Mosbah Héléna, Vatier Camille, Andriss Béatrice, Belalem Inès, Delemer Brigitte, Janmaat Sonja, Bouhnik Anne-Deborah, Le Collen Lauriane, Maiter Dominique, Nobécourt Estelle, Vantyghem Marie-Christine, Vigouroux Corinne, Dumas Agnes
Université Paris Cité, ECEVE UMR 1123, INSERM, 75014 Paris, France.
Service Endocrinologie, Diabétologie, Nutrition, CHU La Milétrie, 86000 Poitiers, France.
J Clin Endocrinol Metab. 2025 Jul 15;110(8):e2532-e2543. doi: 10.1210/clinem/dgae837.
Lipodystrophy syndromes are rare diseases characterized by a generalized or partial lipoatrophic morphotype and metabolic complications. Data on health-related quality of life and impact of genetic lipodystrophy on social or psychological well-being are lacking.
Patients with genetic lipodystrophy were recruited throughout the French national reference network for rare diseases of insulin secretion and insulin sensitivity. Patients completed a self-reported questionnaire exploring their physical, psychological, and social well-being and perceived impact of the disease. Descriptive analyses and comparison with general population norms were conducted.
Of 175 eligible patients, 109 (84% of women) were included, either with familial partial (n = 93) or congenital generalized (n = 16) lipodystrophy. Health-related quality of life based on physical and mental scores was significantly decreased compared to the French general population of similar age and gender (P < .001 for both). Forty-one percent of patients reported moderate or severe depression and 69% dealt with chronic pain. Half of respondents had taken tranquilizers, sleeping pills, or antidepressants over their life. Female participants with genetic lipodystrophy were more frequently unemployed due to health issues as compared to the general population. Social discrimination was highly prevalent (73%), coming, in 34% of cases, from health professionals. More than half of affected women reported a very negative impact of lipodystrophy on body image, significantly associated with depressive symptoms.
This study highlights the need of psychosocial support in patients with lipodystrophy. An integrated approach and evaluation of psychological and physical symptoms by physicians should be made available to organize specialized care and set up specific therapeutic educational programs.
脂肪营养不良综合征是一种罕见疾病,其特征为全身性或部分性脂肪萎缩形态以及代谢并发症。目前缺乏关于与健康相关的生活质量以及遗传性脂肪营养不良对社会或心理健康影响的数据。
通过法国全国罕见病胰岛素分泌与胰岛素敏感性参考网络招募遗传性脂肪营养不良患者。患者完成一份自我报告问卷,该问卷探讨了他们的身体、心理和社会健康状况以及疾病的感知影响。进行了描述性分析并与一般人群标准进行了比较。
在175名符合条件的患者中,纳入了109名(84%为女性),其中包括家族性部分性脂肪营养不良患者(n = 93)或先天性全身性脂肪营养不良患者(n = 16)。与年龄和性别相似的法国普通人群相比,基于身体和心理评分的与健康相关的生活质量显著下降(两者P <.001)。41%的患者报告有中度或重度抑郁症,69%的患者患有慢性疼痛。一半的受访者一生中服用过镇静剂、安眠药或抗抑郁药。与普通人群相比,患有遗传性脂肪营养不良的女性参与者因健康问题失业的频率更高。社会歧视非常普遍(73%),在34%的情况下,歧视来自医疗专业人员。超过一半的受影响女性报告脂肪营养不良对身体形象有非常负面的影响,这与抑郁症状显著相关。
本研究强调了脂肪营养不良患者需要心理社会支持。医生应采用综合方法并评估心理和身体症状,以便组织专门护理并制定特定的治疗教育计划。