Lipodystrophy in Ecuador: A Critical Review of Its Low Visibility and Challenges in Differentiating It from Obesity in Clinical Practice

Authors

DOI:

https://doi.org/10.59653/jhsmt.v4i02.2227

Keywords:

lipodystrophy, Ecuador, obesity, lipohypertrophy

Abstract

The present systematic review of Ecuadorian academic literature (2015-2025) establishes that lipodystrophy is a nosological entity characterized by high clinical prevalence but low epidemiological visibility, with research predominantly concentrated on the therapeutic sequelae of diabetes mellitus and HIV/AIDS (SLAV). Evidence reveals that the condition's chronic underreporting is perpetuated by the diagnostic differentiation challenge, in which manifestations of lipoaccumulation (lipo-hypertrophy due to insulin or visceral fat due to HAART) are systematically subsumed under the umbrella of obesity in general clinical practice. This confusion hinders the identification of specific etiological factors and minimizes the recognition of the high metabolic and cardiovascular risks associated with these pathological adipose alterations. It is concluded that the imperative is to establish standardized national clinical protocols that mandate rigorous differential diagnosis for obesity, thereby reducing underreporting and ensuring specialized therapeutic intervention in Ecuador.

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References

Akinci, B., Gular, M. C., & Oral, E. A. (2024). Lipodystrophy Syndromes: Presentation and Treatment. https://www.ncbi.nlm.nih.gov/books/NBK513130/

Alemseged, T., Mohamed, A. A., Hailu, A. G., Hadgu, F. B., & Mohammedamin, M. M. (2024). Prevalence and associated factors of lipodystrophy in type 1 diabetic children and adolescents at Ayder Comprehensive Specialized Hospital, Tigray, Ethiopia. BMC Pediatrics, 24(1), 548. https://doi.org/10.1186/s12887-024-05018-0

Bagias, C., Xiarchou, A., Bargiota, A., & Tigas, S. (2020). Familial Partial Lipodystrophy (FPLD): Recent Insights. Diabetes, Metabolic Syndrome and Obesity, 13, 1531-1544. https://doi.org/10.2147/DMSO.S206053

Calderon, E., Ghattas, P. E., Salolín, V. P., García-González, O. Y., Fermín, M. D., Rueda, D. E., Campos, T., Sánchez, C., & Terán, C. (2025). A comprehensive guide to conduct a systematic review and meta-analysis in medical research. Medicine, 104(33), e41868. https://doi.org/10.1097/MD.0000000000041868

Ceccarini, G., Magno, S., Gilio, D., Pelosini, C., & Santini, F. (2021). Autoimmunity in lipodystrophy syndromes. La Presse Médicale, 50(3), 104073. https://doi.org/10.1016/j.lpm.2021.104073

Cecchetti, C., D’Apice, M. R., Morini, E., Novelli, G., Pizzi, C., Pagotto, U., & Gambineri, A. (2021). Case report: An atypical form of familial partial lipodystrophy type 2 due to mutation in the rod domain of lamin A/C. Frontiers in Endocrinology, 12, 675096. https://doi.org/10.3389/fendo.2021.675096

Cisneros, A. J., Vaca, A. L., Almeida, C. F., Ramírez, E. S., Vega, Y. M., Soria, Y. F., Hidalgo, A. F., & Pulupa, L. A. (2025). Diagnóstico y manejo de lipodistrofia en cirugía plástica corporal—Revisión actual de la literatura. Ibero-American Journal of Health Science Research, 5(2), 95-101. https://doi.org/10.56183/iberojhr.v5i2.777

Cruz, Y., Pinos Cedeño, M. J., Revelo, A., & Valdez Benalcazar, J. S. (2021). Lipoatrofia Facial Idiopática: A propósito de un caso. Anatomía Digital, 4(4), 15-22. https://doi.org/10.33262/anatomiadigital.v4i4.1887

Elachola, M. S., Sasikumarame, A. P., Lashari, U. G., Nazeer, H., Koduvayalil, R. H., Fathima, H., Ponnumundasseri, S. K., & Ririe, A. K. (2025). Mixed-methods study with a systematic review of personalized drug therapy approaches and survey analysis of pharmacogenomics in internal medicine. Cureus, 17(12), e100375. https://doi.org/10.7759/cureus.100375

Frías-Toral, E., Angamarca-Iguago, J., Calvo Higuera, I., Carriel-Mancilla, J., Contreras, G., Franco-Núñez, R., Larreátegui Arosemena, R., Maza Moscoso, C., Restrepo, J., Cagua-Ordoñez, J., Simancas-Racines, A., Reytor-González, C., & Simancas-Racines, D. (2025). Multilevel barriers to clinical and nutritional research in Latin America: A socioeconomic comparative analysis. Frontiers in Nutrition, 12, 1599344. https://doi.org/10.3389/fnut.2025.1599344

Giralt, M., Domingo, P., Quesada-López, T., Cereijo, R., & Villarroya, F. (2025). Lipodystrophy in HIV: Evolving Challenges and Unresolved Questions. International Journal of Molecular Sciences, 26(14), 6546. https://doi.org/10.3390/ijms26146546

Granizo-Rubio, J., Pinos-León, V., Madrigal, C., Moreno, A., & Ortiz-Prado, E. (2016). Síndrome de Barraquer-Simons o lipodistrofia parcial adquirida. Piel, 31(3), 184–188. https://doi.org/10.1016/j.piel.2015.05.005

Ibáñez, A., Maito, M., Botero-Rodríguez, F., Fittipaldi, S., Coronel, C., Migeot, J., Lacroix, A., Lawlor, B., Durán-Aniotz, C., Báez, S., & Santamaría-García, H. (2024). Healthy aging meta-analyses and scoping review of risk factors across Latin America reveal large heterogeneity and weak predictive models. Nature Aging, 4(8), 1153–1165. https://doi.org/10.1038/s43587-024-00648-6

Iglesias, C. E., Mesías, M., Morocho, F. B., Jerez, J. S., & Jami, J. E. (2024). Lipodistrofia en pacientes diagnosticados con virus de inmunodeficiencia humana. Revista de la Universidad de Ciencias Médicas de Guantánamo, 103, e4544. https://doi.org/10.5281/zenodo.10950623

Kelly, S. E., Brooks, S. P. J., Benkhedda, K., MacFarlane, A. J., Greene-Finestone, L. S., Skidmore, B., Clifford, T. J., & Wells, G. A. (2024). A scoping review shows that no single existing risk of bias assessment tool considers all sources of bias for cross-sectional studies. Journal of Clinical Epidemiology, 172, 111408. https://doi.org/10.1016/j.jclinepi.2024.111408

Knebel, B., Müller-Wieland, D., & Kotzka, J. (2020). Lipodystrophies—Disorders of the Fatty Tissue. International Journal of Molecular Sciences, 21(22), 8778. https://doi.org/10.3390/ijms21228778

Lima, J. G., Valerio, C. M., Godoy-Matos, A. F., Carvalho, G., Dantas, J. R., Nunes Salles, J. E., Gerchman, F., & Montenegro, R., Jr. (2025). Pathways to improving the awareness, diagnosis and management of lipodystrophy in Brazil: An expert panel discussion. Diabetology & Metabolic Syndrome, 17(1), 438. https://doi.org/10.1186/s13098-025-01990-4

Llerena, N. E. (2017). Incidencia de síndrome metabólico y su asociación con inhibidores de proteasa en pacientes con terapia antirretroviral. Hospital Vicente Corral Moscoso. Cuenca – Ecuador. Marzo – agosto 2016 [Master’s thesis, Universidad de Cuenca]. UCUENCA Repository. http://dspace.ucuenca.edu.ec/handle/123456789/27897

López, T. E., & López, T. V. (2019). Lipodistrofia en adultos con Diabetes Mellitus Tipo 2 en Hospital General Puyo. Mayo 2018—Enero 2019 [Undergraduate thesis, Escuela Superior Politécnica del Chimborazo]. ESPOCH Repository https://dspace.espoch.edu.ec/items/2e80013b-9141-4045-8d47-37836c2f5e1a

Lunny, C., Kanji, S., Thabet, P., Haidich, A. B., Bougioukas, K. I., & Pieper, D. (2024). Assessing the methodological quality and risk of bias of systematic reviews: Primer for authors of overviews of systematic reviews. BMJ Medicine, 3(1), e000604. https://doi.org/10.1136/bmjmed-2023-000604

Miranda, K., Ochoa, M., Giler, N., & Bonifaz, M. (2020). Lipodistrofia Congénita Generalizada. Informe de caso. Práctica Familiar Rural, 5(3). https://practicafamiliarrural.org/index.php/pfr/article/view/181

Musso, C. (2024). ¿Qué hay de nuevo en lipodistrofias? Revista de la Sociedad Argentina de Diabetes, 58(3Sup), 23-23. https://revistasad.com/index.php/diabetes/article/view/946/844

Nair, A. S. (2019). Publication bias – Importance of studies with negative results! Indian Journal of Anaesthesia, 63(6), 505–507. https://doi.org/10.4103/ija.IJA_142_19

Orellana, C. J., Pinos, E. A., Parra, M. R., & Vélez, E. P. (2022). Prevalencia de lipodistrofia en pacientes adultos con diabetes mellitus tipo 1 del hospital Luis Vernaza. Journal of American Health, 5(1). https://jah-journal.com/index.php/jah/article/view/122

Pacheco, A. E. (2015). Determinación de dislipidemias y su relación con el síndrome de lipodistrofia en pacientes con VIH positivo con tratamiento antirretroviral del Hospital Francisco de Orellana. [Undergraduate thesis, Universidad Técnica de Ambato]. UTA Repository. http://repositorio.uta.edu.ec/handle/123456789/9975

Page, M. J., McKenzie, J. E., Bossuyt, P. M., Boutron, I., Hoffmann, T. C., Mulrow, C. D., Shamseer, L., Tetzlaff, J. M., Akl, E. A., Brennan, S. E., Chou, R., Glanville, J., Grimshaw, J. M., Hróbjartsson, A., Lalu, M. M., Li, T., Loder, E. W., Mayo-Wilson, E., McDonald, S., McGuinness, L. A., Stewart, L. A., Thomas, J., Tricco, A. C., Welch, V. A., Whiting, P., & Moher, D. (2021). Declaración PRISMA 2020: Una guía actualizada para la publicación de revisiones sistemáticas. Revista Española de Cardiología, 74(9), 790–799. https://doi.org/10.1016/j.recesp.2021.06.016

Patni, N., Chard, C., Araújo-Vilar, D., Phillips, H., Magee, D. A., & Akinci, B. (2024). Diagnosis, treatment and management of lipodystrophy: The physician perspective on the patient journey. Orphanet Journal of Rare Diseases, 19(1), 263. https://doi.org/10.1186/s13023-024-03245-3

Quinn, K., Chauhan, S., & Purcell, S. M. (2023). Lipodystrophies. StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK459180/

Rubio, D. A. (2021). Estrategia de prevención de riesgo metabólico y cardiovascular en pacientes con lipodistrofia e infección por VIH en tratamiento antirretroviral [Master’s thesis, Universidad Técnica de Ambato]. UTA Repository. https://repositorio.uta.edu.ec/bitstreams/bcc31788-e398-44fd-8144-9c07784c9d41/download

Tsadik, A. G., Atey, T. M., Nedi, T., Fantahun, B., & Feyissa, M. (2018). Effect of insulin-induced lipodystrophy on glycemic control among children and adolescents with diabetes in Tikur Anbessa Specialized Hospital, Addis Ababa, Ethiopia. Journal of Diabetes Research, 2018, 4910962. https://doi.org/10.1155/2018/4910962

Vintimilla, J., Parra, C. del R., Martínez, C., Rodríguez, F. C., Durazno, C., Sacoto, A., Cruz, M., Campoverde, J., & Hermida, A. (2019). Técnica de aplicación de insulina y su relación con lipodistrofia en pacientes con Diabetes Mellitus Tipo 1. Archivos Venezolanos de Farmacología y Terapéutica, 38(1), 1-5. https://www.redalyc.org/journal/559/55959379001/html/

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Published

2026-05-01

How to Cite

Véliz, S. D., Rodríguez, D., & García, M. A. (2026). Lipodystrophy in Ecuador: A Critical Review of Its Low Visibility and Challenges in Differentiating It from Obesity in Clinical Practice. Journal of Health Science and Medical Therapy, 4(02), 132–149. https://doi.org/10.59653/jhsmt.v4i02.2227

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