Table_1_The effect of a low-carbohydrate diet on subcutaneous adipose tissue in females with lipedema.DOCX

IntroductionLipedema is a common, yet underdiagnosed, subcutaneous adipose tissue (SAT) disorder. The main characteristics are SAT expansion in the lower extremities and arms, pain, and tenderness to palpation. It remains unknown if a low-carbohydrate diet (LCD) influences SAT in females with lipedema.ObjectivesTo evaluate the effect of a LCD low-energy diet, compared to a low-fat isoenergetic control diet, on calf subcutaneous adipose tissue area, muscle area, SAT/muscle ratio, calf circumference and body composition in females with lipedema.Subjects/methodsAdult females with obesity and lipedema were randomized to 1,200 kcal/day diets, either LCD or control (75 and 180 g/day of carbohydrates, respectively) for 8 weeks. Body composition was measured with bioelectrical impedance analysis, calf SAT area, muscle area, and circumference with magnetic resonance imaging and pain with brief pain inventory, before and after the intervention.ResultsThirteen participants were included (five in the LCD group), with a mean age of 46 ± 12 years and a BMI of 37 ± 6 kg/m2. A significant reduction in calf SAT area, calf circumference, and pain was observed in the LCD group only. Both LCD and control groups experienced a significant reduction body weight, fat mass, fat free mass, and muscle area, with no differences between groups. No significant changes over time were found for SAT/muscle ratio.ConclusionA LCD has the potential to reduce SAT and pain in females with lipedema, despite a reduction in muscle mass in lipedema affected areas in both diet groups. Further studies are needed to confirm these findings and explore potential mechanisms.Clinical trial registrationNCT04632810: Effect of ketosis on pain and quality of life in patients with lipedema (Lipodiet). https://clinicaltrials.gov/study/NCT04632810.

脂膜炎是一种常见但诊断率较低的皮下脂肪组织（SAT）疾病。其主要特征为下肢及上臂的SAT扩张、疼痛及触痛。关于低碳水化合物饮食（LCD）是否会影响患有脂膜炎的女性SAT尚无定论。研究目标在于评估低碳能量饮食（LCD）与低脂等能量控制饮食相比，对患有脂膜炎女性的腓肠皮下脂肪面积、肌肉面积、SAT/肌肉比例、腓肠周长及身体成分的影响。研究对象与方法：肥胖并伴有脂膜炎的成年女性被随机分配至每日摄入1,200千卡尔的饮食中，分为LCD组或对照组（碳水化合物摄入量分别为每日75克和180克），持续8周。通过生物电阻抗分析测量身体成分，利用磁共振成像测量腓肠SAT面积、肌肉面积及周长，并通过简短疼痛问卷评估疼痛程度。干预前后进行测量。结果：共有13名参与者被纳入研究（LCD组5人），平均年龄为46±12岁，BMI为37±6千克/平方米。仅在LCD组观察到腓肠SAT面积、腓肠周长和疼痛显著减少。LCD组和对照组均经历了体重、体脂、去脂体重和肌肉面积的显著减少，两组之间无显著差异。SAT/肌肉比例随时间推移无显著变化。结论：低碳水化合物饮食具有降低患有脂膜炎女性SAT和疼痛的潜力，尽管两组饮食中受脂膜炎影响的区域肌肉质量均有所减少。需要进一步的研究来证实这些发现并探索潜在的机制。临床试验注册号：NCT04632810：酮症对脂膜炎患者疼痛和生活质量的影响（Lipodiet）。https://clinicaltrials.gov/study/NCT04632810。