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It is involved in preadipocyte differentiation via PPARG activation, suggesting a potential mechanism by which estrogen contributes to adipocyte hyperproliferation and fat accumulation in lipedema.7 Also, adipocytes in lipedema may exhibit enhanced local production of steroidogenic enzymes, further increasing local estrogen activity through ER activation and perpetuating adipose tissue expansion.15 Recent multi-omics studies have identified metabolic, lipid, and gene expression abnormalities in lipedema

Protein assay agents were purchased from Bio-Rad (Hercules, CA, USA)

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