BMC Res. Notes, 18.","DOI":"10.1186\/s13104-016-1975-9"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"1086","DOI":"10.1016\/j.metabol.2015.06.004","article-title":"Acquired partial lipodystrophy is associated with increased risk for developing metabolic abnormalities","volume":"64","author":"Akinci","year":"2015","journal-title":"Metabolism"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"bvaf067","DOI":"10.1210\/jendso\/bvaf067","article-title":"Changes After Leptin Administration in Partial Lipodystrophy and Factors Associated with Hepatic and Metabolic Response","volume":"9","author":"Akinci","year":"2025","journal-title":"J. Endocr. Soc."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"66","DOI":"10.1016\/j.metabol.2019.05.001","article-title":"Fatty liver in lipodystrophy: A review with a focus on therapeutic perspectives of adiponectin and\/or leptin replacement","volume":"96","author":"Polyzos","year":"2019","journal-title":"Metabolism"},{"key":"ref_6","doi-asserted-by":"crossref","unstructured":"Georgescu, D., Lighezan, D.F., Rosca, C.I., Nistor, D., Ancusa, O.E., Suceava, I., Iancu, M.A., and Kundnani, N.R. (2024). NASH\/NAFLD-Related Hepatocellular Carcinoma: An Added Burden. Life, 14.","DOI":"10.3390\/life14010025"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"3","DOI":"10.1038\/s41387-024-00260-y","article-title":"Clinical and imaging features of women with polygenic partial lipodystrophy: A case series","volume":"14","author":"Loh","year":"2024","journal-title":"Nutr. Diabetes"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"S42","DOI":"10.1016\/j.dld.2022.01.084","article-title":"Liver disease and lipodystrophy: Data from an Italian cohort","volume":"54","author":"Salvati","year":"2022","journal-title":"Dig. Liver Dis."},{"key":"ref_9","doi-asserted-by":"crossref","unstructured":"Bozic, D., Podrug, K., Mikolasevic, I., and Grgurevic, I. (2022). Ultrasound Methods for the Assessment of Liver Steatosis: A Critical Appraisal. Diagnostics, 12.","DOI":"10.3390\/diagnostics12102287"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"e222695","DOI":"10.1148\/radiol.222695","article-title":"Diagnosis and Monitoring of Nonalcoholic Steatohepatitis: Current State and Future Directions","volume":"310","author":"Kadi","year":"2024","journal-title":"Radiology"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"4437","DOI":"10.1007\/s00261-024-04407-4","article-title":"Diffuse and focal liver fat: Advanced imaging techniques and diagnostic insights","volume":"49","author":"Miranda","year":"2024","journal-title":"Abdom. Radiol."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"182","DOI":"10.1186\/s13098-023-01156-0","article-title":"Waist circumference is independently associated with liver steatosis and fibrosis in LMNA-related and unrelated Familial Partial Lipodystrophy women","volume":"15","author":"Viola","year":"2023","journal-title":"Diabetol. Metab. Syndr."},{"key":"ref_13","doi-asserted-by":"crossref","unstructured":"Buzas, R., Ciubotaru, P., Faur, A.C., Preda, M., Ardelean, M., Georgescu, D., Dumitrescu, P., Lighezan, D.F., and Popa, M.D. (2024). Correlation of the FIB-4 Liver Biomarker Score with the Severity of Heart Failure. Medicina, 60.","DOI":"10.3390\/medicina60121943"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"20170959","DOI":"10.1259\/bjr.20170959","article-title":"Liver fat imaging\u2014A clinical overview of ultrasound, CT, and MR imaging","volume":"91","author":"Zhang","year":"2018","journal-title":"Br. J. Radiol."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"489","DOI":"10.1007\/s10396-021-01106-1","article-title":"Quantitative assessment of liver steatosis using ultrasound controlled attenuation parameter (Echosens)","volume":"48","author":"Ferraioli","year":"2021","journal-title":"J. Med. Ultrason."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"S5","DOI":"10.3350\/cmh.2022.0424","article-title":"Non-alcoholic fatty liver disease: Definition and subtypes","volume":"29","author":"Han","year":"2023","journal-title":"Clin. Mol. Hepatol."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"46","DOI":"10.1007\/s11892-025-01602-5","article-title":"Lipodystrophy Syndromes: One Name but Many Diseases Highlighting the Importance of Adipose Tissue in Metabolism","volume":"25","author":"Gilio","year":"2025","journal-title":"Curr. Diabetes Rep."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"131","DOI":"10.1016\/j.jhep.2013.02.007","article-title":"The liver diseases of lipodystrophy: The long-term effect of leptin treatment","volume":"59","author":"Lungu","year":"2013","journal-title":"J. Hepatol."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"698","DOI":"10.1111\/cen.13311","article-title":"Spectrum of disease associated with partial lipodystrophy: Lessons from a trial cohort","volume":"86","author":"Ajluni","year":"2017","journal-title":"Clin. Endocrinol."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"143","DOI":"10.1007\/s11892-018-1099-9","article-title":"Phenotypic and Genetic Characteristics of Lipodystrophy: Pathophysiology, Metabolic Abnormalities, and Comorbidities","volume":"18","author":"Akinci","year":"2018","journal-title":"Curr. Diabetes Rep."},{"key":"ref_21","doi-asserted-by":"crossref","unstructured":"Fourman, L.T., Lima, J.G., Simha, V., Cappa, M., Alyaarubi, S., Montenegro, R., Akinci, B., and Santini, F. (2024). A rapid action plan to improve diagnosis and management of lipodystrophy syndromes. Front. Endocrinol., 15.","DOI":"10.3389\/fendo.2024.1383318"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"588","DOI":"10.5152\/tjg.2020.19114","article-title":"Magnetic resonance spectroscopy to assess hepatic steatosis in patients with lipodystrophy","volume":"31","author":"Altay","year":"2020","journal-title":"Turk. J. Gastroenterol."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"484","DOI":"10.1007\/s11604-007-0166-y","article-title":"Computed tomography findings of congenital generalized lipodystrophy: Multiple nodular fatty liver and diffuse sclerosis of bones","volume":"25","author":"Shinya","year":"2007","journal-title":"Radiat. Med."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"136","DOI":"10.1186\/s13098-022-00908-8","article-title":"Reduced gut microbiota diversity in patients with congenital generalized lipodystrophy","volume":"14","author":"Ponte","year":"2022","journal-title":"Diabetol. Metab. Syndr."},{"key":"ref_25","doi-asserted-by":"crossref","unstructured":"Bahitham, W., Alghamdi, S., Omer, I., Alsudais, A., Hakeem, I., Alghamdi, A., Abualnaja, R., Sanai, F.M., Rosado, A.S., and Sergi, C.M. (2024). Double Trouble: How Microbiome Dysbiosis and Mitochondrial Dysfunction Drive Non-Alcoholic Fatty Liver Disease and Non-Alcoholic Steatohepatitis. Biomedicines, 12.","DOI":"10.3390\/biomedicines12030550"},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"1756","DOI":"10.12688\/f1000research.20150.1","article-title":"Recent advances in understanding lipodystrophy: A focus on lipodystrophy-associated cardiovascular disease and potential effects of leptin therapy on cardiovascular function","volume":"8","author":"Kress","year":"2019","journal-title":"F1000Research"},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"65","DOI":"10.2478\/jce-2018-0008","article-title":"Nuclear Transcription Factor Kappa B (NF-\u03baB) and Molecular Damage Mechanisms in Acute Cardiovascular Diseases. A Review","volume":"4","author":"Buzas","year":"2018","journal-title":"J. Cardiovasc. Emergencies"},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"107","DOI":"10.1210\/clinem\/dgaf315","article-title":"Clinical Features, Metabolic and Autoimmune Derangements in Acquired Partial Lipodystrophy (Barraquer\u2013Simons Syndrome)","volume":"111","author":"Kaewkrasaesin","year":"2025","journal-title":"J. Clin. Endocrinol. Metab."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"71","DOI":"10.1186\/s13098-018-0375-9","article-title":"Pancreatic fat deposition is increased and related to beta-cell function in women with familial partial lipodystrophy","volume":"10","author":"Valerio","year":"2018","journal-title":"Diabetol. Metab. Syndr."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"e1204","DOI":"10.1210\/clinem\/dgad606","article-title":"Deciphering the clinical presentations in LMNA-related lipodystrophy: Report of 115 cases and a systematic review","volume":"109","author":"Besci","year":"2023","journal-title":"J. Clin. Endocrinol. Metab."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"65","DOI":"10.1111\/cen.13732","article-title":"Renal complications of lipodystrophy: A closer look at the natural history of kidney disease","volume":"89","author":"Akinci","year":"2018","journal-title":"Clin. Endocrinol."},{"key":"ref_32","unstructured":"Feingold, K.R., Ahmed, S.F., Anawalt, B., Anawalt, B., Blackman, M.R., Chrousos, G., Corpas, E., de Herder, W.W., Dhatariya, K., and Dungan, K. (2024, August 21). Lipodystrophy Syndromes: Presentation and Treatment [Updated 21 August 2024], Endotext [Internet], Available online: https:\/\/www.ncbi.nlm.nih.gov\/books\/NBK513130\/."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"885","DOI":"10.1080\/03007995.2022.2059974","article-title":"Metreleptin for the treatment of lipodystrophy: Leading the way among novel therapeutics for this unmet clinical need","volume":"38","author":"Polyzos","year":"2022","journal-title":"Curr. Med. Res. Opin."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"565","DOI":"10.1080\/17446651.2025.2574318","article-title":"Advances of pharmacological therapies in lipodystrophy syndromes: Current evidence and future directions","volume":"20","author":"Besci","year":"2025","journal-title":"Expert Rev. Endocrinol. Metab."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"1526","DOI":"10.1111\/liv.15930","article-title":"The first MASH drug therapy on the horizon: Current perspectives of resmetirom","volume":"44","author":"Petta","year":"2024","journal-title":"Liver Int."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"94","DOI":"10.1016\/j.livres.2025.01.001","article-title":"New drug therapies for metabolic dysfunction-associated steatohepatitis","volume":"9","author":"Chiang","year":"2025","journal-title":"Liver Res."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"1401","DOI":"10.1080\/17474124.2022.2016391","article-title":"Effects of probiotics on nonalcoholic fatty liver disease: A systematic review and meta-analysis","volume":"15","author":"Yang","year":"2021","journal-title":"Expert Rev. Gastroenterol. Hepatol."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"3168","DOI":"10.1016\/j.jacc.2018.11.002","article-title":"AHA\/ACC\/AACVPR\/AAPA\/ABC\/ACPM\/ADA\/AGS\/APhA\/ASPC\/NLA\/PCNA Guideline on the management of blood cholesterol: Executive summary: A report of the American College of Cardiology\/American Heart Association Task Force on Clinical Practice Guidelines","volume":"73","author":"Grundy","year":"2019","journal-title":"JACC"},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"212","DOI":"10.1002\/kjm2.12800","article-title":"Recent advances in the treatment of type 2 diabetes mellitus using new drug therapies","volume":"40","author":"Chong","year":"2024","journal-title":"Kaohsiung J. Med. Sci."}],"container-title":["Life"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2075-1729\/16\/1\/156\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,1,19]],"date-time":"2026-01-19T08:33:24Z","timestamp":1768811604000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2075-1729\/16\/1\/156"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,1,17]]},"references-count":39,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2026,1]]}},"alternative-id":["life16010156"],"URL":"https:\/\/doi.org\/10.3390\/life16010156","relation":{},"ISSN":["2075-1729"],"issn-type":[{"value":"2075-1729","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,1,17]]}}}