Endocrine Abstracts

Aim: Lipedema is a painful fat disorder that affects ~11% of the female population, characterized by bilateral, disproportionate accumulation of subcutaneous adipose tissue predominantly in the lower body. The initial manifestations of lipedema arise in phases of hormonal change (puberty, pregnancy, menopause). The pathophysiology of lipedema is unclear. The putative causes proposed include altered adipogenesis, microangiopathy, and disturbed lymphatic microcirculation The diseases is diagnosed on the basis of its main manifestations: pain, a feeling of tension, and increased tendency to form hematomas in the affected areas. Treatment is symptomatically oriented and based on complex decongestive therapy and nutritional regimen, low carb or ketogenic. There are four stages of lipedema that refer primarily to changes in the skin, based on the progression of fat accumulation and changes to the skin. The fourth stage is a condition characterized by lymphological complications secondary to the failure of lymphatic system. A higher incidence of endocrinopathies, such as obesity and thyroid diseases, has been described in woman with lipedema, but no studies have been done in Italy. The aim of the study was to evaluate the prevalence of these endocrine diseases in an Italian population of women with lipedema

Materials and methods: Sixty-five women suffering from lipedema, who arrived consecutively at the lymphological clinic, underwent an endocrinological examination, with particular reference to the presence of obesity and thyroid diseases.

Results: The median age was 41.1 ± 13.5 years. Twenty-two women had stage 1 lipedema, twenty-five stage 2 lipedema, fifteen stage 3 lipedema and three stage 4 lipedema. Thirteen women (20%) were normal weght (BMI <25 kg/m2), twenty-two women (33.8 %) were overweight (BMI ≥ 25 <30), thirty women (46.2%) were obese (BMI ≥30.0). The prevalence of obesity increases with the lipedema stage (P<0.001): 9.1% in stage 1, 48 % in stage 2, 86.7 % in stage 3, 100 % in stage 4. Hypothyroidism was present in twenty-seven patients (41.5%). The prevalence of hypothyroidism (autoimmune and non-autoimmune hypothyroidism) increases with the lipedema stage (P<0.001): 18.2 % in stage 1, 40 % in stage 2, 66.7 % in stage 3, 100 % in stage 4.

Conclsion: The study confirms a high prevalence of obesity and hypothyroidism in patients with lipedema in Italian population and suggests a correlation between these diseases with the lipedema stage. Obesity and thyroid dysfunction should be evaluated in patients with lipedema, especially because for the possible worsening effect on the evolution of lipedema.