What is lipotoxicity?

Lipotoxicity is damage to tissues not designed for fatty acid storage. It can develop in patients with diabetes and some other conditions, and has been explored as a possible cause of what is commonly called "metabolic syndrome." Diagnosis of this problem can be achieved with testing of the tissues in question, along with medical imaging studies and a review of the patient's history. The best treatment options may depend on the details of the case.

Tissues in the human body have the ability to store energy in the form of fat in specialized cells developed for this purpose. These cells are capable of handling accumulations of fatty acids, releasing them when the body needs them as a source of fuel. Other tissues are more sensitive and cannot tolerate accumulations of fatty acids or their by-products. When these materials are mistakenly stored in inappropriate places, the tissue can develop lipotoxicity, which interferes with cellular function.

Organs such as the liver and kidneys are particularly vulnerable to lipotoxicity due to their construction and nature, which involves numerous highly specialized cells. The accumulation of fat can disrupt the normal activity of the organ, which can lead to eventual failure. This can cause a chain reaction as the liver or kidneys are no longer able to fully participate in metabolism. Serious complications can develop because the body can no longer metabolize many compounds and can experience a toxic buildup of chemicals and byproducts.

The heart can also be affected by lipotoxicity; It's also not designed to store fatty acids, and they can interfere with heart function. Cells within the heart may die or fail to beat in an organized manner, leading to complications like myocardial infarction and arrhythmia in the patient. A blood test may reveal increased levels of circulating fatty acids, while medical imaging studies may show deposits within the organs, indicating that lipotoxicity is occurring.

Treatment options depend on the organs involved and the patient's medical history. Diet changes and medication may be needed to address high levels of circulating fatty acids. Supportive therapy may also be needed to help the kidneys, liver, or other organs recover. People with kidney failure, for example, might need dialysis or a transplant to replace organs too damaged to continue to function. The underlying cause, such as poorly controlled diabetes, can also be addressed to prevent a future episode and keep the patient as healthy as possible.

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