LipedemaCare

建议用于脂肪水肿的补充剂及其机制

2026/4/29

引言

脂肪水肿是通常在女性中观察到的一种状况,其特征为下肢异常的脂肪积聚。治疗方案包括饮食、物理治疗和外科干预,以及建议使用各种补充剂。本研究将详细讨论在脂肪水肿治疗中提议的补充剂的效果和机制。

脂肪水肿的病理生理及补充剂的作用

脂肪水肿伴随着脂肪组织的异常积累,通常表现为疼痛、淤血和淋巴水肿等症状。尽管脂肪水肿的病理生理尚未完全了解,但遗传因素、荷尔蒙变化和炎症被认为起着重要作用。补充剂可以通过影响这些病理生理过程来支持脂肪水肿的管理。

此外,特别是具有抗炎和脂解特性的补充剂,可以帮助减少脂肪组织并控制炎症。例如,Omega-3脂肪酸通过其抗炎作用,可以对脂肪水肿患者的脂肪组织代谢产生积极影响 [1]。

补充剂的有效性可能因脂肪水肿的不同亚组中的个体而异。因此,确定个性化的治疗方法至关重要。补充剂的使用可以改善脂肪水肿的病程及对治疗的反应。

Omega-3脂肪酸

特别是含有EPA(二十碳五烯酸)和DHA(Docosahexaenoic acid,束状酸)的Omega-3脂肪酸,是脂肪水肿治疗中建议的关键补充剂。这些脂肪酸具有减少炎症和调节脂肪代谢的能力。研究表明,Omega-3脂肪酸可以阻止脂肪细胞的生长和繁殖 [2]。

此外,Omega-3脂肪酸通过抑制细胞水平的炎症反应和提高胰岛素敏感性,可以改善代谢。在脂肪水肿个体中,饮食中的Omega-3脂肪酸的摄入已被证明可以减少炎症和疼痛水平。这些补充剂的定期摄入可以为脂肪水肿的管理提供重要的支持。

黄酮类和抗氧化剂

黄酮类作为植物来源的化合物,具有强抗氧化特性。在脂肪水肿治疗中建议的黄酮之一是地奥司明。地奥司明通过增加静脉张力,具有改善淋巴流动的潜力 [3]。这可以帮助减少在脂肪水肿患者中常见的肿胀和疼痛。

此外,黄酮类减少炎症反应的能力可能在脂肪水肿的病理生理中提供重要的好处。由于其抗氧化特性,它们有助于防止细胞损伤,从而维持脂肪组织的健康。定期摄入黄酮类可能是一种有效的策略,以减缓脂肪水肿的进展。

维生素和矿物质

维生素和矿物质对整体健康和免疫功能是必需的。在脂肪水肿治疗中,尤其是维生素C和维生素D至关重要。维生素C通过增加胶原蛋白合成来支持皮肤健康,并维持血管完整性。维生素D在脂肪代谢中发挥作用,并能够提高胰岛素敏感性 [4]。

此外,镁和锌等矿物质也很重要。镁在细胞能量生产中发挥作用,而锌增强免疫系统并减少炎症。这些维生素和矿物质的充足摄入,可以显著改善脂肪水肿个体的整体健康状况。

酮体饮食与补充剂

酮体饮食以高脂肪和低碳水化合物的内容为特征。该饮食在脂肪水肿治疗中的潜力与提高身体脂肪燃烧能力和降低胰岛素水平有关 [5]。已有研究表明,酮体饮食的应用对脂肪水肿个体中的脂肪组织减少有积极影响。

结合酮体饮食,建议使用补充剂以确保必要营养素的充足摄入。特别是电解质补充剂(钠、钾、镁)起着关键作用。这些矿物质有助于在酮体过程中的电解质平衡,从而减少副作用的发生 [6]。

氨基酸和蛋白质补充剂

氨基酸是蛋白质的组成部分,在脂肪水肿的治疗中可发挥重要作用。特定的氨基酸,如谷氨酰胺和精氨酸,具有减少炎症和支持免疫系统的特性。谷氨酰胺在改善肠道健康方面有效,而精氨酸具有增加血流量的潜力 [7]。

蛋白质补充剂在支持脂肪损失和保持肌肉质量方面也是重要的。需要保证脂肪水肿个体的足够蛋白质摄入,以防止肌肉流失。高质量蛋白质来源和必要氨基酸的补充可以在治疗过程中提供支持。

结论与建议

脂肪水肿是一种具有复杂病理生理的状况,治疗过程需要多学科的方法。补充剂可以在脂肪水肿的管理中发挥重要作用,但应考虑到它们对每个个体的不同影响。因此,建议在使用补充剂之前咨询健康专业人士。

为了提高补充剂的有效性,均衡的饮食计划和定期的体育活动同样重要。在脂肪水肿个体中,治疗过程的持续性和规律的方法对于获得积极成果是必要的。适当使用补充剂可以改善脂肪水肿的病程,并提高患者的生活质量。

参考文献

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    摘要
    Rare adipose disorders (RADs) including multiple symmetric lipomatosis (MSL), lipedema and Dercum's disease (DD) may be misdiagnosed as obesity. Lifestyle changes, such as reduced caloric intake and increased physical activity are standard care for obesity. Although lifestyle changes and bariatric surgery work effectively for the obesity component of RADs, these treatments do not routinely reduce the abnormal subcutaneous adipose tissue (SAT) of RADs. RAD SAT likely results from the growth of a brown stem cell population with secondary lymphatic dysfunction in MSL, or by primary vascular and lymphatic dysfunction in lipedema and DD. People with RADs do not lose SAT from caloric limitation and increased energy expenditure alone. In order to improve recognition of RADs apart from obesity, the diagnostic criteria, histology and pathophysiology of RADs are presented and contrasted to familial partial lipodystrophies, acquired partial lipodystrophies and obesity with which they may be confused. Treatment recommendations focus on evidence-based data and include lymphatic decongestive therapy, medications and supplements that support loss of RAD SAT. Associated RAD conditions including depression, anxiety and pain will improve as healthcare providers learn to identify and adopt alternative treatment regimens for the abnormal SAT component of RADs. Effective dietary and exercise regimens are needed in RAD populations to improve quality of life and construct advanced treatment regimens for future generations.
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    Lipedema is a chronic disease that mostly manifests in females as the abnormal distribution of subcutaneous adipose connective tissue, usually coupled with bruising, pain, and edema. Lipedema molecular pathophysiology is currently not clear, but several studies suggest that genetics and hormonal imbalance participate in lipedema pathogenesis. Women with lipedema present in some cases with elevated body mass index, and the appearance of obesity in addition to lipedema, where the obesity can cause serious health issues as in lipedema-free individuals with obesity, such as diabetes and cardiovascular disorders. Unlike obesity, lipedema tissue does not respond well to diet or physical exercise alone. Therefore, in this review we discuss the effect of various dietary supplements that, along with diet and physical exercise, cause fat burning and weight loss, and which could potentially be important in the treatment of lipedema. Indeed, an effective fat burner should convert stored fats into energy, mobilize and break down triglycerides in adipocytes, boost metabolism and inhibit lipogenesis. Common ingredients of fat burning supplements are green tea, caffeine, chromium, carnitine, and conjugated linoleic acid. The use of fat burners could act synergistically with a healthy diet and physical exercise for decreasing adipose tissue deposition in patients with lipedema and resolve related health issues. The effects of fat burners in human studies are sometimes contradictory, and further studies should test their effectiveness in treating lipedema.
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    Lipedema, a chronic condition primarily affecting women, is characterized by abnormal subcutaneous fat accumulation and swelling in the extremities (while sparing the hands, feet, and trunk). This disease is associated with genetic predisposition, hormonal imbalances, impaired lymphatic function, and vascular dysfunction. Lipedema does not directly cause weight gain, but excess weight can worsen symptoms and accelerate disease progression. Bariatric surgery is considered a treatment option for body weight management and reduction of subcutaneous fat; however, reported studies have indicated that this treatment cannot reduce localized fat accumulation or fat cell hypertrophy or alleviate pain symptoms. Although no proven dietary treatment currently exists, nutrition plays a key role in managing lipedema. Certain dietary approaches such as ketogenic, low-carbohydrate, and modified Mediterranean diets have been explored for weight management and inflammation reduction in lipedema, with studies showing positive effects on body composition and pain. However, according to the current literature no evidence-based nutritional treatments or nutritional supplements are effective in this patient group. Nutritional therapy in lipedema is complicated by frequent comorbidities; therefore, precision nutritional therapy should be planned by evaluating the causes and consequences of the disease. In this review, we evaluated reported studies of current evidence-based clinical nutritional approaches to lipedema treatment.
  4. Bonetti Gabriele, Herbst Karen L, Donato Kevin, Dhuli Kristjana, Kiani Aysha Karim, Aquilanti Barbara, Velluti Valeria, Matera Giuseppina, Iaconelli Amerigo, Bertelli Matteo (2022). Dietary supplements for obesity.. Journal of preventive medicine and hygiene. PubMed.https://doi.org/10.15167/2421-4248/jpmh2022.63.2S3.2757
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    Obesity and associated complications including diabetes, cardiometabolic dysfunction, disability, malignancy and premature mortality are considered epidemic. Research on obesity is therefore of worldwide importance. The development of obesity is a multifactorial phenomenon with contributions from biological, behavioral, genetic and environmental factors. Obesity and its associated issues require various lifestyle modifications and treatment options such medication, exercise, diet, surgery, pharmacological therapy and dietary supplements. Dietary supplements are considered an attractive alternative to traditional therapy due to their low toxicity profile and their accessibility to the general population. Dietary supplements may include one or more dietary ingredients. In this narrative review, we analyze the effects on obesity and obesity-related issues of various natural components. For example, there are a myriad of supplements that have been used as dietary supplements for weight loss such as minerals, vitamins, amino acids, metabolites, herbs, and plant extracts. This narrative review aims to present the benefits and side-effects of several ingredients of dietary supplements for weight loss and treatment of obesity. In particular, the mechanism of action, results of clinical trials, and possible side effects will be presented for the following ingredients: β-Glucans, bitter orange, calcium, vitamin D, chitosan, chromium, cocoa, coleus forskohlii, conjugate linoleic acid, ephedra sinica, fucoxanthin, garcinia cambogia, glucomannan, green coffee, green tea, guar gum, raspberry, hoodia gordonii, irvingia gabonensis, phenylpropylamine, pyruvate, white kidney bean.
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    摘要
    Lipedema is a chronical progressive disease mostly found in women, characterized by an unproportional increase of fat in the limbs and pain. So far mental perspectives are not acceptably resolved. This study examines patients' aspects in health-related quality of life.733 women with lipedema were asked to answer the questionnaires SF-36, Mini-SCL, EFK, DKB-35 and RSES which were compared with normative data. Additional questions for continuative analysis were appended.Depending on the comparison sample, statistical calculation showed significant differences of means in all collected aspects of health-related quality of life. Affected people reported consistently more impairment. Investigations in coping showed that 'depressive processing' is used most frequently. Furthermore, there were significant saliences in SF-36 scales regarding to the stadium and the use of conservative therapies. Analyses of answers to additional questions showed that most patients feel insufficient understood by fellow men. Also, nearly the half feels inadequately informed about the disease.The outcome exposes clear restrictions in quality of life in patients with lipedema. Previous publications can be confirmed and supplemented. However, the study design of an open online survey makes distortions (e. g. selection of highly informed patients) within the sample possible.The resulting need of psychological interventions is obvious. In addition, enlightenment and sensitization in science and public are important to reduce stigmatization, to relieve patients' everyday life and increase the quality of life.
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    The Editor in Chief and the Publisher are issuing an expression of concern to alert readers to the fact that the Special Issue titled "Omics sciences in the personalization of diagnosis and therapy" and, in particular, the following articles: ·      J. Kaftalli, K. Donato, G. Bonetti, K. Dhuli, A. Macchia, P.E. Maltese, K. Louise Herbst, S. Michelini, P. Chiurazzi, M. Hill, S. Michelini, S. Michelini, G. Marceddu, A. Bernini, M. Bertelli. Aldo-keto reductase 1C2 (AKR1C2) as the second gene associated to non-syndromic primary lipedema: investigating activating mutation or overexpression as causative factors. Eur Rev Med Pharmacol Sci 2023; 27 (6 Suppl): 127-136. DOI: 10.26355/eurrev_202312_34697-PMID: 38112953. ·      M.C. Medori, K. Donato, L. Stuppia, T. Beccari, M. Dundar, R.S. Marks, S. Michelini, E. Borghetti, C. Zuccato, L. Seppilli, H. Elsangak, G. Sozanski, D. Malacarne, M. Bertelli. Achievement of sustainable development goals through the Mediterranean diet. Eur Rev Med Pharmacol Sci 2023; 27 (6 Suppl): 89-99. DOI: 10.26355/eurrev_202312_34693-PMID: 38112950. ·      K. Donato, M.C. Medori, A. Macchia, S. Cecchin, M.R. Ceccarini, T. Beccari, V. Gatta, L. Stuppia, V. Benfatti, L. Dalla Ragione, P. Chiurazzi C. Micheletti, K. Dhuli, G. Madeo, G. Bonetti, G. Marceddu, M. Bertelli. Genetic variants identified in novel candidate genes for anorexia nervosa and analysis of molecular pathways for diagnostic applications. Eur Rev Med Pharmacol Sci 2023; 27 (6 Suppl): 77-88. DOI: 10.26355/eurrev_202312_34692-PMID: 38112957. ·      K. Donato, K. Dhuli, A. Macchia, M.C. Medori, C. Micheletti, G. Bonetti, M.R. Ceccarini, T. Beccari, P. Chiurazzi, S. Cristoni, V. Benfatti, L. Dalla Ragione, M. Bertelli. Metabolomic profiling of amino acid alterations in anorexia nervosa: implications for appetite regulation and therapeutic strategies. Eur Rev Med Pharmacol Sci 2023; 27 (6 Suppl): 64-76. DOI: 10.26355/eurrev_202312_34691-PMID: 38112949. ·      M.R. Ceccarini, M.C. Medori, K. Dhuli, S. Tezzele, G. Bonetti, C. Micheletti, P.E. Maltese, S. Cecchin, K. Donato, L. Colombo, L. Rossetti, G. Staurenghi, A.P. Salvetti, M. Oldani, L. Ziccardi, D. Marangoni, G. Iarossi, B. Falsini, G. Placidi, F. D'Esposito, F. Viola, M. Nassisi, G. Leone, L. Cimino, L. De Simone, V. Mastrofilippo, T. Beccari, M. Bertelli. Autoantibodies detection in patients affected by autoimmune retinopathies. Eur Rev Med Pharmacol Sci 2023; 27 (6 Suppl): 57-63. DOI: 10.26355/eurrev_202312_34690-PMID: 38112948. ·      E. Kalluçi, E. Noka, K. Bani, X. Dhamo, I. Alimehmeti, K. Dhuli, G. Madeo, C. Micheletti, G. Bonetti, C. Zuccato, E. Borghetti, G. Marceddu, M. Bertelli. Correlation between COVID-19 and air pollution: the effects of PM2.5 and PM10 on COVID-19 outcomes. Eur Rev Med Pharmacol Sci 2023; 27 (6 Suppl): 39-47. DOI: 10.26355/eurrev_202312_34688-PMID: 38112947. ·      K. Dhuli, C. Micheletti, M.C. Medori, G. Madeo, G. Bonetti, K. Donato, F. Gaffuri, G.M. Tartaglia, S. Michelini, A. Fiorentino, D. Cesarz, S.T. Connelly, N. Capodicasa, M. Bertelli. The potential preventive role of a dietary supplement containing hydroxytyrosol in COVID-19: a multi-center study. Eur Rev Med Pharmacol Sci 2023; 27 (6 Suppl): 33-38. DOI: 10.26355/eurrev_202312_34687-PMID: 38112946. ·      K. Dhuli, M.C. Medori, C. Micheletti, K. Donato, F. Fioretti, A. Calzoni, A. Praderio, M.G. De Angelis, G. Arabia, S. Cristoni, S. Nodari, M. Bertelli. Presence of viral spike protein and vaccinal spike protein in the blood serum of patients with long-COVID syndrome. Eur Rev Med Pharmacol Sci 2023; 27 (6 Suppl): 13-19. DOI: 10.26355/eurrev_202312_34685-PMID: 38112944. are being reviewed again after publication by an independent Editor and a new group of reviewers due to concerns raised by readers on PubPeer regarding an undisclosed authors' conflict of interest and methodological issues of some articles. Further updates will be provided once the investigation is completed. The authors have been notified about this expression of concern.
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    摘要
    Lipoedema is a progressive disease, which predominantly affects women. It is characterised by circumferential growth, with increase in fat tissue of the extremities, and can lead to oedema. In contrast, the lymphoedema is defined by a specific lymphatic drainage disorder and can lead to fibrosis of the surrounding connective tissue. While lipoedema is diagnosed through clinical symptoms and diagnostic imaging can usually only be used to rule out comorbidities, lymphatic drainage disorder can be visualised using imaging methods. Ultrasound is a basis diagnostic tool to show retained interstitial fluid in lip- and lymphoedema. Lymphoscintigraphy is considered to be the gold standard to demonstrate a lymphatic drainage disorder, which can be combined with computed tomography. Indocyanine green(ICG) lymphography is a dynamic imaging tool, which is of increasing significance due to its possible intraoperative use. Magnetic resonance imaging (MRI) lymphography has the ability to visualise a lymphoedema and a lymphatic drainage disorder in three dimensions and is therefore considered to be a meaningful supplement. Therapy of lip- and lymphoedema should always be based on a combination of conservative and surgical strategies. While liposuction and other resection procedures can lead to symptom relief in lipedoema or advanced lymphoedema, newer reconstructive procedures such as lymph node transplantation or lymphovenous anastomoses are modern techniques to treat lymphoedema. A long lasting volume reduction can be achieved by creating new lymphatic pathways leading to improved quality of life and reduced symptoms.

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