Jornal Vascular Brasileiro
https://jvascbras.org/article/doi/10.1590/1677-5449.202101981
Jornal Vascular Brasileiro
Original Article

Prevalência e fatores de risco para lipedema no Brasil

Lipedema prevalence and risk factors in Brazil

Alexandre Campos Moraes Amato; Fernando Campos Moraes Amato; Juliana Lelis Spirandeli Amato; Daniel Augusto Benitti

Downloads: 2
Views: 230

Resumo

Resumo: Contexto: O lipedema é caracterizado por deposição anormal de gordura em glúteos e pernas bilateralmente, que pode ser acompanhada por edema, dor e sensibilidade ao toque. Ainda é frequentemente confundido com condições mais frequentes, como obesidade e linfedema. A prevalência estimada na Europa varia entre 0,06% e 39%.

Objetivos: Avaliar a prevalência do lipedema na população brasileira e identificar fatores de saúde relacionados a essa doença.

Métodos: Foi aplicado um questionário de rastreamento on-line, previamente validado em amostra representativa da população geral. O questionário de rastreamento foi distribuído e aplicado em voluntárias anônimas representativas da população geral brasileira por software dedicado a análises populacionais.

Resultados: Um total de 253 mulheres respondeu ao questionário, e 12,3 ± 4% (intervalo de confiança de 95%) apresentaram sintomatologia compatível com alta probabilidade de diagnóstico de lipedema. Ansiedade, depressão, hipertensão e anemia foram correlacionadas com a alta probabilidade diagnóstica da doença.

Conclusões: A prevalência estimada do lipedema na população de mulheres brasileiras é de 12,3%.

Palavras-chave

prevalência, questionários, lipedema, obesidade, linfedema

Abstract

Lipedema is characterized as an abnormal deposition of fat in the buttocks and legs bilaterally that may be accompanied by swelling, pain, and tenderness. It is still often confused with more frequent conditions such as obesity and lymphedema. The estimated prevalence in Europe varies between 0.06% and 39%. Objectives: To evaluate the prevalence of lipedema and identify health factors related to it in the Brazilian population. Methods: Administration of a previously validated online screening questionnaire to a representative sample of the general population. The questionnaire was distributed and administered to anonymous volunteers representing the general Brazilian population using software designed for population analyses. Results: 253 women answered the questionnaire, 12.3 ± 4% (Confidence Interval [CI] 95%) of whom presented symptoms compatible with a high probability of being diagnosed with lipedema. Furthermore, anxiety, depression, hypertension, and anemia were also correlated with a high probability of the diagnosis. Conclusions: The estimated prevalence of lipedema in the population of Brazilian women is 12.3%.

Keywords

prevalence; questionnaires; lipedema; obesity; lymphedema.

References

1 Allen EV, Hines EA, Hines EA. Lipedema of the legs: a syndrome characterized by fat legs and orthostatic edema. Proc Staff Meet Mayo Clin. 1940;15:184-7.

2 Wold L, Hines EA Jr, Allen EV. Lipedema of the legs: a syndrome characterized by fat legs and edema. Ann Intern Med. 1951;34(5):1243-50. http://dx.doi.org/10.7326/0003-4819-34-5-1243. PMid:14830102.

3 Whonamedit? Allen-Hines syndrome. 2021 [citado 2021 out 28]. https://www.whonamedit.com/synd.cfm/2015.html

4 Kruppa P, Georgiou I, Biermann N, Prantl L, Klein-Weigel P, Ghods M. Lipedema-Pathogenesis, Diagnosis, and Treatment Options. Dtsch Arztebl Int. 2020;117(22-23):396-403. PMid:32762835.

5 Amato ACM. Is lipedema a unique entity? EC Clin Med Cases Reports. 2020;2:1-7.

6 Dudek JE, Białaszek W, Gabriel M. Quality of life, its factors, and sociodemographic characteristics of Polish women with lipedema. BMC Womens Health. 2021;21(1):27. http://dx.doi.org/10.1186/s12905-021-01174-y. PMid:33446179.

7 Fife CE, Maus EA, Carter MJ. Lipedema: a frequently misdiagnosed and misunderstood fatty deposition syndrome. Adv Skin Wound Care. 2010;23(2):81-92. http://dx.doi.org/10.1097/01.ASW.0000363503.92360.91. PMid:20087075.

8 Beninson J, Edelglass JW. Lipedema: the non-lymphatic masquerader. Angiology. 1984;35(8):506-10. http://dx.doi.org/10.1177/000331978403500806. PMid:6476475.

9 Amato ACM, Amato FCM, Benitti DA, Santos RV. Translation, cultural adaptation, and validation of a lipedema symptoms questionnaire. J Vasc Bras. 2020;19:e20200049. http://dx.doi.org/10.1590/1677-5449.200049. PMid:34178078.

10 Amato ACM, Saucedo DZ, Santos KS, Benitti DA. Ultrasound criteria for lipedema diagnosis. Phlebol J Venous Dis. 2021;36(8):026835552110023. PMid:33853452.

11 Cellina M, Gibelli D, Soresina M, et al. Non-contrast MR Lymphography of lipedema of the lower extremities. Magn Reson Imaging. 2020;71:115-24. http://dx.doi.org/10.1016/j.mri.2020.06.010. PMid:32561380.

12 Monnin-Delhom ED, Gallix BP, Achard C, Bruel JM, Janbon C. High resolution unenhanced computed tomography in patients with swollen legs. Lymphology. 2002;35(3):121-8. PMid:12363222.

13 Amato ACM, Amato FCM, Benitti DA, Amato LGL. Criação de questionário e modelo de rastreamento de lipedema. J Vasc Bras. 2020;19:e20200114. http://dx.doi.org/10.1590/1677-5449.200114.

14 Mandrekar JN. Receiver operating characteristic curve in diagnostic test assessment. J Thorac Oncol. 2010;5(9):1315-6. http://dx.doi.org/10.1097/JTO.0b013e3181ec173d. PMid:20736804.

15 Choy M, Switzer P, De Martel C, Parsonnet J. Estimating disease prevalence using census data. Epidemiol Infect. 2008;136(9):1253-60. http://dx.doi.org/10.1017/S0950268807009752. PMid:18047747.

16 Herpertz U. Krankheitsspektrum des lipodems an einer lymphologischen fachklinik - erscheinungsformen, mischbilder und behandlungsmoglichkeiten. Vasomed. 1997;9:301-7.

17 Amato ACM, Markus DV, dos Santos RV. Lipedema associado a obesidade, linfedema e insuficiência venosa: relato de um caso. Diagnóstico e Trat. 2020;25:4-8.

18 Schwahn-Schreiber C, Marshall M. Prävalenz des Lipödems bei berufstätigen Frauen in Deutschland. Phlebologie. 2011;40(03):127-34. http://dx.doi.org/10.1055/s-0037-1621766.

19 Instituto Brasileiro de Geografia e Estatística – IBGE. Projeção da população brasileira. 2021 [citado 2021 out 28]. https://www.ibge.gov.br/apps/populacao/projecao/index.html ().

20 Heen MSJ, Lieberman JD, Miethe TD. A comparison of different online sampling approaches for generating national samples. Cent Crime Justice Policy. 2014;1:1-8.

21 Instituto Brasileiro de Geografia e Estatística – IBGE. SIDRA. Tabela 5919: população, por níveis de instrução. 2021 [citado 2021 out 28]. https://sidra.ibge.gov.br/tabela/5919

22 Nunnaly J, Bernstein I. No psychometric theory. 3rd ed. New York: McGraw-Hill; 1994.

23 Asmussen PD, Földi M, Strößenreuther R, et al. Földi’s textbook of lymphology for physicians and lymphedema therapists. München: Elsevier Urban & Fischer; 2012.

24 Forner-Cordero I, Szolnoky G, Forner-Cordero A, Kemény L. Lipedema: an overview of its clinical manifestations, diagnosis and treatment of the disproportional fatty deposition syndrome - systematic review. Clin Obes. 2012;2(3-4):86-95. http://dx.doi.org/10.1111/j.1758-8111.2012.00045.x. PMid:25586162.

25 Schmeller W, Hueppe M, Meier-Vollrath I. Tumescent liposuction in lipoedema yields good long-term results. Br J Dermatol. 2012;166(1):161-8. http://dx.doi.org/10.1111/j.1365-2133.2011.10566.x. PMid:21824127.

26 Harwood CA, Bull RH, Evans J, Mortimer PS. Lymphatic and venous function in lipoedema. Br J Dermatol. 1996;134(1):1-6. http://dx.doi.org/10.1111/j.1365-2133.1996.tb07831.x. PMid:8745878.

27 Ruopp MD, Perkins NJ, Whitcomb BW, Schisterman EF. Youden index and optimal cut-point estimated from observations affected by a lower limit of detection. Biom J. 2008;50(3):419-30. http://dx.doi.org/10.1002/bimj.200710415. PMid:18435502.

28 Moraes IN. Cânones da beleza. Rev Cult e Saude. 2003;1:25-30.

29 Child AH, Gordon KD, Sharpe P, et al. Lipedema: an inherited condition. Am J Med Genet A. 2010;152A(4):970-6. http://dx.doi.org/10.1002/ajmg.a.33313. PMid:20358611.

30 Dudek JE, Białaszek W, Ostaszewski P. Quality of life in women with lipoedema: a contextual behavioral approach. Qual Life Res. 2016;25(2):401-8. http://dx.doi.org/10.1007/s11136-015-1080-x. PMid:26216585.

31 Romeijn JRM, de Rooij MJM, Janssen L, Martens H. Exploration of Patient Characteristics and Quality of Life in Patients with Lipoedema Using a Survey. Dermatol Ther (Heidelb). 2018;8(2):303-11. http://dx.doi.org/10.1007/s13555-018-0241-6. PMid:29748843.

32 Amato ACM, Silva AEC, Bernal IM, et al. Combined nutcracker and Ehlers-Danlos syndromes: a case report. EJVES Vasc Forum. 2020;47:12-7. http://dx.doi.org/10.1016/j.ejvsvf.2020.02.005. PMid:33078146.

33 Buck DW 2nd, Herbst KL. Lipedema: a relatively common disease with extremely common misconceptions. Plast Reconstr Surg Glob Open. 2016;4(9):e1043. http://dx.doi.org/10.1097/GOX.0000000000001043. PMid:27757353.

34 Wollina U, Heinig B. Treatment of lipedema by low-volume micro-cannular liposuction in tumescent anesthesia: results in 111 patients. Dermatol Ther. 2019;32(2):e12820. http://dx.doi.org/10.1111/dth.12820. PMid:30638291.

35 Herbst KL, Kahn LA, Iker E, et al. Standard of care for lipedema in the United States. Phlebology. 2021;36(10):779-96. http://dx.doi.org/10.1177/02683555211015887. PMid:34049453.

36 La Torre YSD, Wadeea R, Rosas V, Herbst KL. Lipedema: friend and foe. Horm Mol Biol Clin Investig. 2018;33(1):20170076. http://dx.doi.org/10.1515/hmbci-2017-0076. PMid:29522416.

37 Reich-Schupke S, Altmeyer P, Stücker M. Thick legs: not always lipedema Stefanie. J Dtsch Dermatol Ges. 2013;11(3):225-34. PMid:23231593.

38 Dayan E, Kim JN, Smith ML, et al. Lipedema - The Disease They Call FAT: An Overview for Clinicians. Lipedema Simplified Publications, 2017.
 


Submitted date:
12/21/2021

Accepted date:
03/09/2022

Sociedade Brasileira de Angiologia e Cirurgia Vascular (SBACV)"> Sociedade Brasileira de Angiologia e Cirurgia Vascular (SBACV)">
6287d81ca9539510f57c48a4 jvb Articles

J Vasc Bras

Share this page
Page Sections