Assessment of Venous Insufficiency and Clinical Features in Lipedema

Lipedema is a chronic progressive disorder of subcutaneous adipose tissue that predominantly affects women and is characterized by symmetrical enlargement of the lower extremities, pain, tenderness, easy bruising, and functional limitation. Beyond adipose tissue abnormalities, vascular and microcirculatory alterations have increasingly been implicated in the pathophysiology of the disease. Many individuals with lipedema report symptoms suggestive of venous dysfunction, including leg heaviness, swelling, discomfort, and exercise intolerance. Nevertheless, the clinical significance of venous insufficiency in lipedema has not been fully clarified.This cross-sectional controlled observational study aims to investigate venous insufficiency findings in individuals with lipedema using venous Doppler ultrasonography and to explore their relationship with clinical symptoms and functional status. Venous reflux characteristics, venous diameters, and affected venous segments will be evaluated in the superficial and deep venous systems. These vascular findings will subsequently be analyzed in relation to lipedema severity, pain intensity, lower extremity function, anthropometric measurements, and patient-reported outcomes. By improving the understanding of venous involvement in lipedema, this study may contribute to more comprehensive diagnostic assessment and multidisciplinary management strategies for affected individuals. Patients with lipedema are expected to show more frequent venous insufficiency findings, which may be associated with increased symptom severity and functional limitation.

Inclusion criteria

• Female participants aged 18 years or older
• Clinically diagnosed lipedema according to established diagnostic criteria
• Ability to provide written informed consent
• Ability to complete clinical assessments and questionnaires

Exclusion criteria

• History of lower extremity venous surgery or sclerotherapy
• Known peripheral arterial disease
• Secondary lymphedema or other causes of lower extremity edema
• Active infection, cellulitis, or inflammatory disease affecting the lower extremities
• Pregnancy or postpartum period
• Neurological, rheumatological, or musculoskeletal disorders significantly affecting lower extremity function
• Malignancy or severe systemic disease
• Inability to undergo venous Doppler ultrasonography
• Inability to understand or complete study assessments and questionnaires