{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T23:10:16Z","timestamp":1787008216825,"version":"build-2736575974"},"reference-count":28,"publisher":"SAGE Publications","issue":"1","license":[{"start":{"date-parts":[[2023,2,1]],"date-time":"2023-02-01T00:00:00Z","timestamp":1675209600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Lymphatic Research and Biology"],"published-print":{"date-parts":[[2023,2,1]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Lipedema of lower limbs is characterized by bilateral accumulations of excess adipose tissue starting from the ankle to the hips and buttocks. The studies with lymphoscintigraphy (LSC) and magnetic resonance (MR) lymphography show altered transport index and enlarged lymphatic vessels (LVs). Our studies aimed to investigate the superficial lymph flow, water accumulation, skin and subcutaneous tissue elasticity, and the possibility of using this information to diagnose lipedema.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods and Results:<\/jats:title>\n                    <jats:p>\n                      Fifty patients with lipedema and 50 control subjects (women) were included. The Indocyanine Green (ICG) lymphography, LSC, skin water measurement, skin durometry, and deep tissue tonometry were done in all participants. ICG lymphography revealed: (1) Slower lymph flow in lipedema patients; after 3 minutes of feet movement in a horizontal position, the ICG-dyed lymph reached the upper calf level in 8% of lipedema patients compared with 56% in the control group (\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009\u02c2\u20090.0001). (2) More than three LVs were noticed more often in lipedema patients. (3) The higher number of abnormal LV images at all limb levels and during each observation stage with a statistically significant number of foggy and dilated. (4) Statistically significant higher fluorescent intensity in all limb levels. Skin water concentration was higher in the feet in lipedema (\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009=\u20090.000189).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>Our studies have shown the differences in superficial lymph flow and water concentration between lipedema and normal limbs. Data proove the usefulness of ICG lymphography, skin water concentration and skin and subcutaneous tissue elasticity measurements in diagnosing lipedema.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1089\/lrb.2022.0010","type":"journal-article","created":{"date-parts":[[2022,6,8]],"date-time":"2022-06-08T16:58:11Z","timestamp":1654707491000},"page":"60-69","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":9,"title":["Lower Limb Lipedema\u2013Superficial Lymph Flow, Skin Water Concentration, Skin and Subcutaneous Tissue Elasticity"],"prefix":"10.1177","volume":"21","author":[{"given":"Marzanna T.","family":"Zaleska","sequence":"first","affiliation":[{"name":"Department of Applied Physiology, Mossakowski Medical Research Institute Polish Academy of Sciences, Warsaw, Poland."},{"name":"Department of Vascular Surgery, Central Clinical Hospital of Internal Affairs, Warsaw, Poland."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Waldemar L.","family":"Olszewski","sequence":"additional","affiliation":[{"name":"Department of Vascular Surgery, Central Clinical Hospital of Internal Affairs, Warsaw, Poland."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Natalia E.","family":"Krzesniak","sequence":"additional","affiliation":[{"name":"Department of Plastic and Reconstructive Surgery, Center of Postgraduate Medical Education, Warsaw, Poland."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2023,2,16]]},"reference":[{"key":"e_1_3_3_2_2","doi-asserted-by":"publisher","DOI":"10.1177\/000331979504600408"},{"key":"e_1_3_3_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.mvr.2009.01.005"},{"key":"e_1_3_3_4_2","doi-asserted-by":"publisher","DOI":"10.1002\/ajmg.a.33313"},{"key":"e_1_3_3_5_2","doi-asserted-by":"publisher","DOI":"10.1002\/oby.22090"},{"key":"e_1_3_3_6_2","first-page":"411","article-title":"MRI and ultrasonographic findings in the investigation of lymphedema and lipedema","volume":"82","author":"Dimakakos PB","year":"1997","unstructured":"Dimakakos PB, , Stefanopoulos T, , Antoniades P, et al. MRI and ultrasonographic findings in the investigation of lymphedema and lipedema. Int Surg, 1997; 82:411\u2013416.","journal-title":"Int Surg"},{"key":"e_1_3_3_7_2","doi-asserted-by":"publisher","DOI":"10.1055\/s-0039-1697904"},{"key":"e_1_3_3_8_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.mri.2020.06.010"},{"key":"e_1_3_3_9_2","first-page":"e11854","article-title":"Lipedema and the evolution to lymphedema with the progression of obesity","volume":"12","author":"Pereira de Godoy L","year":"2020","unstructured":"Pereira de Godoy L, , Pereira de Godoy H, , Pereira de Godoy Capeletto P, et al. Lipedema and the evolution to lymphedema with the progression of obesity. Cureus, 2020; 12:e11854.","journal-title":"Cureus"},{"key":"e_1_3_3_10_2","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-34-5-1243"},{"key":"e_1_3_3_11_2","doi-asserted-by":"publisher","DOI":"10.1002\/jbio.201700150"},{"key":"e_1_3_3_12_2","doi-asserted-by":"publisher","DOI":"10.1089\/lrb.2018.0005"},{"key":"e_1_3_3_13_2","doi-asserted-by":"publisher","DOI":"10.1089\/lrb.2016.0054"},{"key":"e_1_3_3_14_2","doi-asserted-by":"publisher","DOI":"10.1089\/lrb.2016.0029"},{"key":"e_1_3_3_15_2","first-page":"396","article-title":"Lipedema-pathogenesis, diagnosis, and treatment options","volume":"117","author":"Kruppa P","year":"2020","unstructured":"Kruppa P, , Georgiou I, , Biermann N, , Prantl L, , Klein-Weigel P, , Ghods M. Lipedema-pathogenesis, diagnosis, and treatment options. Dtsch Arztebl Int, 2020; 117:396\u2013403.","journal-title":"Dtsch Arztebl Int"},{"key":"e_1_3_3_16_2","doi-asserted-by":"publisher","DOI":"10.1089\/lrb.2016.0069"},{"key":"e_1_3_3_17_2","first-page":"170","article-title":"Microlymphatic aneurysms in patients with lipedema","volume":"34","author":"Amann-Vesti BR","year":"2001","unstructured":"Amann-Vesti BR, , Franzeck UK, , Bollinger A. Microlymphatic aneurysms in patients with lipedema. Lymphology, 2001; 34:170\u2013175.","journal-title":"Lymphology"},{"key":"e_1_3_3_18_2","doi-asserted-by":"publisher","DOI":"10.1089\/lrb.2019.0011"},{"key":"e_1_3_3_19_2","doi-asserted-by":"publisher","DOI":"10.1155\/2019\/8747461"},{"key":"e_1_3_3_20_2","doi-asserted-by":"publisher","DOI":"10.2337\/diabetes.54.7.1934"},{"key":"e_1_3_3_21_2","first-page":"480","article-title":"Interstitial fluid in lipedema and control skin","volume":"1","author":"Allen M","year":"2020","unstructured":"Allen M, , Schwartz M, , Herbst KL. Interstitial fluid in lipedema and control skin. Women Health Rep (New Rochelle), 2020; 1:480\u2013487.","journal-title":"Women Health Rep (New Rochelle)"},{"key":"e_1_3_3_22_2","first-page":"303","article-title":"Microvascular disorders of adipose tissue","volume":"11","author":"Curri SB","year":"1986","unstructured":"Curri SB, , Merlen JF. Microvascular disorders of adipose tissue. J Mal Vasc, 1986; 11:303\u2013330.","journal-title":"J Mal Vasc"},{"key":"e_1_3_3_23_2","doi-asserted-by":"publisher","DOI":"10.3400\/avd.oa.16-00122"},{"key":"e_1_3_3_24_2","doi-asserted-by":"publisher","DOI":"10.3389\/fphys.2020.00459"},{"key":"e_1_3_3_25_2","first-page":"1072","article-title":"Lymphatic vascular defects promoted by Prox1 haploinsufficiency cause adult-onset obesity. Nat","volume":"37","author":"Harvey N","year":"2005","unstructured":"Harvey N, , Srinivasan RS, , Dillard ME, , Johnson NC, , Witte MH, , Boyd K, et al. 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