Lipedema research has expanded sharply in recent years. Annual output stayed below 12 publications through 2009, began accelerating from 2010, and showed a marked increase from 2017. The analysis counted 145 publications in 2025. A model fitted to annual counts from 2010 through 2024 estimated that output doubled every 3.6 years. The reported fit statistic was 0.90, with a p-value below 0.001. Publications from 2020 through 2025 accounted for 59.3% of the full corpus.
Within that expansion, immunological work remains a small but increasingly visible part of the record. Matching a predefined list of terms in article titles identified 30 publications, or 3.2% of the corpus. The share was essentially zero before 2019 but reached 4.8% of publications in 2025. These papers averaged 16.6 citations, compared with 14.5 for non-immunological publications. The authors interpret the pattern as consistent with an emerging immunological research direction, while cautioning that title matching produces a conservative lower bound.
The map behind the numbers
To build the dataset, the researchers searched title fields in Google Scholar, PubMed, Crossref, OpenAlex and Scopus in May 2026 for the terms 'lipedema' or 'lipoedema', without date or language restrictions. Normalized-title matching followed by DOI cross-referencing produced 942 unique publications dated from 1940 to 2025. OpenAlex metadata were available for 511 records with valid DOIs, representing 54.2% of the corpus. The main publication analysis covered 2000 to 2025, while the older records remained in the full dataset.
The researchers measured annual output, citation totals and averages, the field h-index, author metrics and first-author country. They estimated doubling time with ordinary least-squares regression on log-transformed annual publication counts from 2010 through 2024. Specialty labels were assigned through journal-title keywords and, when no journal matched, OpenAlex primary-topic subfields; unmatched records were labeled Multidisciplinary/Other.
A field spread across disciplines
Across the corpus, the analysis counted 13,688 citations. The field h-index, a citation measure, was 60. Mean citations per publication were 14.5, while the median was 2. The average therefore sat well above the median.
Name normalization identified 2,942 authors. Karen Lynn Herbst had the strongest corpus-specific citation and h-index profile, with 46 publications, 1,586 citations and a corpus h-index of 20. Her work accounted for 11.6% of all citations in the dataset. Across the field, publications had an average of 3.6 authors, a median of 3, and 27.0% were single-author papers.
By first-author country, the United States led with 58 publications, followed by Germany with 56 and Brazil with 54. Italy had 31, Hungary 21 and Spain 12. The analysis also reported citation-cohesion figures of 88% for Germany, 79% for Italy and 74% for both the United States and Brazil, based on only 14 to 38 analyzable articles per country.
The disciplinary picture was broad, but most records fell into a catch-all category. Multidisciplinary/Other accounted for 69.3% of publications. Lymphology and phlebology made up 17.1%, followed by endocrinology and metabolism at 5.2%, plastic and aesthetic surgery at 4.5%, and dermatology at 3.9%. Dermatology-classified articles had the highest mean citation count, at 47.6 per article. These labels were assigned through journal-title keywords and OpenAlex topic subfields, so the large Multidisciplinary/Other share should be read as a classification result as well as a description of the literature.
The immune signal is still early
Immunological content was not determined by reading the full text of every publication. Instead, the researchers used regular-expression matching, a computerized search for a predefined list of terms, in article titles. That approach can miss relevant studies when the title does not name the pathway, so the reported 3.2% is a conservative lower bound rather than a complete count.
The authors interpret the rising share and higher citation average as consistent with an emerging framework centered on chronic low-grade inflammation in adipose tissue, macrophage infiltration and interaction between immune and lymphatic systems. They propose it as a possible unifying direction for future lipedema research. Because the study maps publication records and title-defined themes, it identifies a research signal rather than establishing those processes as a causal disease mechanism.
Several cautions narrow the reading. Citation counts are time-dependent, and recent publications have had less time to accumulate them. Author-name normalization can merge or split identities. The country cohesion estimates were based on small analyzable groups, and specialty assignment is an approximation for multidisciplinary journals. Title-based matching can also miss relevant immunological papers. Taken together, these limits make the findings most useful as a map of publication volume, citation patterns, disciplinary structure and thematic visibility.
Paper data and sources
Original title: Lipedema research (2000–2025): a global bibliometric analysis with evidence of an emerging immunological paradigm
Authors: Amato A, Amato J, Benitti D
Journal/Repository: Revista da Associacao Medica Brasileira (1992)
Status: Peer-reviewed
First online: 2026-10-19
DOI: Not available
Original paper · Full text