The Adipovascular Unit in Lipedema: A Framework for Regional Adipose Tissue Dysregulatio n

Lipedema is a chronic, predominantly female disorder characterized by disproportionate regional expansion of subcutaneous adipose tissue, pain, tenderness and easy bruising. Although adipocyte hypertrophy, altered progenitor-cell behavior, microvascular dysfunction, extracellular-matrix remodeling, immune-cell alterations and variable lymphatic abnormalities have been reported, their causal and temporal relationships remain unresolved. Here, we propose that these findings may represent interacting manifestations of dysregulation within an adipovascular unit (AVU) rather than independent pathological processes.