[Lipodystrophy: a new insight into an old disease].

Adipose tissue is now recognized as a highly active metabolic and endocrine organ secreting a range of bioactive peptides with both local and distant action, known as adipokines. Some of these factors are specific fat-related hormones that are involved in regulating energy homeostasis, carbohydrate and lipid metabolism. Adipose tissue disorders may have potential repercussions in the pathophysiology of obesity, insulin resistance, and dyslipidemia. Lipodystrophies are characterized by a selective loss of body fat although the extent of fat loss is different. They may be either inherited or acquired, as well as either generalized or limited to some parts of the body. Females are affected more often than men. If the fat loss is marked, patients develop insulin resistance and its complications, such as diabetes, atherogenic dyslipidemia, hepatic steatosis, and indices of hyperandrogenism. The aim of this article is to discuss the aetiology, clinical manifestations, diagnosis and treatment of different lipodystrophy syndromes with a special emphasis on the most recent literature.