Differentiating lipedema and Dercum's disease
Differentiating lipedema and Dercum's disease
复制标题
DOI：
10.1038/ijo.2016.205
复制
发表时间：
2017-02-01
影响因子：
4.9
通讯作者：
Herbst, K. L.
中科院分区：
文献类型：
--
作者：
Beltran, K.;Herbst, K. L.
背景技术背景：患有脂肪水肿或Dercum病（DD）的人可能有类似的多余疼痛结节性皮下脂肪组织（SAT）分布，这使得他们难以区分。病例系列包括94例DD患者、160例脂肪水肿患者和18例两种诊断（Lip+DD）患者，这些患者来自一个学术医学中心的一个诊所，通过比较临床结果来提高这些疾病的识别和鉴别，2型糖尿病（DM 2）的患病率，通过Beighton评分和炎症标志物总补体活性（CH 50）的评估的高活动性。与DD组相比，脂水肿组的体重、体重指数（BMI）、妇科样分布的结节状SAT、纤维化和重组织明显更大。脂水肿组的高活动性（58个副产物0.5%）显著高于DD组（23 +/- 0.4%; P < 0.0001）。DD组的DM 2（16 +/- 0.2%; P = 0.0007）显著高于脂肪水肿组（6 +/- 0.2%）。模拟量表显示，DD组的平均疼痛（6 +/- 2.5%）显著高于脂肪水肿组（4 +/- 2.1%; P < 0.0001）。疲劳和肿胀在两组中都很常见。容易瘀伤在脂肪水肿组中更常见，而腹痛、呼吸急促、纤维肌痛、偏头痛和脂肪瘤在DD组中更常见。CH 50升高的患者的百分比是显着积极的两个groups.CONCLUSIONS：DM 2的人与脂肪水肿的患病率显着降低DD相比，可能是由于更大量的gynoid脂肪已知是保护代谢紊乱。脂肪水肿患者中高比例的高活动性表明它可能是一种共病。脂肪的位置，高平均每日疼痛，脂肪瘤的存在和合并症的疼痛疾病的DD患者可能有助于区分脂肪水肿。
BACKGROUND: People with lipedema or Dercum's disease (DD) can have a similar distribution of excess painful nodular subcutaneous adipose tissue (SAT), making them difficult to differentiate.METHODS: Case series of 94 patients with DD, 160 with lipedema and 18 with both diagnoses (Lip+DD) from a single clinic in an academic medical center to improve identification and differentiation of these disorders by comparison of clinical findings, prevalence of type 2 diabetes (DM2), hypermobility by the Beighton score and assessment of a marker of inflammation, Total complement activity (CH50).RESULTS: Differences between groups were by Student's t-test with a of 0.05. The Lipedema Group had significantly greater weight, body mass index (BMI), gynoid distributed nodular SAT and fibrotic and heavy tissue than the DD Group. Hypermobility was significantly higher in the Lipedema (58 coproduct 0.5%) than DD Group (23 +/- 0.4%; P < 0.0001). DM2 was significantly greater in the DD (16 +/- 0.2%; P = 0.0007) than the Lipedema Group (6 +/- 0.2%). Average pain by an analog scale was significantly higher in the DD (6 +/- 2.5%) than the Lipedema Group (4 +/- 2.1%; P < 0.0001). Fatigue and swelling were common in both groups. Easy bruising was more common in the Lipedema Group, whereas abdominal pain, shortness of breath, fibromyalgia, migraines and lipomas were more prevalent in the DD Group. The percentage of patients with elevated CH50 was significantly positive in both groups.CONCLUSIONS: The significantly lower prevalence of DM2 in people with lipedema compared with DD may be due to the greater amount of gynoid fat known to be protective against metabolic disorders. The high percentage of hypermobility in lipedema patients indicates that it may be a comorbid condition. The location of fat, high average daily pain, presence of lipomas and comorbid painful disorders in DD patients may help differentiate from lipedema.