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BackgroundThere are no validated Norwegian disease-specific patient-reported outcome measures (PROMs) assessing quality of life (QoL) in females with lipedema, limiting evaluation of treatment effect in clinical practice and research.ObjectiveTo translate and validate a Norwegian translation of the LIPQOL questionnaire.MethodsA cross-sectional validation study was performed in 432 females with lipedema in Norway. Descriptive statistics and floor and ceiling effects were assessed. The psychometric properties of the questionnaire were assessed using confirmatory factor analysis (CFA). The overall goodness of fit was evaluated using the root mean square error of approximation (RMSEA), the comparative fit index (CFI) and the Tucker–Lewis index (TLI). Internal consistency was assessed using composite reliability from the CFA. Associations between LIPQOL subscales and RAND-12 physical component score (PCS) and mental component score (MCS) were examined using Spearman correlations.ResultsThe LIPQOL questionnaire comprises four subscales, Function, Body image, Symptoms, and Feelings. No subscales was affected by floor or ceiling effects. The unmodified CFA shows CFI = 0.929, TLI = 0.922, standardized root mean square residual (SRMR) = 0.073, and RMSEA = 0.079 (90% CI: 0.073 to 0.084). All composite reliability were considered reasonable (ranged from 0.890 to 0.916). Modification indices were evaluated, and two modifications were performed between items 5 and 8, and between items 17 and 18. With modification indices, the overall structure validity showed reasonable, but not unequivocally support for the four factor structure with CFI = 0.944, and TLI = 0.938, SRMR = 0.068, and RMSEA = 0.070 (90% CI: 0.064 to 0.075). Correlation between RAND-12 and LIPQOL subscales were large. Function, Symptoms, and overall quality of life show large correlation with PCS (Spearman's rho = −0.682, Spearman's rho = −0.550, and Spearman's rho = 0.554, respectively) and the subscales feelings and overall quality of life shows large correlation with MCS from RAND-12 (Spearman's rho = −0.685 and 0.608, respectively).ConclusionInitial findings suggest that the Norwegian version of the LIPQOL is a reasonably valid instrument for assessing quality of life in females with lipedema, although the findings do not provide unequivocal support for all aspects of its measurement properties.
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Introduction: Low-carbohydrate diets (LCDs) have been suggested as a potential treatment option for females with lipedema, due to their superiority in reducing pain, possibly through improvements in insulin dynamics. Objectives: The objective of this secondary analysis was to compare changes in markers of glucose and insulin dynamics after a low-carbohydrate versus low-fat low-energy diets in females with lipedema and obesity. A secondary objective was to investigate potential associations between changes in glucose and insulin dynamics and changes in pain.Methods: Females with obesity and lipedema were randomized to either an LCD or a low-fat low-energy diets (1200 kcal/day for both; 75 vs. 180 g carbohydrates/day) for 8 weeks. Basal and postprandial (total and incremental area under the curve (tAUC and iAUC)) concentrations of glucose, insulin, glucose-dependent insulinotropic polypeptide (GIP), and C-peptide were measured before and after the intervention, and HOMA-IR, Matsuda index and insulin clearance calculated.Results: A total of 70 females (35 in each group, age 47 ± 11 years, BMI 37 ± 5 kg/m2) were included in the analysis. Both groups lost body weight, but with a significantly greater weight loss in the LCD group. Both groups showed ed a reduction in basal glucose, C-peptide, and insulin concentrations, with a greater reduction in glucose on the LCD. A significant increase in glucose iAUC, C-peptide iAUC, insulin clearance, and Matsuda index was observed in the LCD group only. Both groups experienced an increase in GIP tAUC, as well as a reduction in HOMA-IR, with no significant differences between groups. No associations were seen between changes in glucose and insulin measures and changes in pain.Conclusion: Both diets improved insulin dynamics in females with lipedema and obesity, despite additional benefits in the LCD group. However, changes in the measured indices of insulin dynamics were not associated with pain reduction, suggesting that the effects of the LCD on pain and systemic metabolic regulation may involve other pathways.