Forner-Cordero Isabel, Muñoz-Langa José
Lymphedema Unit, Physical Medicine and Rehabilitation Service, Hospital Universitari i Politècnic La Fe, Valencia, Spain.
Department of Medicine, University of Valencia, Valencia, Spain.
Vasc Med. 2025 Apr;30(2):205-212. doi: 10.1177/1358863X241306415. Epub 2025 Jan 20.
It is not yet known whether lipedema is a progressive chronic disease or not. The aim of this paper is to describe the long-term changes in the volume of the lower limbs.
The primary endpoint of this prospective cohort study of patients with lipedema was the percentage of volume change (PVC) during follow up. Progression was defined as when the PVC was > 10% from the baseline, whereas improvement was defined as when the PVC was < -10%, and stability as PVC -10% to 10%.
A cohort of 100 patients with lipedema were included in the study. The average follow-up period from the start of this study was 4.6 years. The average PVC was 2.8%. Stability was observed in 62% of the patients, progression in 28%, and improvement in 10%. In the univariate analysis, a significant positive association was observed between PVC and both BMI-change and waist-to-height ratio (WHtR)-change. The more the BMI increased, the more the lipedema progressed ( < 0.0001), as did the WHtR ( < 0.0001). In the adjusted regression analysis, age was not seen to be an influencing factor for PVC. Regarding maintenance therapies, no associations were observed.
Lipedema was seen to be stable in two-thirds of the patients. Age was not related to progression. Progression was related to WHtR increase, which is an indicator of abdominal fat gain. This demonstrates the relationship between fat gain and lipedema progression.
脂肪性水肿是否为一种进行性慢性病尚不清楚。本文旨在描述下肢体积的长期变化情况。
这项针对脂肪性水肿患者的前瞻性队列研究的主要终点是随访期间的体积变化百分比（PVC）。进展定义为PVC较基线水平增加>10%，改善定义为PVC较基线水平降低<-10%，稳定定义为PVC在-10%至10%之间。
该研究纳入了100例脂肪性水肿患者。从本研究开始的平均随访期为4.6年。平均PVC为2.8%。62%的患者观察到病情稳定，28%的患者病情进展，10%的患者病情改善。在单因素分析中，观察到PVC与BMI变化和腰高比（WHtR）变化之间存在显著正相关。BMI增加越多，脂肪性水肿进展越明显（<0.0001），WHtR增加也是如此（<0.0001）。在调整后的回归分析中，年龄未被视为PVC的影响因素。关于维持治疗，未观察到相关性。
三分之二的患者脂肪性水肿病情稳定。年龄与病情进展无关。病情进展与WHtR增加有关，WHtR是腹部脂肪增加的一个指标。这证明了脂肪增加与脂肪性水肿进展之间的关系。
