The Difficulties in Emotional Regulation among a Cohort of Females with Lipedema.

BACKGROUND: Lipedema is a chronic and progressive adipose tissue disorder that causes significant morbidity and negatively influences mental health and quality of life, and increases the risk of depression, anxiety, and eating disorders. One construct of relevance to better understanding psychological disorders is emotion regulation (ER). Therefore, the aim of this study is to investigate the difficulties in ER among lipedema patients compared to healthy people without lipedema. METHODS: This cross-sectional study assessed differences in ER and anxiety between two groups: 26 female patients with lipedema and 26 sex- and age-matched healthy controls. The Difficulties in Emotion Regulation Scale (DERS) assessed emotional regulation across six dimensions: Impulse control, goal-directed behavior, awareness, clarity, non-acceptance, and strategies. Anxiety was assessed by the Hamilton Anxiety Scale (HAM-A). ANOVA assessed differences in measures between lipedema and healthy control groups. RESULTS: Lipedema patients presented with significantly more difficulties in ER and a higher level of anxiety than those without lipedema. Specifically, the lipedema group showed higher and significant differences in total DERS and anxiety scores and all DERS subscales scores compared to those without lipedema. CONCLUSIONS: Lipedema patients showed significant difficulties with ER, and were associated with anxiety symptoms, indicating that ER difficulties may play a role in developing emotional disorders, such as anxiety, for patients with lipedema. The health care provider should pay more attention to ER difficulties and psychological status among lipedema patients.

The association between serum vitamin D and mood disorders in a cohort of lipedema patients.

OBJECTIVES: The association between serum Vitamin D (Vit. D) and mood disorders in lipedema patients has not been investigated. Therefore, the main aim of this study is to investigate the correlation between serum Vit. D, depression and anxiety risk. METHODS: A cross-sectional cohort of lipedema patients were investigated by collecting the clinical and demographic data. The Hamilton Depression Scale (HAM-D) and the Hamilton of Anxiety Scale (HAM-A) were used to evaluating the risk of depression and anxiety. Serum concentrations of Vit. D were measured. The association between Vit. D levels and both HAM-A and HAM-D scores were statistically examined by bivariate and partial correlations. RESULTS: Forty lipedema patients were enrolled in this study. Around two-thirds of them had a higher depression or anxiety risk, and 77.5% were under the normal serum Vit. D levels. A significant and inverse correlation was observed between serum Vit. D levels and both HAM-D (r=-0.661, p<0.001), and HAM-A (r=-0.496, p=0.001) scores. This strong association was sustained after the statistical model adjusted for the main potential confounding factors (age, body mass index (BMI), disease duration, and lipedema stages). Additionally, serum Vit. D correlated significantly and inversely with BMI (r=-0.647, p<0.001). Moreover, BMI significantly correlated with HAM-D: r=0.560, p<0.001, and HAM-A: r=0.511, p=0.00. CONCLUSIONS: This study suggests a strong correlation between Vit. D levels, depression scores, and anxiety scores in lipedema patients. Our results also demonstrate a strong and direct relationship between BMI, Vit. D levels, depression, and anxiety.

The effect of lipedema on health-related quality of life and psychological status: a narrative review of the literature.

PURPOSE: The aim of this narrative review of the literature was to evaluate and summarize the current literature regarding the effect of lipedema on health-related quality of life (HRQOL) and psychological status. METHODS: The authors collected articles through a search into Medline, Embase, Scopus, Web of Science, Physiotherapy Evidence Database (PEDro), and the Cochrane Review. Search terms used included "Lipoedema," "Lipedema," "psychological status," "Quality of life," "Health related quality of life," and "HRQOL." RESULTS: A total of four observational studies were evaluated. The included studies were moderate-quality according to the Newcastle-Ottawa Scale. Three of the included studies demonstrated deterioration of HRQOL and psychological status in patients with lipedema. These studies also identify that pain and tenderness are a more common and dominant characteristic. CONCLUSION: Future studies should establish a specific approach to treat and manage lipedema symptoms. Based on this narrative review of the literature findings, we recommended for the health care provider to pay more attention to HRQOL and psychological status. Moreover, validated and adapted measures of HRQOL and psychological status for patients with lipedema are required. LEVEL OF EVIDENCE: Level V, narrative review.

Health benefits of Mediterranean diet in nonalcoholic fatty liver disease.

INTRODUCTION: Nonalcoholic fatty liver disease (NAFLD) is the most common liver disease worldwide. Insulin resistance and obesity-related inflammatory status, associated with genetic, dietary, and lifestyle factors, are involved in its pathogenesis. There is no consensus concerning the pharmacological treatment of NAFLD. However, the international guidelines agree to define a dietetic nutritional management to achieve weight loss, as an essential component of any therapeutic strategy. Areas covered: An overview on the beneficial effects of the Mediterranean diet in the prevention and treatment of NAFLD. Expert commentary: On the basis of its components, the literature reports the beneficial effects of the Mediterranean diet in preventing major chronic diseases, including obesity, diabetes, cardiovascular diseases, and some forms of cancers. In recent years, a growing body of evidence has supported the idea that the Mediterranean diet, associated with physical activity and cognitive behavior therapy, may be the reference nutritional profile for the prevention and the treatment of NAFLD patients.

Association between hypertension and metabolic disorders among elderly patients in North Jordan.

BACKGROUND: Hypertension (HTN), dyslipidemia and hyperglycemia are major risk factors for cardiovascular disease, accounting for the highest morbidity and mortality among the elderly Jordanian population. This study aimed to evaluate serum lipid and glucose profiles of hypertensive patients and normotensive controls, and determine the risk factors for HTN among elderly population in Jordan. METHODS: A cross-sectional study was carried out among 200 participants, including 111 hypertensive patients and 89 normotensive controls from June to October 2017 in North Jordan. Data were collected on sociodemographic factors, anthropometric measurements, blood pressure, and lipid profile including total cholesterol (TC), triglyceride (TG), low density lipoprotein (LDL), high density lipoprotein (HDL) and fasting blood sugar (FBS). RESULTS: Serum levels of TC, TG, LDL and FBS were higher while HDL levels were lower in hypertensive subjects compared to normotensives (p < 0.01). There were no differences between hypertensive and normotensives patients regarding their age, waist circumference (WC), waist-to-height ratio (WHtR) and body mass index (BMI). Anthropometric and biochemical parameters were significantly correlated only in normotensive group. Significant associations between blood pressure and biochemical parameters were seen only in the HTN group. Overweight/obesity, abdominal obesity (WHtR), hyperglycemia, hypertriglyceridemia and low HDL were found as the risk factors for HTN. CONCLUSION: from our results, future strategies for preventing dyslipidemia, hyperglycemia and, consequently, HTN through modification of risk factors such as lifestyle changes and medical management. It's recommended for patients with HTN to measure the BP, lipid and glucose profiles regularly throughout their primary health care to prevent non-communicable diseases.