1
|
Ekti H, Toktas H, Yesil H, Kaya F. Assessment of lower extremity venous insufficiency and lipedema and their association with knee symptoms, functions, and quality of life in patients with knee osteoarthritis. Phlebology 2024; 39:251-258. [PMID: 38092367 DOI: 10.1177/02683555231221615] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/05/2024]
Abstract
OBJECTIVE To evaluate the effects of the venous insufficiency (VI) or lipedema on the symptoms, functions, and quality of life (QoL) of patients with knee osteoarthritis (OA). METHODS 96 patients with stage 3/4 knee OA were included in the study. Patients were grouped as OA (n = 35), VI + OA (n = 35), and lipedema + OA (n = 26). Range of motion (ROM), Visual Analogue Scale (VAS), Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), short-form (SF-36), and 6-minute walking test (6MWT) were evaluated. RESULTS WOMAC stiffness score was significantly higher in the VI group than the other groups (p < .05). VAS resting, WOMAC pain, function, and total scores were significantly higher in the lipedema + OA and VI + OA groups than the OA group (p < .05). SF-36-physical role limitation was significantly lower in the lipedema and VI groups (p < .05). CONCLUSION VI or lipedema accompanying knee OA increases the existing disability due to OA by negatively affecting patients regarding pain, QoL, and physical functioning.
Collapse
Affiliation(s)
- Hilmi Ekti
- Department of Physical Medicine and Rehabilitation, Afyonkarahisar Health Sciences University, Afyonkarahisar, Turkey
| | - Hasan Toktas
- Department of Physical Medicine and Rehabilitation, Afyonkarahisar Health Sciences University, Afyonkarahisar, Turkey
| | - Hilal Yesil
- Department of Physical Medicine and Rehabilitation, Afyonkarahisar Health Sciences University, Afyonkarahisar, Turkey
| | - Furkan Kaya
- Department of Radiology, Afyonkarahisar Health Sciences University, Afyonkarahisar, Turkey
| |
Collapse
|
2
|
Mortimer PS, Pearson M, Gawrysiak P, Riches K, Keeley V, Tew KF, Cranwell EJ. LymphActiv: A Digital Physical Activity Behavior Intervention for the Treatment of Lymphedema and Lipedema. Lymphat Res Biol 2024; 22:112-119. [PMID: 38394133 DOI: 10.1089/lrb.2023.0033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/25/2024] Open
Abstract
Background: Lymphedema and lipedema are debilitating conditions with no proven drug or surgical therapy. Effective treatment requires self-management through movement and compression to reduce limb volume and the incidence of cellulitis. The addition of personalized everyday physical activity (PA) could be transformative, increasing the therapy window to include all waking hours per week and enabling an increased dose of PA. Aim: This service evaluation aimed to determine the feasibility of LymphActiv as a treatment option for lymphedema and lipedema patients. Methods: This service evaluation followed an open observational cohort design, including 55 patients who participated in LymphActiv over 24 weeks. Patients wore an objective PA monitor and interacted with their data in an online dashboard, alongside remote mentor support. Primary outcomes were changes to PA, body weight, limb volume and quality of life. Clinical assessments occurred at baseline and after the 24-week program. Noncompleters were used as a quasi-control group for comparison. Results: Thirty-seven patients completed, of which 81% improved PA. On average, completers reduced their right and left lower limb volumes by -1.8% and -2.1%, respectively. Completers also experienced small average weight losses of -1.2 kg. Noncompleters experienced small average increases in each of these outcome measures. Discussion: These results establish the value of LymphActiv, providing benefit to patients who might otherwise have deteriorated. For services, this could lead to substantial cost-savings through reduced admissions, greater patient independence, and less need for community health care input. The next step is to undertake a randomized, controlled trial comparing the intervention with standard care.
Collapse
Affiliation(s)
- Peter S Mortimer
- Department of Dermatology, Molecular and Clinical Sciences Institute, St. George's University Hospital NHS Foundation Trust, London, United Kingdom
| | - Mark Pearson
- Department of Dermatology, Molecular and Clinical Sciences Institute, St. George's University Hospital NHS Foundation Trust, London, United Kingdom
| | - Patryk Gawrysiak
- Department of Dermatology, Molecular and Clinical Sciences Institute, St. George's University Hospital NHS Foundation Trust, London, United Kingdom
| | - Katie Riches
- Department of Dermatology, Royal Derby Hospital, Derby, United Kingdom
| | - Vaughan Keeley
- Department of Dermatology, Royal Derby Hospital, Derby, United Kingdom
- Department of Medicine, University of Nottingham Medical School, Nottingham, United Kingdom
| | - Kirstie F Tew
- Department of Physical Activity Science, KiActiv®, London, United Kingdom
| | - Ewan J Cranwell
- Department of Physical Activity Science, KiActiv, London, United Kingdom
| |
Collapse
|
3
|
Keith L, Seo C, Wahi MM, Huggins S, Carmody M, Faerber G, Forner-Cordero I, Michelini S, Rapprich S, Rockson SG. Proposed Framework for Research Case Definitions of Lipedema. Lymphat Res Biol 2024; 22:93-105. [PMID: 38546398 PMCID: PMC11044873 DOI: 10.1089/lrb.2023.0062] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/19/2024] Open
Abstract
Background: Our aim is to propose a framework for the development of a research case definition of lipedema, based on current available literature and those observations that can be applied to future lipedema research with the intent to standardize and strengthen the scientific evidence base. Methods and Results: We conducted a narrative review of the literature, and identified consensus characteristics and disputed characteristics that could be included in a research case definition of lipedema. After considering the strength of the evidence and how each characteristic might be measured in a research study, we recommended an approach for the development of a research case definition of lipedema that would be based on consideration of five agreed-upon characteristics, and five disputed, or less substantiated, characteristics as additional evidence to enhance specificity. Conclusions: We present a case definition framework for lipedema drawn from the scientific literature that can be applied to future studies on lipedema. Utilizing this framework should help to increase the sensitivity and specificity of case definition and provide an opportunity for meta-analysis of clinical studies and facilitate future research intercomparisons.
Collapse
Affiliation(s)
- Leslyn Keith
- Lipedema Project, Inc., Boston, Massachusetts, USA
| | - Catherine Seo
- Lipedema Project, Inc., Boston, Massachusetts, USA
- Lipedema Simplified, LLC, Boston, Massachusetts, USA
| | | | - Siobhan Huggins
- Lipedema Project, Inc., Boston, Massachusetts, USA
- Lipedema Simplified, LLC, Boston, Massachusetts, USA
| | - Matthew Carmody
- Lipedema Simplified, LLC, Boston, Massachusetts, USA
- Harvard Medical School, Boston, Massachusetts, USA
| | | | | | | | | | - Stanley G. Rockson
- Stanford Center for Lymphatic and Venous Disorders, Stanford University School of Medicine, Stanford, California, USA
| |
Collapse
|
4
|
Hashimi S, Rajagopalan U. National Lymphoedema Conference 2024: session summaries. Br J Community Nurs 2024; 29:S37-S42. [PMID: 38578923 DOI: 10.12968/bjcn.2024.29.sup4.s37] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/07/2024]
Abstract
The 11th annual National Lymphoedema Conference, organised by the British Journal of Community Nursing in association with the British Lymphology Society and Lipoedema UK, was hosted at the America Square Conference Centre, London, on 22 February 2024. The conference, which aims to provide new insights into the latests developments in lymphoedema care and management through talks by leading experts in the field, was attended by an impressive number of delegates and exhibitors. The sessions were Chaired by BLS Trustee Rebecca Elwell, and are summarised below.
Collapse
|
5
|
Cagliyan Turk A, Erden E, Eker Buyuksireci D, Umaroglu M, Borman P. Prevalence of Fibromyalgia Syndrome in Women with Lipedema and Its Effect on Anxiety, Depression, and Quality of Life. Lymphat Res Biol 2024; 22:2-7. [PMID: 38127646 DOI: 10.1089/lrb.2023.0038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2023] Open
Abstract
Background/Aim: The aim of this study was to determine the frequency of fibromyalgia syndrome (FMS) in patients with lipedema and to evaluate the effects of FMS on anxiety, depression, and quality of life (QoL) in this patient group. Methods: Patients with lipedema were invited to participate in a Survey-Monkey questionnaire (according to inclusion and exclusion criteria) that was announced on the facebook page of the lipedema patient community. The demographic and clinical properties, including age, body mass index (BMI), education, marital status, and types and stage of lipedema, were collected. Presence of fibromyalgia was assessed by the questions based on American College of Rheumatology 2016 FMS diagnostic criteria. The Hospital Anxiety and Depression Scale and Short Form-12 (SF-12) were used to assess the anxiety and depression, and QoL respectively. The demographic and clinical characteristics, as well as anxiety/depression level and QoL of lipedema patients were evaluated in regard to the presence (Group 1) and absence (Group 2) of FMS. Results: A total of 354 participants with a mean age of 43.18 ± 9.53 years and BMI of 30.61 ± 6.86 were included. The majority of them were married and had university education. Most of the patients had types 1, 2 and commonly stages 1 and 2 lipedema. One hundred twenty-four patients (35%) satisfied FMS criteria. The demographic characteristics except pain intensity were similar between the groups. The mean anxiety and depression scores of Group 1 were significantly higher compared with Group 2 (13.11 ± 4.2 vs. 9.87 ± 4.65, 10.23 ± 3.79 vs. 8.26 ± 4.15, respectively, p < 0.001). The mental and physical subgroup scores of SF-12 (35.37 ± 8.59 vs. 42.55 ± 10.15, 35.27 ± 8.49 vs. 40.38 ± 11.36, respectively) were significantly lower in Group 1 than in Group 2 (p < 0.001). Conclusion: More than every 3 lipedema patient may have FMS. This comorbidity may increase depression and anxiety, and impair QoL. Therefore, FMS must be kept in mind especially in the assessment of painful lipedema patients to decrease anxiety/depression and enhance the QoL of them.
Collapse
Affiliation(s)
- Ayla Cagliyan Turk
- Department of Physical Medicine and Rehabilitation, Faculty of Medicine, Hitit University, Corum, Turkey
| | - Ender Erden
- Department of Physical Medicine and Rehabilitation, Faculty of Medicine, Hitit University, Corum, Turkey
| | - Dilek Eker Buyuksireci
- Department of Physical Medicine and Rehabilitation, Faculty of Medicine, Hitit University, Corum, Turkey
| | - Mutlu Umaroglu
- Institutional Big Data Management Coordination Office, Middle East Technical University, Ankara, Turkey
| | - Pinar Borman
- Department of Physical Medicine and Rehabilitation, Ankara City Hospital, University of Health Sciences, Ankara, Turkey
| |
Collapse
|
6
|
de Oliveira J. Lipedema: a new phenomenon for many people and a new field of study for psychiatry, nutrition, and psychology in Brazil. Rev Assoc Med Bras (1992) 2023; 70:e20231074. [PMID: 38126452 PMCID: PMC10729668 DOI: 10.1590/1806-9282.20231074] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/14/2023] [Accepted: 08/27/2023] [Indexed: 12/23/2023]
Affiliation(s)
- Jônatas de Oliveira
- Universidade de Sao Paulo, Faculty of Medicine, School of Medicine – Sao Paulo (SP), Brazil
| |
Collapse
|
7
|
Kaftalli J, Donato K, Bonetti G, Dhuli K, Macchia A, Maltese PE, Louise Herbst K, Michelini S, Chiurazzi P, Hill M, Michelini S, Michelini S, Marceddu G, Bernini A, Bertelli M. Aldo-keto reductase 1C2 (AKR1C2) as the second gene associated to non-syndromic primary lipedema: investigating activating mutation or overexpression as causative factors. Eur Rev Med Pharmacol Sci 2023; 27:127-136. [PMID: 38112953 DOI: 10.26355/eurrev_202312_34697] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/21/2023]
Abstract
OBJECTIVE Lipedema is a debilitating chronic condition predominantly affecting women, characterized by the abnormal accumulation of fat in a symmetrical, bilateral pattern in the extremities, often coinciding with hormonal imbalances. PATIENTS AND METHODS Despite the conjectured role of sex hormones in its etiology, a definitive link has remained elusive. This study explores the case of a patient possessing a mutation deletion within the C-terminal region of Aldo-keto reductases Member C2 (AKR1C2), Ser320PheTer2, that could lead to heightened enzyme activity. A cohort of 19 additional lipedema patients and 2 additional affected family members14 were enrolled in this study. The two additional affected family members are relatives of the patient with the AKR1C1 L213Q variant, which is included in the 19 cohorts and described in literature. RESULTS Our investigation revealed that AKR1C2 was overexpressed, as quantified by qPCR, in 5 out of 21 (24%) lipedema patients who did not possess mutations in the AKR1C2 gene. Collectively, these findings implicate AKR1C2 in the pathogenesis of lipedema, substantiating its causative role. CONCLUSIONS This study demonstrates that the activating mutation in the enzyme or its overexpression is a causative factor in the development of lipedema. Further exploration and replication in diverse populations will bolster our understanding of this significant connection.
Collapse
|
8
|
Jeziorek M, Chachaj A, Sowicz M, Adaszyńska A, Truszyński A, Putek J, Kujawa K, Szuba A. The Benefits of Low-Carbohydrate, High-Fat (LCHF) Diet on Body Composition, Leg Volume, and Pain in Women with Lipedema. J Obes 2023; 2023:5826630. [PMID: 38026822 PMCID: PMC10676278 DOI: 10.1155/2023/5826630] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/13/2023] [Revised: 11/06/2023] [Accepted: 11/09/2023] [Indexed: 12/01/2023] Open
Abstract
This study aimed to assess the potential benefits of a low-carbohydrate, high-fat (LCHF) diet on body composition, leg volume, and pain reduction in women with lipedema compared to overweight or women with obesity. The study included 113 female participants, 56 with lipedema and 57 with overweight/obesity (BMI >25 kg/m2) without lipedema. All subjects were prescribed a low-carbohydrate, high-fat (LCHF) diet with anti-inflammatory properties to adhere to for a duration of 7 months. Measurements of anthropometry, body weight, composition, and pain (VAS) were conducted at the study's commencement and conclusion. 52 participants completed the study. Both groups experienced a similar weight reduction, amounting to 12.9% compared to the baseline (-10.8 kg vs. -11.9 kg; p = 0.14, for lipedema and women with overweight/obesity, respectively). The most reduction was in body fat mass. Improvements in various parameters were observed, except for ankle circumferences, which decreased more in the lipedema group. Lipedema participants showed significantly reduced pain levels following the LCHF diet (4.6 ± 2.6 vs 3.0 ± 2.3; p < 0.001). The LCHF diet holds promise for weight loss, body fat reduction, leg volume management, and pain alleviation in women with lipedema. These findings provide valuable insights into potential therapeutic strategies for lipedema management.
Collapse
Affiliation(s)
- Małgorzata Jeziorek
- Department of Dietetics and Bromatology, Faculty of Pharmacy, Wroclaw Medical University, Wroclaw, Poland
| | - Angelika Chachaj
- Department of Angiology and Internal Medicine, Faculty of Medicine, Wroclaw Medical University, Wroclaw, Poland
| | - Monika Sowicz
- Department of Angiology and Internal Medicine, Faculty of Medicine, Wroclaw Medical University, Wroclaw, Poland
| | - Agnieszka Adaszyńska
- Department of Angiology and Internal Medicine, Faculty of Medicine, Wroclaw Medical University, Wroclaw, Poland
| | - Aleksander Truszyński
- Department of Angiology and Internal Medicine, Faculty of Medicine, Wroclaw Medical University, Wroclaw, Poland
| | - Justyna Putek
- Department of Angiology and Internal Medicine, Faculty of Medicine, Wroclaw Medical University, Wroclaw, Poland
| | - Krzysztof Kujawa
- Statistical Analysis Center, Wroclaw Medical University, Wroclaw, Poland
| | - Andrzej Szuba
- Department of Angiology and Internal Medicine, Faculty of Medicine, Wroclaw Medical University, Wroclaw, Poland
| |
Collapse
|
9
|
Forster K. Together we can beat lipoedema: collaboratively founding a Lipedema World Alliance. Br J Community Nurs 2023; 28:S10-S13. [PMID: 37757817 DOI: 10.12968/bjcn.2023.28.sup10.s10] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/29/2023]
Affiliation(s)
- Kate Forster
- Chartered Fellow of the Chartered Institute of Personnel and Development; Trustee of Lipoedema UK
| |
Collapse
|
10
|
Al-Ghadban S, Walczak SG, Isern SU, Martin EC, Herbst KL, Bunnell BA. Enhanced Angiogenesis in HUVECs Preconditioned with Media from Adipocytes Differentiated from Lipedema Adipose Stem Cells In Vitro. Int J Mol Sci 2023; 24:13572. [PMID: 37686378 PMCID: PMC10487727 DOI: 10.3390/ijms241713572] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2023] [Revised: 08/25/2023] [Accepted: 08/31/2023] [Indexed: 09/10/2023] Open
Abstract
Lipedema is a connective tissue disorder characterized by increased dilated blood vessels (angiogenesis), inflammation, and fibrosis of the subcutaneous adipose tissue. This project aims to gain insights into the angiogenic processes in lipedema using human umbilical vein endothelial cells (HUVECs) as an in vitro model. HUVECs were cultured in conditioned media (CM) collected from healthy (non-lipedema, AQH) and lipedema adipocytes (AQL). The impacts on the expression levels of multiple endothelial and angiogenic markers [CD31, von Willebrand Factor (vWF), angiopoietin 2 (ANG2), hepatocyte growth factor (HGF), vascular endothelial growth factor (VEGF), matrix metalloproteinase (MMPs), NOTCH and its ligands] in HUVECs were investigated. The data demonstrate an increased expression of CD31 and ANG2 at both the gene and protein levels in HUVECs treated with AQL CM in 2D monolayer and 3D cultures compared to untreated cells. Furthermore, the expression of the vWF, NOTCH 4, and DELTA-4 genes decreased. In contrast, increased VEGF, MMP9, and HGF gene expression was detected in HUVECs treated with AQL CM cultured in a 2D monolayer. In addition, the results of a tube formation assay indicate that the number of formed tubes increased in lipedema-treated HUVECs cultured in a 2D monolayer. Together, the data indicate that lipedema adipocyte-CM promotes angiogenesis through paracrine-driven mechanisms.
Collapse
Affiliation(s)
- Sara Al-Ghadban
- Department of Microbiology, Immunology and Genetics, University of North Texas Health Science Center, Fort Worth, TX 76107, USA; (S.G.W.); (S.U.I.)
| | - Samantha G. Walczak
- Department of Microbiology, Immunology and Genetics, University of North Texas Health Science Center, Fort Worth, TX 76107, USA; (S.G.W.); (S.U.I.)
| | - Spencer U. Isern
- Department of Microbiology, Immunology and Genetics, University of North Texas Health Science Center, Fort Worth, TX 76107, USA; (S.G.W.); (S.U.I.)
| | - Elizabeth C. Martin
- Department of Medicine, Section of Hematology and Oncology, Tulane University, New Orleans, LA 70118, USA;
| | | | - Bruce A. Bunnell
- Department of Microbiology, Immunology and Genetics, University of North Texas Health Science Center, Fort Worth, TX 76107, USA; (S.G.W.); (S.U.I.)
| |
Collapse
|
11
|
Di Renzo L, Gualtieri P, Zomparelli S, De Santis GL, Seraceno S, Zuena C, Frank G, Cianci R, Centofanti D, De Lorenzo A. Modified Mediterranean-Ketogenic Diet and Carboxytherapy as Personalized Therapeutic Strategies in Lipedema: A Pilot Study. Nutrients 2023; 15:3654. [PMID: 37630844 PMCID: PMC10457774 DOI: 10.3390/nu15163654] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2023] [Revised: 08/08/2023] [Accepted: 08/18/2023] [Indexed: 08/27/2023] Open
Abstract
In recent years, the use of the ketogenic diet as a proper nutritional treatment for lipedema has been hypothesized in the literature. This is the first clinical study evaluating the ketogenic diet and carboxytherapy in lipedema patients. In the present study, it was decided to use a modified Mediterranean ketogenic diet (MMKD) in combination with carboxytherapy. Since lipedema is characterized by microangiopathy, local hypoxia, and increased subcutaneous adipose tissue (SAT) deposition, carboxytherapy could improve painful symptoms and skin tone. A total of 22 subjects were included in the data analysis, divided into three groups; 8 patients underwent MMKD combined with carboxytherapy sessions (KDCB group), 8 underwent MMKD nutritional treatment alone (KD group), and 6 patients underwent only carboxytherapy sessions (CB group), for a total of 10 weeks of treatment for all three groups. It was observed that the ketogenic diet effectively induced weight and fat mass loss, including in the limbs, areas considered unresponsive to diet therapy in lipedema patients. However, the best results were obtained from the combination of the ketogenic diet and carboxytherapy, which showed improvements in both body composition and skin texture and a reduction in pain, along with an improvement in sleep quality. It would be helpful to conduct a clinical trial on a larger scale and over a more extended period to observe the results in the long term as well.
Collapse
Affiliation(s)
- Laura Di Renzo
- Section of Clinical Nutrition and Nutrigenomics, Department of Biomedicine and Prevention, University of Rome Tor Vergata, Via Montpellier 1, 00133 Rome, Italy
| | - Paola Gualtieri
- Section of Clinical Nutrition and Nutrigenomics, Department of Biomedicine and Prevention, University of Rome Tor Vergata, Via Montpellier 1, 00133 Rome, Italy
| | - Samanta Zomparelli
- School of Specialization in Food Science, University of Tor Vergata, Via Montpellier 1, 00133 Rome, Italy
| | - Gemma Lou De Santis
- PhD School of Applied Medical-Surgical Sciences, University of Rome Tor Vergata, Via Montpellier 1, 00133 Rome, Italy
| | - Silvia Seraceno
- School of Specialization in Food Science, University of Tor Vergata, Via Montpellier 1, 00133 Rome, Italy
| | - Claudia Zuena
- School of Specialization in Food Science, University of Tor Vergata, Via Montpellier 1, 00133 Rome, Italy
| | - Giulia Frank
- School of Specialization in Food Science, University of Tor Vergata, Via Montpellier 1, 00133 Rome, Italy
- PhD School of Applied Medical-Surgical Sciences, University of Rome Tor Vergata, Via Montpellier 1, 00133 Rome, Italy
| | - Rossella Cianci
- Department of Translational Medicine and Surgery, Fondazione Policlinico Universitario A. Gemelli, IRCCS, 00168 Rome, Italy
| | | | - Antonino De Lorenzo
- Section of Clinical Nutrition and Nutrigenomics, Department of Biomedicine and Prevention, University of Rome Tor Vergata, Via Montpellier 1, 00133 Rome, Italy
| |
Collapse
|
12
|
Esen Özdemir E, Borman P, Mete Civelek G, Umaroğlu MM. YouTube as a Source of Information on Lipedema: Property, Quality, and Reliability Assessment. Lymphat Res Biol 2023; 21:403-409. [PMID: 36927077 DOI: 10.1089/lrb.2022.0028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/18/2023] Open
Abstract
Background/Aim: YouTube provides information on several health-conditions including lipedema. The aim of this study was to investigate the properties, quality, and quantity of YouTube videos on lipedema. Methods: We explored YouTube using the key word lipedema and the initial top 50 videos were included to review. The properties comprising informers, target, and domains of videos covering number of views, likes, dislikes, duration, viewing rate (VR), and video power index (VPI) were recorded. A modified DISCERN tool and global quality scale (GQS) were used to assess the reliability and quality of videos, respectively. Results: The top 50 videos had a mean of 35,805 views, 282 likes, 12 dislikes, and 30 comments. The mean VPI (96.4) and VR (63.8%) were high. The videos were generally uploaded by health professionals for patient/public and health professional targets with the same ratio (50%). The majority of video contents was related to general information (68%) followed by surgical treatment (62%). Only a small ratio of their content (22%) was about nonsurgical management. The reliability and quality of the videos were intermediate to low. The median DISCERN and GQS scores were higher in the videos uploaded by health professional group compared with nonhealth professionals, but the number of views, VPI, and VR were similar between the groups with regard to the source. Conclusion: YouTube videos on lipedema are mostly provided by health professionals targeting both public/patients and health care providers but the content is limited and the quality and reliability of them were low to intermediate. Therefore, the lipedema specialists are suggested to work together to create up-to-date, high-quality, accessible online educational content to meet the needs of both patients/public and the health professionals. In addition, control mechanisms and careful peer reviewing of the videos informed by nonhealth professionals are warranted to avoid misleading information.
Collapse
Affiliation(s)
- Elif Esen Özdemir
- Department of Physical Medicine and Rehabilitation, Ankara City Hospital, University of Health Sciences Faculty of Medicine, Ankara, Turkey
| | - Pinar Borman
- Department of Physical Medicine and Rehabilitation, Ankara City Hospital, University of Health Sciences Faculty of Medicine, Ankara, Turkey
| | - Gül Mete Civelek
- Department of Physical Medicine and Rehabilitation, Ankara City Hospital, University of Health Sciences Faculty of Medicine, Ankara, Turkey
| | - Mümtaz Mutlu Umaroğlu
- Institutional Data Management Coordination Office, Middle East Technical University, Ankara, Turkey
| |
Collapse
|
13
|
Klimentidis YC, Chen Z, Gonzalez-Garay ML, Grigoriadis D, Sackey E, Pittman A, Ostergaard P, Herbst KL. Genome-wide association study of a lipedema phenotype among women in the UK Biobank identifies multiple genetic risk factors. Eur J Hum Genet 2023; 31:338-344. [PMID: 36385154 PMCID: PMC9995497 DOI: 10.1038/s41431-022-01231-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2021] [Revised: 09/27/2022] [Accepted: 10/31/2022] [Indexed: 11/18/2022] Open
Abstract
Lipedema is a common disorder characterized by excessive deposition of subcutaneous adipose tissue (SAT) in the legs, hips, and buttocks, mainly occurring in adult women. Although it appears to be heritable, no specific genes have yet been identified. To identify potential genetic risk factors for lipedema, we used bioelectrical impedance analysis and anthropometric data from the UK Biobank to identify women with and without a lipedema phenotype. Specifically, we identified women with both a high percentage of fat in the lower limbs and a relatively small waist, adjusting for hip circumference. We performed a genome-wide association study (GWAS) for this phenotype, and performed multiple sensitivity GWAS. In an independent case/control study of lipedema based on strict clinical criteria, we attempted to replicate our top hits. We identified 18 significant loci (p < 5 × 10-9), several of which have previously been identified in GWAS of waist-to-hip ratio with larger effects in women. Two loci (VEGFA and GRB14-COBLL1) were significantly associated with lipedema in the independent replication study. Follow-up analyses suggest an enrichment of genes expressed in blood vessels and adipose tissue, among other tissues. Our findings provide a starting point towards better understanding the genetic and physiological basis of lipedema.
Collapse
Affiliation(s)
- Yann C Klimentidis
- Department of Epidemiology and Biostatistics, Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, AZ, USA.
- BIO5 Institute, University of Arizona, Arizona, AZ, USA.
| | - Zhao Chen
- Department of Epidemiology and Biostatistics, Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, AZ, USA
| | | | - Dionysios Grigoriadis
- Genetics Research Centre, Molecular and Clinical Sciences Institute, St George's University of London, London, UK
| | - Ege Sackey
- Genetics Research Centre, Molecular and Clinical Sciences Institute, St George's University of London, London, UK
| | - Alan Pittman
- Genetics Research Centre, Molecular and Clinical Sciences Institute, St George's University of London, London, UK
| | - Pia Ostergaard
- Genetics Research Centre, Molecular and Clinical Sciences Institute, St George's University of London, London, UK
| | - Karen L Herbst
- TREAT Program, College of Medicine, University of Arizona, Tucson, AZ, USA
- Total Lipedema Care, Beverly Hills, CA, USA
| |
Collapse
|
14
|
Dancey A, Pacifico M, Kanapathy M, MacQuillan A, Ross G, Mosahebi A. Summary document on safety and recommendations on liposuction for lipoedema: Joint British association of aesthetic plastic surgeons (BAAPS)/British association of plastic reconstructive and aesthetic surgeons (BAPRAS) expert liposuction group. J Plast Reconstr Aesthet Surg 2023; 77:400-407. [PMID: 36638756 DOI: 10.1016/j.bjps.2022.12.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2021] [Revised: 12/04/2022] [Accepted: 12/09/2022] [Indexed: 12/24/2022]
Abstract
Liposuction plays an important role as a surgical treatment option for lipoedema. This article serves to critically review the evidence in the literature, as well as explain the differences between the lipoedema population compared with the aesthetic surgery population undergoing liposuction. It is not a comprehensive text on lipoedema management but serves to guide surgeons. This guidance was produced on behalf of the British Association of Aesthetic Plastic Surgeons (BAAPS) and the British Association of Plastic Reconstructive and Aesthetic Surgeons (BAPRAS) by the expert liposuction group. The guidance is based on the evidence available in the literature, along with a specialist expert opinion on liposuction for lipoedema, to provide plastic surgeons with a consensus recommendation for surgical treatment. The aim is to identify best practice to maximise the safety of patients. This article summarises current practices and safety considerations and outlines recommendations covering various aspects of patient care.
Collapse
Affiliation(s)
- Anne Dancey
- Parkway Hospital, 1 Damson Parkway, Solihull B91 2PP, United Kingdom.
| | - Marc Pacifico
- Purity Bridge, 19 Mount Ephraim, Tunbridge Wells, Kent TN4 8AE, United Kingdom.
| | - Muholan Kanapathy
- Department of Plastic and Reconstructive Surgery, Royal Free NHS Foundation Trust Hospital, London, NW3 2QG, United Kingdom; Division of Surgery & Interventional Science, University College London, London, WC1E 6BT, United Kingdom.
| | | | - Gary Ross
- University of Manchester, Oxford Rd, Manchester M13 9PL, United Kingdom
| | - Afshin Mosahebi
- Purity Bridge, 19 Mount Ephraim, Tunbridge Wells, Kent TN4 8AE, United Kingdom; Department of Plastic and Reconstructive Surgery, Royal Free NHS Foundation Trust Hospital, London, NW3 2QG, United Kingdom.
| |
Collapse
|
15
|
Kloosterman LM, Hendrickx A, Scafoglieri A, Jager-Wittenaar H, Dekker R. Functioning of People with Lipoedema According to All Domains of the International Classification of Functioning, Disability and Health: A Scoping Review. Int J Environ Res Public Health 2023; 20:1989. [PMID: 36767355 PMCID: PMC9915552 DOI: 10.3390/ijerph20031989] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/21/2022] [Revised: 01/13/2023] [Accepted: 01/19/2023] [Indexed: 06/18/2023]
Abstract
Lipoedema is a painful non-pitting diffuse "fatty" swelling, usually confined to the legs, that occurs mainly in women. This scoping review aimed to provide an overview of the available research on the functioning of people with lipoedema, according to the International Classification of Functioning, Disability and Health (ICF) framework. Relevant publications and gray literature were retrieved until October 2022. The results sections of each publication were organized using a thematic framework approach. All included studies reported at least one outcome fitting within the domains of body functions and body structures, with most studies focusing on the categories of "sensation of pain", "immunological system functions", and "weight maintenance functions". The ICF domains of activities and participation and environmental factors were mentioned in a small number of the included studies (17 and 13%, respectively), while the domain of personal factors was studied in half of the included studies. In conclusion, the emphasis of lipoedema research is on its description from a disorder-oriented point of view in the form of body functions and body structures, with a lack of information about the other domains of functioning.
Collapse
Affiliation(s)
- Lise Maren Kloosterman
- Research Group Healthy Ageing, Allied Health Care and Nursing, Hanze University of Applied Sciences, 9714 CA Groningen, The Netherlands
- FAITH Research, 9714 CA Groningen, The Netherlands
- Center of Expertise for Lymphovascular Medicine, Nij Smellinghe Hospital, Compagnonsplein 1, 9202 NN Drachten, The Netherlands
- Experimental Anatomy Research Department, Vrije Universiteit Brussel, 1090 Brussels, Belgium
| | - Ad Hendrickx
- Research Group Healthy Ageing, Allied Health Care and Nursing, Hanze University of Applied Sciences, 9714 CA Groningen, The Netherlands
- FAITH Research, 9714 CA Groningen, The Netherlands
- Center of Expertise for Lymphovascular Medicine, Nij Smellinghe Hospital, Compagnonsplein 1, 9202 NN Drachten, The Netherlands
- University of Groningen, University Medical Center Groningen, Department of Health Psychology, 9700 RB Groningen, The Netherlands
| | - Aldo Scafoglieri
- Experimental Anatomy Research Department, Vrije Universiteit Brussel, 1090 Brussels, Belgium
| | - Harriët Jager-Wittenaar
- Research Group Healthy Ageing, Allied Health Care and Nursing, Hanze University of Applied Sciences, 9714 CA Groningen, The Netherlands
- FAITH Research, 9714 CA Groningen, The Netherlands
- Experimental Anatomy Research Department, Vrije Universiteit Brussel, 1090 Brussels, Belgium
- University of Groningen, University Medical Center Groningen, Department of Oral and Maxillofacial Surgery, 9700 RB Groningen, The Netherlands
| | - Rienk Dekker
- University of Groningen, University Medical Center Groningen, Department of Rehabilitation Medicine, 9700 RB Groningen, The Netherlands
| |
Collapse
|
16
|
Granger L, Bolam SM, Sur A, Mitchell P, Hutt J, Sandiford NA. Five-year results after total knee arthroplasty in lymphoedema and lipoedema: encouraging functional and clinical outcomes and low rates of infection. Int Orthop 2022; 46:2815-2820. [PMID: 36075971 PMCID: PMC9674715 DOI: 10.1007/s00264-022-05575-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/08/2022] [Accepted: 09/01/2022] [Indexed: 12/13/2022]
Abstract
BACKGROUND The aim of this study was to define outcomes after total knee arthroplasty (TKA) in lymphoedema and lipoedema patients managed by a multidisciplinary team and daily compression bandaging. METHODS A retrospective study was performed in a single centre. Between 2007 and 2018, 36 TKA procedures were performed on 28 consecutive patients with a diagnosis of lymphoedema and lipoedema. Oxford Knee Scores (OKS), EuroQol-5D (EQ-5D) scores, satisfaction scores, radiographs, and complications were obtained at the final follow-up. Patients were admitted to the hospital up to two weeks prior to surgery and remained on the ward for daily compression bandaging by the specialist lymphoedema team. RESULTS Over the study period, 36 TKAs were performed on 28 patients (5 males, 23 females) with a mean age of 71 years (range 54-90). Of these, 30 TKAs were in patients with lymphoedema, five with lipoedema, and one with a dual diagnosis. Overall, 28 TKAs (21 patients) were available at the final follow-up with a mean follow-up time of 61 months (range 9-138). The mean BMI was 38.5 kg/m2. The mean pre-operative and post-operative Oxford Knee Score increased from 18 (range 2-38) to 29 (range 10-54); p < 0.001. EQ-5D score increased from 0.48 (range 0.15-0.80) to 0.74 (0.34-1.00) (p < 0.001). Mean post-operative satisfaction was 7.6/10 (range 2-10), with 89.3% TKAs satisfied. Complications were one (4%, 1/28) deep vein thrombosis, one superficial wound infection, one prosthetic joint infection, one stiff knee requiring manipulation, and one intra-operative femoral fracture. CONCLUSIONS Lymphoedema and lipoedema should not be seen as barriers to TKA if adopting a multidisciplinary approach.
Collapse
Affiliation(s)
- Luke Granger
- Trauma & Orthopaedics, St George's Hospital, London, UK
| | - Scott M Bolam
- Joint Reconstruction Unit, Department of Orthopaedics, Southland Hospital, Invercargill, 9812, New Zealand
- Department of Surgery, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
| | - Avtar Sur
- Trauma & Orthopaedics, St George's Hospital, London, UK
| | | | - Jonathan Hutt
- Trauma & Orthopaedics, St George's Hospital, London, UK
| | - Nemandra A Sandiford
- Joint Reconstruction Unit, Department of Orthopaedics, Southland Hospital, Invercargill, 9812, New Zealand.
- Department of Surgical Sciences, Division of Health Sciences, University of Otago, Dunedin, New Zealand.
| |
Collapse
|
17
|
Hu D, Yang S. Rare Concurrence of Alopecia Areata in the Setting of the Lipedematous Scalp. Am J Dermatopathol 2022; 44:831-833. [PMID: 36066127 DOI: 10.1097/dad.0000000000002261] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
ABSTRACT The lipedematous scalp (LS) is characterized by a thickened scalp because of the increased thickness of the subcutaneous fat layer. When the soft and boggy scalp is associated with shortened hairs and hair loss, it is referred to as lipedematous alopecia (LA). We report a case of alopecia areata with LS, which may be misdiagnosed as LA. However, the histopathologic features showed a thickened subcutaneous fat layer and hair bulb inflammation. Hair regrowth was appreciable after treatment with topical steroids, minoxidil, oral compound glycyrrhizin, and vitamin D. This case report aims to show that LS and alopecia areata may coexist, and histopathologic examination is necessary for precise diagnosis.
Collapse
Affiliation(s)
- Danchen Hu
- Department of Dermatology, Peking University First Hospital, Xicheng District, Beijing, China
- National Clinical Research Center for Skin and Immune Diseases, Beijing, China
- Beijing Key Laboratory of Molecular Diagnosis on Dermatoses, Beijing, China ; and
- NMPA Key Laboratory for Quality Control and Evaluation of Cosmetics, Beijing, China
| | - Shuxia Yang
- Department of Dermatology, Peking University First Hospital, Xicheng District, Beijing, China
- National Clinical Research Center for Skin and Immune Diseases, Beijing, China
- Beijing Key Laboratory of Molecular Diagnosis on Dermatoses, Beijing, China ; and
- NMPA Key Laboratory for Quality Control and Evaluation of Cosmetics, Beijing, China
| |
Collapse
|
18
|
Al-Wardat M, Clarke C, Alwardat N, Kassab M, Salimei C, Gualtieri P, Marchetti M, Best T, Di Renzo L. The Difficulties in Emotional Regulation among a Cohort of Females with Lipedema. Int J Environ Res Public Health 2022; 19:13679. [PMID: 36294260 PMCID: PMC9602978 DOI: 10.3390/ijerph192013679] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/02/2022] [Revised: 09/30/2022] [Accepted: 10/19/2022] [Indexed: 06/16/2023]
Abstract
BACKGROUND Lipedema is a chronic and progressive adipose tissue disorder that causes significant morbidity and negatively influences mental health and quality of life, and increases the risk of depression, anxiety, and eating disorders. One construct of relevance to better understanding psychological disorders is emotion regulation (ER). Therefore, the aim of this study is to investigate the difficulties in ER among lipedema patients compared to healthy people without lipedema. METHODS This cross-sectional study assessed differences in ER and anxiety between two groups: 26 female patients with lipedema and 26 sex- and age-matched healthy controls. The Difficulties in Emotion Regulation Scale (DERS) assessed emotional regulation across six dimensions: Impulse control, goal-directed behavior, awareness, clarity, non-acceptance, and strategies. Anxiety was assessed by the Hamilton Anxiety Scale (HAM-A). ANOVA assessed differences in measures between lipedema and healthy control groups. RESULTS Lipedema patients presented with significantly more difficulties in ER and a higher level of anxiety than those without lipedema. Specifically, the lipedema group showed higher and significant differences in total DERS and anxiety scores and all DERS subscales scores compared to those without lipedema. CONCLUSIONS Lipedema patients showed significant difficulties with ER, and were associated with anxiety symptoms, indicating that ER difficulties may play a role in developing emotional disorders, such as anxiety, for patients with lipedema. The health care provider should pay more attention to ER difficulties and psychological status among lipedema patients.
Collapse
Affiliation(s)
- Mohammad Al-Wardat
- Department of Rehabilitation Sciences, Faculty of Applied Medical Sciences, Jordan University of Science and Technology, Irbid P.O. Box 3030, Jordan
| | - Chantelle Clarke
- NeuroHealth Lab, Appleton Institute, School of Health, Medical and Applied Sciences, CQUniversity Australia, Brisbane 4000, Australia
| | - Nuha Alwardat
- Faculty of Applied Medical Sciences, Jerash University, Jerash P.O. Box 311, Jordan
| | - Manal Kassab
- Department of Maternal and Child Health, Faculty of Nursing, Jordan University of Science and Technology, Irbid P.O. Box 3030, Jordan
| | - Chiara Salimei
- Department of Clinical Sciences and Translational Medicine, University of Tor Vergata, Via Montpellier 1, 00133 Rome, Italy
| | - Paola Gualtieri
- Section of Clinical Nutrition and Nutrigenomic, Department of Biomedicine and Prevention, University of Tor Vergata, Via Montpellier 1, 00133 Rome, Italy
| | - Marco Marchetti
- Department of Clinical Sciences and Translational Medicine, University of Tor Vergata, Via Montpellier 1, 00133 Rome, Italy
- PhD School of Applied Medical-Surgical Sciences, University of Rome Tor Vergata, Via Montpellier 1, 00133 Rome, Italy
| | - Talitha Best
- NeuroHealth Lab, Appleton Institute, School of Health, Medical and Applied Sciences, CQUniversity Australia, Brisbane 4000, Australia
| | - Laura Di Renzo
- Section of Clinical Nutrition and Nutrigenomic, Department of Biomedicine and Prevention, University of Tor Vergata, Via Montpellier 1, 00133 Rome, Italy
| |
Collapse
|
19
|
Grigoriadis D, Sackey E, Riches K, van Zanten M, Brice G, England R, Mills M, Dobbins SE, Lee LL, Jeffery S, Dong L, Savage DB, Mortimer PS, Keeley V, Pittman A, Gordon K, Ostergaard P. Investigation of clinical characteristics and genome associations in the 'UK Lipoedema' cohort. PLoS One 2022; 17:e0274867. [PMID: 36227936 PMCID: PMC9560129 DOI: 10.1371/journal.pone.0274867] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2021] [Accepted: 09/06/2022] [Indexed: 11/08/2022] Open
Abstract
Lipoedema is a chronic adipose tissue disorder mainly affecting women, causing excess subcutaneous fat deposition on the lower limbs with pain and tenderness. There is often a family history of lipoedema, suggesting a genetic origin, but the contribution of genetics is currently unclear. A tightly phenotyped cohort of 200 lipoedema patients was recruited from two UK specialist clinics. Objective clinical characteristics and measures of quality of life data were obtained. In an attempt to understand the genetic architecture of the disease better, genome-wide single nucleotide polymorphism (SNP) genotype data were obtained, and a genome wide association study (GWAS) was performed on 130 of the recruits. The analysis revealed genetic loci suggestively associated with the lipoedema phenotype, with further support provided by an independent cohort taken from the 100,000 Genomes Project. The top SNP rs1409440 (ORmeta ≈ 2.01, Pmeta ≈ 4 x 10-6) is located upstream of LHFPL6, which is thought to be involved with lipoma formation. Exactly how this relates to lipoedema is not yet understood. This first GWAS of a UK lipoedema cohort has identified genetic regions of suggestive association with the disease. Further replication of these findings in different populations is warranted.
Collapse
Affiliation(s)
- Dionysios Grigoriadis
- Molecular and Clinical Sciences Institute, St George’s University of London, London, United Kingdom
| | - Ege Sackey
- Molecular and Clinical Sciences Institute, St George’s University of London, London, United Kingdom
| | - Katie Riches
- University Hospitals of Derby and Burton NHS Foundation Trust, Derby, United Kingdom
| | - Malou van Zanten
- Molecular and Clinical Sciences Institute, St George’s University of London, London, United Kingdom
| | - Glen Brice
- South West Thames Regional Genetics Unit, St George’s University of London, London, United Kingdom
| | - Ruth England
- University Hospitals of Derby and Burton NHS Foundation Trust, Derby, United Kingdom
| | - Mike Mills
- Molecular and Clinical Sciences Institute, St George’s University of London, London, United Kingdom
| | - Sara E. Dobbins
- Molecular and Clinical Sciences Institute, St George’s University of London, London, United Kingdom
| | - Li Ling Lee
- Molecular and Clinical Sciences Institute, St George’s University of London, London, United Kingdom
| | | | | | - Steve Jeffery
- Molecular and Clinical Sciences Institute, St George’s University of London, London, United Kingdom
| | - Liang Dong
- Metabolic Research Laboratories, Wellcome Trust-Medical Research Council Institute of Metabolic Science, University of Cambridge, Cambridge, United Kingdom
| | - David B. Savage
- Metabolic Research Laboratories, Wellcome Trust-Medical Research Council Institute of Metabolic Science, University of Cambridge, Cambridge, United Kingdom
| | - Peter S. Mortimer
- Molecular and Clinical Sciences Institute, St George’s University of London, London, United Kingdom
- Dermatology & Lymphovascular Medicine, St George’s Universities NHS Foundation trust, London, United Kingdom
| | - Vaughan Keeley
- University Hospitals of Derby and Burton NHS Foundation Trust, Derby, United Kingdom
- University of Nottingham Medical School, Nottingham, United Kingdom
| | - Alan Pittman
- Molecular and Clinical Sciences Institute, St George’s University of London, London, United Kingdom
| | - Kristiana Gordon
- Molecular and Clinical Sciences Institute, St George’s University of London, London, United Kingdom
- Dermatology & Lymphovascular Medicine, St George’s Universities NHS Foundation trust, London, United Kingdom
| | - Pia Ostergaard
- Molecular and Clinical Sciences Institute, St George’s University of London, London, United Kingdom
| |
Collapse
|
20
|
Chakraborty A, Crescenzi R, Usman TA, Reyna AJ, Garza ME, Al-Ghadban S, Herbst KL, Donahue PMC, Rutkowski JM. Indications of Peripheral Pain, Dermal Hypersensitivity, and Neurogenic Inflammation in Patients with Lipedema. Int J Mol Sci 2022; 23:10313. [PMID: 36142221 PMCID: PMC9499469 DOI: 10.3390/ijms231810313] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2022] [Revised: 08/25/2022] [Accepted: 09/01/2022] [Indexed: 11/25/2022] Open
Abstract
Lipedema is a disease with abnormally increased adipose tissue deposition and distribution. Pain sensations have been described in the clinical evaluation of lipedema, but its etiology remains poorly understood. We hypothesized that pain sensitivity measurements and ex vivo quantitation of neuronal cell body distribution in the skin would be lipedema stage-dependent, and could, thus, serve to objectively characterize neuropathic pain in lipedema. The pain was assessed by questionnaire and peripheral cutaneous mechanical sensitization (von-Frey) in lipedema (n = 27) and control (n = 23) consenting female volunteers. Dermal biopsies from (n = 11) Stages 1-3 lipedema and control (n = 10) participants were characterized for neuronal cell body and nociceptive neuropeptide calcitonin gene-related peptide (CGRP) and nerve growth factor (NGF) distribution. Stage 2 or 3 lipedema participants responded positively to von Frey sensitization in the calf and thigh, and Stage 3 participants also responded in the arm. Lipedema abdominal skin displayed reduced Tuj-1+ neuronal cell body density, compared to healthy controls, while CGRP and NGF was significantly elevated in Stage 3 lipedema tissues. Together, dermal neuronal cell body loss is consistent with hyper-sensitization in patients with lipedema. Further study of neuropathic pain in lipedema may elucidate underlying disease mechanisms and inform lipedema clinical management and treatment impact.
Collapse
Affiliation(s)
- Adri Chakraborty
- Department of Medical Physiology, Texas A&M University School of Medicine, Bryan, TX 77807, USA
- Currently the Arthritis & Autoimmune Diseases Research Center, Boston University School of Medicine, Boston, MA 02118, USA
| | - Rachelle Crescenzi
- Department of Radiology and Radiological Sciences, Vanderbilt University Medical Center, Nashville, TN 37232, USA
- Vanderbilt University Institute of Imaging Science, Vanderbilt University Medical Center, Nashville, TN 37232, USA
- Department of Biomedical Engineering, Vanderbilt University, Nashville, TN 37232, USA
| | - Timaj A. Usman
- Department of Medical Physiology, Texas A&M University School of Medicine, Bryan, TX 77807, USA
| | - Andrea J. Reyna
- Department of Medical Physiology, Texas A&M University School of Medicine, Bryan, TX 77807, USA
| | - Maria E. Garza
- Department of Radiology and Radiological Sciences, Vanderbilt University Medical Center, Nashville, TN 37232, USA
- Vanderbilt University Institute of Imaging Science, Vanderbilt University Medical Center, Nashville, TN 37232, USA
| | - Sara Al-Ghadban
- Department of Microbiology, Immunology & Genetics, University of North Texas Health Science Center, Fort Worth, TX 76107, USA
| | | | - Paula M. C. Donahue
- Physical Medicine and Rehabilitation, Vanderbilt University Medical Center, Nashville, TN 37232, USA
- Dayani Center for Health and Wellness, Vanderbilt University Medical Center, Nashville, TN 37232, USA
| | - Joseph M. Rutkowski
- Department of Medical Physiology, Texas A&M University School of Medicine, Bryan, TX 77807, USA
| |
Collapse
|
21
|
Justus Brauer W. Stemmer Sign Needs to be Recorded and Interpreted Correctly. Dtsch Arztebl Int 2021; 118:39. [PMID: 33759757 PMCID: PMC8129060 DOI: 10.3238/arztebl.m2021.0058] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
|
22
|
Keith L, Seo CA, Rowsemitt C, Pfeffer M, Wahi M, Staggs M, Dudek J, Gower B, Carmody M. Ketogenic diet as a potential intervention for lipedema. Med Hypotheses 2020; 146:110435. [PMID: 33303304 DOI: 10.1016/j.mehy.2020.110435] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2020] [Revised: 11/06/2020] [Accepted: 11/24/2020] [Indexed: 02/06/2023]
Abstract
Lipedema (LI) is a common yet misdiagnosed condition, often misconstrued with obesity. LI affects women almost exclusively, and its painful and life-changing symptoms have long been thought to be resistant to the lifestyle interventions such as diet and exercise. In this paper, we discuss possible mechanisms by which patients adopting a ketogenic diet (KD) can alleviate many of the unwanted clinical features of LI. This paper is also an effort to provide evidence for the hypothesis of the potency of this dietary intervention for addressing the symptoms of LI. Specifically, we examine the scientific evidence of effectiveness of adopting a KD by patients to alleviate clinical features associated with LI, including excessive and disproportionate lower body adipose tissue (AT) deposition, pain, and reduction in quality of life (QoL). We also explore several clinical features of LI currently under debate, including the potential existence and nature of edema, metabolic and hormonal dysfunction, inflammation, and fibrosis. The effectiveness of a KD on addressing clinical features of LI has been demonstrated in human studies, and shows promise as an intervention for LI. We hope this paper leads to an improved understanding of optimal nutritional management for patients with LI and stimulates future research in this area of study.
Collapse
Affiliation(s)
- L Keith
- The Lipedema Project, Boston, MA, USA; Lipedema Simplified, Boston, MA, USA.
| | - C A Seo
- The Lipedema Project, Boston, MA, USA; Lipedema Simplified, Boston, MA, USA
| | - C Rowsemitt
- Lipedema Simplified, Boston, MA, USA; Comprehensive Weight Management, Templeton, CA and Providence, RI, USA; The Lipedema Project: Medical Advisory Board, Boston, MA, USA
| | - M Pfeffer
- Lipedema Simplified, Boston, MA, USA; The Lipedema Project: Medical Advisory Board, Boston, MA, USA; I Choose Health, Metung, Australia
| | - M Wahi
- DethWench Professional Services, Boston, MA, USA
| | - M Staggs
- Lipedema Simplified, Boston, MA, USA
| | - J Dudek
- The Lipedema Project: Medical Advisory Board, Boston, MA, USA; SWPS University of Social Sciences and Humanities, Warsaw, Poland
| | - B Gower
- University of Alabama at Birmingham, Department of Nutrition Sciences, Birmingham, AL, USA
| | - M Carmody
- Harvard Medical School, Boston, MA, USA
| |
Collapse
|
23
|
Kurtkoti R. The European Lipoedema Association. Br J Community Nurs 2020; 25:S5. [PMID: 33030371 DOI: 10.12968/bjcn.2020.25.sup10.s5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
|
24
|
Hellgren M. [Not Available]. Lakartidningen 2017; 114:EXYI. [PMID: 29297923] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
|
25
|
Mellgrim S, Perbeck L. [Not Available]. Lakartidningen 2017; 114:EYIR. [PMID: 29316606] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Affiliation(s)
- Sue Mellgrim
- Lymfterapi Norrort - lymfterapeutisk verksamhet Stockholm, Sweden Lymfterapi Norrort - Mörbyleden 22, 8 tr. Stockholm, Sweden
| | - Leif Perbeck
- Karolinska Universitetssjukhuset - Bröst- sakrom och endokrinkirurgiska kliniken, P9:03 Stockholm, Sweden Endokrinkirurgiska kliniken - Karolinska Universitetssjukhuset, Soln Stockholm, Sweden
| |
Collapse
|
26
|
Abstract
Lipoedema UK was founded in 2012 by women with lipoedema and clinicians working in the Lymphoedema Service at St George's Hospital in London. Its patron is Professor Peter Mortimer, the UK's leading Lipoedema expert, and its nurse consultant is Sandy Ellis, who diagnoses and treats many women with Lipoedema in the UK and is also the nurse consultant in the St George's team. The charity's objectives are to educate doctors, health professionals and the public about lipoedema and its symptoms, so it may be diagnosed and treated earlier.
Collapse
|
27
|
HINES EA. Lipedema and physiologic edema. Proc Staff Meet Mayo Clin 1952; 27:7-9. [PMID: 14900206] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/28/2023]
|
28
|
|