背景:脂肪水肿中脂肪组织的病理特征通常是诊断的挑战,因此允许可变偏差并导致诊断不足。Lipedema是一种目前世界上鲜为人知的疾病,但它代表了一个公共卫生问题,要求立即,导向良好的医疗保健。科学信息不足限制了医疗行动,这限制了诊断和解决适当的多学科治疗。本研究旨在评估西班牙目前的脂肪水肿状况,以了解该疾病的病理生理特征,从而达成共识,统一并定义其诊断标准和医疗管理。同样,本研究旨在确定应用于研究患者的各种治疗方法的有效性,并评估与该疾病相关的大流行的后果。
方法:目前的工作是描述性的,分析在线问卷的横断面研究。它被应用于1069名患者,并在2021年至2022年期间收集了9个月。调查问卷分发给了主要的国家和地区组织的脂水肿患者。该研究包括一组诊断为脂肪水肿的所有患者和一组有六种或更多症状的未诊断患者。分析的变量是年龄,体重,高度,体重指数(BMI),脂水肿类型(根据Schingale的分类),症状(根据狼的分类,由Herbst修改),和进行的治疗(物理治疗,压缩服装,体育,饮食,射频,综合疗法,和手术),与患者对每种治疗方法的疾病改善程度的评分相关。
结果:有967名女性和2名男性,年龄在18至75岁之间(平均38.5岁);体重在33至150公斤之间(平均75.8公斤);身高在144至180厘米之间(平均164厘米);平均体重指数(BMI)为28.1。在我们的研究人群中,最常见的脂肪水肿是III型(影响臀部,大腿,和小牛)。单独改善患者生活质量最大的治疗方法是手术,只有多学科方法才能超越这种疾病,包括保守措施。
结论:通过这项研究,我们可以得出结论,在西班牙,脂肪水肿的诊断有一个真正的问题,明确需要积极寻求这种诊断,并提出多学科管理,因为它提供了最好的整体结果,当然,不要忘记,手术是治疗这种疾病的最关键的支柱之一。与这项研究中获得的结果一致,提出了标准,并应用于表示在判定临床诊断的脂肿时的统计值,考虑到提出六个或更多这些诊断标准的患者,很有可能,会有脂脉。
The pathologic features of fatty tissue in lipedema are often challenging to diagnose, thus allowing for variable bias and leading to underdiagnosis. Lipedema is a disease that is currently little known worldwide, but it represents a public health problem and demands immediate, well-directed healthcare. Insufficient scientific information limits medical action, which limits making diagnoses and addressing an adequate multidisciplinary treatment. This study aims to evaluate the current state of lipedema in Spain to contextualize the disease\'s pathophysiological characteristics and thus achieve a consensus that unifies and defines its diagnostic criteria and medical management. Likewise, this
study aims to determine the effectiveness of the various treatments applied to the
study patients and to evaluate the consequences of the pandemic related to this disease.
The present work is a descriptive, cross-sectional
study that analyzed online questionnaires. It was applied to 1069 patients and collected over 9 months between 2021 and 2022. The questionnaires were distributed to the leading national and regional associations of patients affected by lipedema. The
study included all patients in a group who had a diagnosis of lipedema and in a group of undiagnosed patients with six or more symptoms. The variables analyzed were age, weight, height, body mass index (BMI), type of lipedema (according to Schingale\'s classification), symptoms (according to Wolf\'s classification, modified by Herbst), and treatments performed (physiotherapy, compression garments, sports, diet, radiofrequency, mesotherapy, and surgery), associated with the score given by the patients regarding the degree of improvement in their disease with each of these treatments.
There were 967 women and 2 men between 18 and 75 years old (mean of 38.5 years); a body weight between 33 and 150 kg (mean 75.8 kg); a height between 144 and 180 cm (mean 164 cm); and an average body mass index (BMI) of 28.1. The most common kind of lipedema in our
study population was type III (affecting the hips, thighs, and calves). The treatment that individually improved patients\' quality of life the most was surgery, only surpassed by the multidisciplinary approach to the disease, including conservative measures.
With this study, we can conclude that, in Spain, there is a real problem associated with the diagnosis of lipedema, specifying the need to seek this diagnosis actively and propose multidisciplinary management, since it offers the best overall results, of course not without forgetting that surgery is one of the most critical pillars in the approach to this disease. Consistent with the results obtained in this
study, criteria were proposed and applied to represent a statistical value at the time of ruling on the clinical diagnosis of lipedema, considering that a patient who presents six or more of these diagnostic criteria, with a very high probability, will have lipedema.