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The Molecular Mechanisms Underlying Dercum’s Disease: Exploring the Intersection of Obesity, Pain, and Inflammation
(MDPI AG, 2025-11-18)
REYTOR GONZÁLEZ, CLAUDIA MARÍA
;
Emilia Jiménez Flores
;
Melannie Toral-Noristz
;
Campuzano Donoso Martín
;
ROMAN GALEANO, NATHALY MERCEDES
Obesity is increasingly recognized not only as a metabolic disorder, but also as a state of chronic low-grade inflammation that predisposes to systemic complications. Within this context, Dercum’s disease (DD), or adiposis dolorosa, emerges as a rare yet debilitating disorder characterized by painful subcutaneous lipomas, most commonly affecting middle-aged women. Despite its clinical impact, DD remains underdiagnosed and is often misclassified as lipedema, fibromyalgia, or lipomatosis, complicating prevalence estimates and hindering the development of targeted interventions. Current evidence suggests that DD represents a distinctive model of inflammatory obesity, where adipose tissue actively contributes to pain generation rather than serving as a passive fat reservoir. Histological and molecular findings point to adipose tissue dysfunction, immune cell infiltration, and elevated secretion of pro-inflammatory adipokines, signals which appear to fuel systemic low-grade inflammation, perineural immune interactions, and nociceptor sensitization. Peripheral mechanisms further shape the clinical phenotype. While familial clustering suggests possible genetic contributions, no definitive markers have been identified, and the role of obesity-induced epigenetic modifications remains unexplored. Therapeutic strategies remain largely symptomatic, including analgesics, antidepressants, physical rehabilitation, and surgical excision of lipomas, whereas molecularly targeted and diet-based interventions are still experimental. This article discusses the pathophysiology of DD, current treatments, and future perspectives, emphasizing that advancing patient registries, omics-based analyses, and interdisciplinary clinical trials will be crucial to elucidate disease mechanisms and guide novel therapies. Improved understanding of DD may not only enhance patient care, but also provide broader insights into the interplay between obesity, inflammation, and chronic pain.
Scopus© Citations 2
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Oesophageal adenocarcinoma, obesity, and cancer: the role of nutrition in prevention and management
(Informa UK Limited, 2025-05-29)
REYTOR GONZÁLEZ, CLAUDIA MARÍA
;
SIMANCAS RACINES, DANIEL ALEJANDRO
;
Emilia Jiménez Flores
;
Martín Campuzano Donoso
;
Angelo Michele Carella
Oesophageal adenocarcinoma (EAC) is increasingly associated with obesity, metabolic dysfunction, and genetic predispositions. This review explores how nutritional factors interact with these risk elements, emphasizing the potential of dietary strategies in EAC prevention and management. Diets such as the Mediterranean and plant-based patterns may reduce inflammation, oxidative stress, and metabolic imbalance, thereby modulating cancer risk. Nutrient-rich foods–particularly omega-3 fatty acids, cruciferous vegetables, and dietary fibre–offer additional protective effects. Personalized nutrition, tailored to individual genetic and metabolic profiles, is emerging as a promising tool in cancer prevention. Moreover, weight management strategies like caloric restriction and intermittent fasting may contribute to risk reduction. Integrating these approaches into clinical and public health practices could play a critical role in mitigating the underlying drivers of EAC. Further research is needed to strengthen dietary guidelines and advance precision nutrition for high-risk populations.
Scopus© Citations 12
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Preventing and Managing Pre- and Postoperative Micronutrient Deficiencies: A Vital Component of Long-Term Success in Bariatric Surgery
(MDPI AG, 2025-02-20)
REYTOR GONZÁLEZ, CLAUDIA MARÍA
;
Evelyn Frias-Toral
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NUÑEZ VASQUEZ, CRISTINA ELIZABETH
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PARISE VASCO, JUAN MARCOS
;
Raynier Zambrano-Villacres
Bariatric surgery (BS) is an effective treatment for severe obesity and its related comorbidities, such as type 2 diabetes and hypertension. However, the anatomical and physiological changes associated with these procedures significantly increase the risk of preoperative and postoperative micronutrient deficiencies, which can lead to severe complications such as anemia, osteoporosis, and neurological disorders. This narrative review examines the prevalence and clinical implications of micronutrient deficiencies in BS patients, as well as evidence-based strategies for their prevention and management. The most common deficiencies include iron, vitamin B12, folate, calcium, vitamin D, and fat-soluble vitamins (A, E, and K). Procedures with a hypoabsorptive component, such as Roux-en-Y gastric bypass (RYGB) and biliopancreatic diversion with duodenal switch (BPD/DS), pose higher risks of deficiencies compared to restrictive procedures like sleeve gastrectomy (SG). Effective strategies involve the preoperative correction of deficiencies, continuous monitoring, and tailored supplementation. However, long-term adherence to supplementation tends to decrease over time, influenced by behavioral and socioeconomic factors. Hence, preventing and managing micronutrient deficiencies are crucial for the long-term success of BS. While current guidelines provide valuable recommendations, many are based on low-certainty evidence, underscoring the need for more robust studies. A multidisciplinary approach, combined with innovative strategies, such as telemedicine, can enhance adherence and achieve sustainable clinical outcomes.
Scopus© Citations 43
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Preoperative Nutrition in Bariatric Surgery: A Narrative Review on Enhancing Surgical Success and Patient Outcomes
(MDPI AG, 2025-02-02)
SIMANCAS RACINES, DANIEL ALEJANDRO
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Evelyn Frias Toral
;
Martín Campuzano-Donoso
;
RAMOS SARMIENTO, DANIEL ALEXANDER
;
Raynier Zambrano-Villacres
Bariatric surgery has become the preferred treatment for individuals with morbid obesity. Nutrition is key in optimizing surgical outcomes by reducing risks and enhancing recovery. Preoperative strategies, such as reducing body fat, decreasing liver size, and improving metabolic profiles, have been shown to facilitate safer surgical procedures with fewer complications. This narrative review aims to provide an analysis of the fundamental role of preoperative nutritional management in improving bariatric surgery outcomes, emphasizing the importance of addressing specific nutritional challenges to enhance surgical safety, recovery, and overall health. Preoperative nutritional interventions focus on correcting comorbidities and nutritional deficiencies, particularly hypovitaminosis and micronutrient imbalances, through a multidisciplinary approach involving nutritionists and other healthcare professionals. These interventions not only prepare patients for the physiological demands of surgery but also initiate a period of adaptation to new dietary habits, aiming to improve long-term compliance and mitigate risks such as postoperative weight regain and dumping syndrome. Adopting dietary changes, such as very low-calorie or ketogenic diets 6–12 weeks before surgery, enhances adherence to postoperative restrictions and overall surgical success. Future research should focus on developing comprehensive guidelines for preoperative nutritional care to improve patient outcomes globally.
Scopus© Citations 22
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Obesity and periodontitis: a comprehensive review of their interconnected pathophysiology and clinical implications
(Frontiers Media SA, 2024-08-07)
REYTOR GONZÁLEZ, CLAUDIA MARÍA
;
Parise Vasco Juan Marcos
;
Natali González
;
Alison Simancas-Racines
;
Raynier Zambrano-Villacres
Obesity and periodontitis are significant health problems with a complex bidirectional relationship. Excess body fat is linked to systemic diseases and can lead to persistent inflammation, potentially harming periodontal health. Periodontitis, a chronic inflammatory condition affecting the supporting structures of teeth, poses substantial health risks. Both conditions share pathological processes such as inflammation and oxidative stress, which aggravate health status and make treatment more challenging. Understanding this interaction is crucial for developing effective management strategies for both diseases. This study explores the multifaceted aspects of obesity and periodontitis and their reciprocal relationship.
Scopus© Citations 38

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