Department of Plastic, Aesthetic and Reconstructive Microsurgery/Hand surgery, Hospital Ernst von Bergmann, Potsdam, Germany.
Center of Sports Medicine, University of Potsdam, Potsdam, Germany.
Dermatol Ther. 2020 Nov;33(6):e14534. doi: 10.1111/dth.14534. Epub 2020 Nov 22.
Multiple associated comorbidities have been described for lipedema patients. Disease diagnosis still remains challenging in many cases and is frequently delayed. The purpose of this study was to determine the most common comorbidities in lipedema patients and the impact of surgical treatment onto disease progression. A retrospective assessment of disease-related epidemiologic data was performed for patients who underwent liposuction between July 2009 and July 2019 in a specialized clinic for lipedema surgery. All patients received a standardized questionnaire regarding the clinical history and changes of lipedema-associated symptoms and comorbidities after surgery. 106 patients who underwent a total of 298 liposuction procedures were included in this study after returning the questionnaire fully filled-in. Multiple comorbidities were observed in the assessed collective. The prevalence for obesity, hypothyroidism, migraine, and depression were markedly increased in relation to comparable nonlipedema populations. Despite a median body mass index (BMI) of 31.6 kg/m (IQR 26.4-38.8), unexpected low prevalence of diabetes (5%) and dyslipidemia (7%) was found. Diagnosis and initiation of guideline-appropriate treatment were delayed by years in many patients. After surgical treatment (medium follow-up 20 months, IQR 11-42), a significant reduction of lipedema-associated symptoms was demonstrated. Lipedema occurs with a diversity of associated comorbidities. Therefore, on the basis of available data, the authors suggest the necessity of a multimodal therapy concept for a comprehensive and holistic treatment. Despite a commonly increased BMI, lipedema patients appear to have an advantageous metabolic risk profile.
脂性水肿患者常伴有多种合并症。在许多情况下，疾病的诊断仍然具有挑战性，且经常被延误。本研究的目的是确定脂性水肿患者最常见的合并症，以及手术治疗对疾病进展的影响。对 2009 年 7 月至 2019 年 7 月期间在一家脂性水肿手术专科诊所接受吸脂术的患者进行了回顾性评估。所有患者在手术后都收到了一份标准化问卷，内容涉及脂性水肿相关症状和合并症的临床病史和变化。在返回完整填写的问卷后，共有 106 名患者（共进行了 298 次吸脂术）被纳入本研究。评估的患者群体中存在多种合并症。与可比的非脂性水肿人群相比，肥胖症、甲状腺功能减退症、偏头痛和抑郁症的患病率明显增加。尽管平均体重指数（BMI）为 31.6kg/m（IQR 26.4-38.8），但出乎意料的是，糖尿病（5%）和血脂异常（7%）的患病率较低。许多患者的诊断和开始进行符合指南的治疗都被延迟了数年。在接受手术治疗后（平均随访 20 个月，IQR 11-42），脂性水肿相关症状显著减轻。脂性水肿伴有多种合并症。因此，根据现有数据，作者建议需要采用多模式治疗概念来进行全面和整体治疗。尽管 BMI 通常升高，但脂性水肿患者的代谢风险特征似乎具有优势。
