Investigation of Systemic Inflammation Markers in Lipedema

Systemic Inflammatory Indices in Lipedema Compared With BMI-Matched Obesity: The Distinct Clinical Relevance of the C-Reactive Protein-to-Albumin Ratio

The aim of this study is to evaluate systemic inflammation in individuals with lipedema using hematological and biochemical inflammation indices and to examine the relationship between these indices and clinical findings. Additionally, the study aims to evaluate whether systemic inflammatory markers serve as objective biomarkers reflecting lipedema progression and clinical severity, and to assess their practical applicability in clinical practice.

Hypothesis: Systemic inflammation markers are higher in the lipedema group compared to healthy controls, and these markers are associated with clinical severity.

Although the current literature demonstrates local inflammation secondary to microvascular dysregulation and macrophage infiltration at the subcutaneous adipose tissue level, the impact of this pathological cascade on systemic circulation has not been sufficiently investigated. This research aims to comprehensively elucidate the systemic inflammatory component of lipedema for the first time in the literature by analyzing the pro-inflammatory and immunoregulatory status in lipedema cases through objective, quantitative, and standardized hematological biomarkers such as systemic hematological and biochemical indices. Furthermore, it is believed that examining the correlation of this inflammatory load with clinical findings will contribute to understanding the progression mechanisms of lipedema.

The aim of this research is to determine whether indices derived from complete blood count and biochemical hematological data, which are routine and low-cost tests, are valid inflammatory biomarkers in the pathology of lipedema. The main expected benefit is to provide clinicians with new, non-invasive, rapid, and cost-effective parameters that can be used in the differential diagnosis, clinical staging, and determination of progression risk of lipedema. It is also thought that demonstrating the inflammatory basis of the disease at the systemic level will lay the groundwork for identifying future therapeutic targets (anti-inflammatory or immunomodulatory agents).

Inclusion Criteria:

1. Inclusion Criteria (Patient Group)

1. Diagnosis of lipedema
2. Female patients aged 18-65 years
3. Literacy
4. Signing the informed consent form to participate in the study

2. Inclusion Criteria (Obese-Overweight Control Group)

1. Female patients aged 18-65 years
2. Age and BMI matched with patients with lipedema
3. Literacy
4. Signing the informed consent form to participate in the study

3. Inclusion criteria (healthy control group)

1. Being female, aged 18-65
2. BMI <25
3. Being literate
4. Having signed the informed consent form by agreeing to participate in the study

Exclusion Criteria:

1. Being under 18 or over 65 years of age
2. Acute infection, autoimmune/rheumatological disease, malignancy, hematological disease, receiving steroid/immunosuppressive treatment
3. Pregnancy
4. Peripheral artery disease
5. Severe cardiopulmonary failure (stage 3-4)
6. Systemic diseases such as uncontrolled hypertension and diabetes
7. Presence of cognitive impairment, hearing loss, communication difficulties that would hinder understanding of questionnaires and protocols