Non-obese lipedema patients show a distinctly altered Quantitative Sensory Testing profile with high diagnostic potential

Abstract

AbstractBackgroundLipedema is a widespread severe chronic disease affecting mostly women. Characterized by painful bilateral fat accumulation in extremities sparing hands and feet, objective measurement-based diagnosis is currently missing. We tested for characteristic psychometric and/or sensory alterations including pain and for their potential for medical routine diagnostic.MethodsPain-psychometry were assessed using the German Pain Questionnaire. Sensory sensitivity toward painful and non-painful stimuli was characterized in non-obese lipedema patients and matched controls using the validated QST-protocol of the German Research Network on Neuropathic Pain.ResultsLipedema patients showed no overt psychometric abnormalities. Pain was reported as somatic rather than psychosomatic-aversive. All QST measurements were normal, but the pressure pain threshold (PPT) was twofold reduced and the vibration detection threshold (VDT) was two and a half times increased. Both thresholds were selectively altered at the affected thigh but not the unaffected hand. ROC-analysis of the combination of PPT and VDT of thigh versus hand into a PVTH-score shows high sensitivity and specificity, categorizing correctly 96.5% of the participants as lipedema patients or healthy controls. Bayesian inference analysis corroborated the diagnostic potential of a combined PVTH score.ConclusionWe propose to assess PPT and VDT at the painful thigh and the pain-free hand. Combination in a PVTH-score may allow a convenient lipedema diagnosis early during disease development.Trial RegistrationGerman Clinical Trials Register (DRKS00030509)FundingThe project was funded by the DFG (459479161).