Clinical Guidelines for the Diagnosis and Management of Generalized and Partial Lipodystrophies: A Position Statement Endorsed by the Hellenic Endocrine Society
Endocrine Practice, vol.32, no.6, pp.1008-1016, 2026 (SCI-Expanded, Scopus)
- Publication Type: Article / Review
- Volume: 32 Issue: 6
- Publication Date: 2026
- Doi Number: 10.1016/j.eprac.2026.02.014
- Journal Name: Endocrine Practice
- Journal Indexes: Science Citation Index Expanded (SCI-EXPANDED), Scopus, EMBASE, MEDLINE
- Page Numbers: pp.1008-1016
- Keywords: generalized lipodystrophy, genetic testing, insulin resistance, lipodystrophy, metabolic syndrome, partial lipodystrophy
- Dokuz Eylül University Affiliated: Yes
Abstract
Objective: Lipodystrophy syndromes are rare disorders characterized by generalized or partial loss of adipose tissue and severe metabolic complications. Due to phenotypic overlap with common metabolic conditions, diagnosis is frequently delayed. This position statement aims to provide practical, consensus-based guidance for the diagnosis and management of generalized and partial lipodystrophies in clinical practice. Methods: A targeted literature review was conducted using PubMed, MEDLINE, Scopus, and Google Scholar from database inception through October 2024. Evidence was synthesized with expert consensus derived from 2 multidisciplinary panels convened by the Hellenic Endocrine Society in 2024-2025, focusing on diagnostic strategies, metabolic management, and emerging therapies. Results: Early recognition relies on careful assessment of fat distribution, metabolic abnormalities, and selected use of imaging and genetic testing. Management requires a multidisciplinary approach incorporating lifestyle interventions, pharmacologic treatment of diabetes, dyslipidemia, and liver disease, and targeted therapy with metreleptin in eligible patients. Adjunctive therapies, including glucagon-like peptide-1 receptor agonists and SGLT2 inhibitors, may offer additional metabolic benefit in selected cases. Psychosocial support is essential due to the high burden of psychological distress and stigma. Conclusion: Timely diagnosis and individualized, multidisciplinary management of lipodystrophy are critical to improving metabolic control and long-term outcomes. This position statement provides a practical framework to support clinicians in recognizing and managing these rare but serious disorders in everyday practice.