From the Department of Plastic Surgery and Hand Surgery, Klinikum rechts der Isar, Technical University Munich; the Praxis Ästhetik in München, Dr. von Lukowicz und Kollegen; and the Division of Plastic, Reconstructive, and Aesthetic Surgery, Ospedale Regionale di Lugano, Ente Ospedaliero Cantonale.
Plast Reconstr Surg. 2019 Dec;144(6):1475-1484. doi: 10.1097/PRS.0000000000006280.
Although a large number of adult women worldwide are affected by lipedema, the physiologic conditions triggering onset and progression of this chronic disease remain enigmatic. In the present study, a descriptive epidemiologic situation of postoperative lipedema patients is presented.
The authors developed an online survey questionnaire for lipedema patients in Germany. The survey was conducted on 209 female patients who had been diagnosed with lipedema and had undergone tumescent liposuction.
Most of the participants (average age, 38.5 years) had noticed a first manifestation of the disease at the age of 16. It took a mean of 15 years to accomplish diagnosis. Liposuction led to a significant reduction of pain, swelling, tenderness, and easy bruising as confirmed by the majority of patients. Hypothyroidism [n = 75 (35.9 percent) and depression [n = 48 (23.0 percent)] occurred at a frequency far beyond the average prevalence in the German population. The prevalence of diabetes type 1 [n = 3 (1.4 percent)], and diabetes type 2 [n = 2 (1 percent)] was particularly low among the respondents. Forty-seven of the lipedema patients (approximately 22.5 percent) suffered from a diagnosed migraine. Following liposuction, the frequency and/or intensity of migraine attacks became markedly reduced, as stated by 32 patients (68.1 percent).
Quality of life increases significantly after surgery with a reduction of pain and swelling and decreased tendency to easy bruising. The high prevalence of hypothyroidism in lipedema patients could be related to the frequently observed lipedema-associated obesity. The low prevalence of diabetes, dyslipidemia, and hypertension appears to be a specific characteristic distinguishing lipedema from lifestyle-induced obesity.
尽管全世界有大量成年女性受到脂肪水肿的影响，但触发这种慢性疾病发作和进展的生理状况仍然是个谜。在本研究中，呈现了脂肪水肿术后患者的描述性流行病学情况。
作者为德国的脂肪水肿患者开发了在线调查问卷调查表。该调查针对 209 名已被诊断患有脂肪水肿并接受肿胀吸脂术的女性患者进行。
大多数参与者（平均年龄 38.5 岁）在 16 岁时首次注意到该疾病的表现。平均需要 15 年才能确诊。大多数患者证实吸脂术显著减轻了疼痛、肿胀、压痛和容易瘀伤。甲状腺功能减退症[75 例（35.9%）]和抑郁症[48 例（23.0%）]的发生率远高于德国人口的平均发生率。1 型糖尿病[3 例（1.4%）]和 2 型糖尿病[2 例（1.0%）]的患病率在受访者中特别低。47 名脂肪水肿患者（约 22.5%）患有确诊的偏头痛。32 名患者（68.1%）表示，吸脂术后偏头痛发作的频率和/或强度明显降低。
手术后生活质量显著提高，疼痛和肿胀减轻，容易瘀伤的倾向降低。脂肪水肿患者中甲状腺功能减退症的高患病率可能与经常观察到的脂肪水肿相关肥胖有关。糖尿病、血脂异常和高血压的低患病率似乎是脂肪水肿与生活方式引起的肥胖的区别特征。
