Leg Volume in Patients with Lipoedema following Bariatric Surgery

Abstract

<b><i>Introduction:</i></b> Lipoedema is characterized as subcutaneous lipohypertrophy in association with soft-tissue pain affecting female patients. Recently, the disease has undergone a paradigm shift departing from historic reiterations of defining lipoedema in terms of classic edema paired with the notion of weight loss-resistant leg volume towards an evidence-based, patient-centered approach. Although lipoedema is strongly associated with obesity, the effect of bariatric surgery on thigh volume and weight loss has not been explored. <b><i>Material and Methods:</i></b> In a retrospective cohort study, thigh volume and weight loss of 31 patients with lipoedema were analyzed before and 10–18 and ≥19 months after sleeve gastrectomy (SG) or Roux-en-Y gastric bypass (RYGB). Fourteen patients, with distal leg lymphoedema (i.e., with healthy thighs), who had undergone bariatric surgery served as controls. Statistical analysis was performed using a linear mixed-effects model adjusted for patient age and initial BMI. <b><i>Results:</i></b> Adjusted initial thigh volume in patients with lipoedema was 23,785.4 mL (95% confidence interval [CI] 22,316.6–25,254.1). Thigh volumes decreased significantly in lipoedema and control patients (baseline vs. 1st follow-up, <i>p</i> < 0.0001 and <i>p</i> = 0.0001; baseline vs. 2nd follow-up, <i>p</i> < 0.0001 and <i>p</i> = 0.0013). Adjusted thigh volume reduction amounted to 33.4 and 37.0% in the lipoedema and control groups at the 1st follow-up, and 30.4 and 34.7% at the 2nd follow-up, respectively (lipoedema vs. control <i>p</i> > 0.999 for both). SG and RYGB led to an equal reduction in leg volume (operation type × time, <i>p</i> = 0.83). Volume reduction was equally effective in obese and superobese patients (weight category × time, <i>p</i> = 0.43). <b><i>Conclusion:</i></b> SG and RYGB lead to a significant thigh volume reduction in patients with lipoedema.

Indications of Peripheral Pain, Dermal Hypersensitivity, and Neurogenic Inflammation in Patients with Lipedema

“…There is a growing clinical consensus that therapeutic management of lipedema should consider the severity and location of pain present with disease severity. For instance, patients report a reduction in surveyed pain with use of compression garments or following limb volume reduction [ 1 , 34 , 35 ]. Though few treatment options specifically addressing pain are in use, a diagnostic approach to clinically identify pain in lipedema could objectively test and evaluate potential treatment options for one of the most troubling symptoms of lipedema.…”

Body‐Mass‐Index vs. Taille‐zu‐Größe‐Verhältnis bei Patientinnen mit Lipohyperplasia dolorosa (vulgo Lipödem)

“…Es gibt nur wenige LiDo‐Studien, die den WHtR zumindest erwähnen, ihn aber nicht zur Klassifizierung von metabolischen Risiken verwenden 18–22 . Ziel unserer Studie ist es, die Verteilung des WHtR bei LiDo‐Patientinnen zu bestimmen und mit ihrem BMI zu vergleichen.…”

Body mass index vs. waist‐to‐height‐ratio in patients with lipohyperplasia dolorosa (vulgo lipedema)

“…There are only a few LiDo studies that at least mention WHtR, although they do not use it for the classification of metabolic risks 18–22 . Our study aims to determine the distribution of WHtR in LiDo patients and to compare it with their BMI.…”

“…There are only a few LiDo studies that at least mention WHtR, although they do not use it for the classification of metabolic risks. [18][19][20][21][22] Our study aims to determine the distribution of WHtR in LiDo patients and to compare it with their BMI. The primary question is what WHtR patients with reliably diagnosed LiDo and any coincident overweight or obesity present.…”