What are the causes of simple upper body wasting type? Progressive lipodystrophy Progressive lipodystrophy is a rare autonomic disorder characterized by disorders of adipose tissue metabolism. It is characterized clinically and histologically by slowly progressive bilateral distribution of largely symmetrical, well-defined, subcutaneous adipose tissue atrophy or loss, sometimes combined with limited adipose tissue hyperplasia and hypertrophy. Due to the extent of lipodystrophy, it can be divided into limited lipodystrophy (Simons disease or cephalothoracic lipodystrophy) and generalized lipodystrophy (Seip-Laurence syndrome). Lipodystrophy The age of onset of lipodystrophy ranges from 1 to 40 years, and it is more common in girls aged 5 to 15 years. The incidence of kidney damage is 15-30%. Because complete lipodystrophy often occurs in conjunction with diabetes, non-diabetic nephropathy is often found, and its pathological manifestations cannot be distinguished from diabetic nephropathy without lipodystrophy, and it has been reported that in patients without diabetes, the pathological manifestations are glomerulonephritis, and the relationship between lipodystrophy and glomerulopathy is unknown, and Tuck et al. reported that a very small percentage of their patients had peripheral thylakoid implantation of capillaries , subepithelial and intramembranous deposits, but in general there were no particular features, the patient had normal serum complement C3 levels, no proteinuria and only slightly reduced renal function. Pediatric malnutrition Malnutrition is a chronic nutritional deficiency due to caloric and/or protein deficiencies. It is mostly seen in infancy and early childhood. With the continuous improvement of people’s life, the incidence of malnutrition has decreased significantly, and the malnutrition seen now is mostly caused by improper feeding methods during infancy or disease factors and is mostly mild. Long-term food intake is not group is the main cause of malnutrition. Such as multiple births, twin births and premature infants if not pay attention to scientific feeding, often cause malnutrition. Congenital malformations such as cleft lip and chronic wasting diseases such as tuberculosis, can also produce malnutrition. The manifestation is no weight gain or loss, and the subcutaneous fat gradually disappears, generally in the order of abdomen, chest and back, waist, both upper and lower limbs, and cheeks. In severe cases, muscle atrophy, delayed development of motor function, low intelligence, poor immunity, susceptibility to indigestion and various infections. Myotonic dystrophy is a group of primary skeletal muscle necrosis disorders characterized by progressive skeletal muscle weakness due to genetic factors, which mainly manifests clinically as progressive aggravated skeletal muscle atrophy and weakness of different degrees and distributions. Cardiac muscle may also be involved. There are many types of myotonic dystrophy, some are congenital myotonic dystrophies that can be observed at birth, while others are observed at puberty, regardless of the exact time of onset, and some myotonic dystrophies can lead to impaired movement or even paralysis.