Exploring uric acid as a biomarker in lipedema and lymphedema: A metabolomics study with prospective validation

Q2 Medicine

Obesity Medicine Pub Date : 2025-05-01 DOI:10.1016/j.obmed.2025.100618

Fahad Alkhalfan , Naseer Sangwan , Anu Aggarwal , Alliefair Scalise , José O. Alemán , Bhairavi Rajasekar , Douglas Joseph , Kimberly Peterson , Annelise Hamer , Mariya Ali , John R. Bartholomew , Scott J. Cameron

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引用次数: 0

Abstract

Aims

Lipedema is a condition often mistaken for other causes of limb swelling including lymphedema and obesity. Lipedema may have a unique metabolic profile. Interrogation of the metabolome is a strategy that could reveal unique biomarkers to distinguish lipedema from lymphedema and obesity.

Methods

Unbiased metabolomics was utilized to examine 38 BMI-matched overweight patients compared with patients with lipedema, lymphedema, and lipolymphedema. Machine learning identified biomarkers to distinguish diseases, and further examined in a validation cohort of 198 patients with each disorders. Adjustments were made for baseline clinical and demographic variables.

Results

Plasma metabolomics firstly revealed uric acid as a biomarker that performs well to distinguish between phenotypically similar diseases in patients with elevated BMI. In a validation cohort of 64 patients with lipedema, uric acid (5.05 mg/dL) was compared with 64 patients with lymphedema (5.4 mg/dl), and 70 overweight patients without these conditions (4.6 mg/dL, p < 0.05). Uric acid-to-cystatin c ratio distinguished between all three groups (Lipedema: 5.2; Lymphedema: 6.3; overweight: 4.0, p < 0.01); however, significance was lost after adjustment for renal function.

Conclusion

Metabolomic analysis revealed uric acid may differentiate between lipedema, lymphedema, lipolymphedema and obese individuals without those conditions. In a validation cohort, while uric acid was higher in lipedema and lymphedema, uric acid adjusted by cystatin c clearance revealed uric acid to be a less useful marker to distinguish lipedema from lymphedema in the context of renal insufficiency.

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探索尿酸作为脂水肿和淋巴水肿的生物标志物：一项具有前瞻性验证的代谢组学研究

目的：肢体水肿是一种经常被误认为肢体肿胀的其他原因，包括淋巴水肿和肥胖。脂水肿可能具有独特的代谢特征。代谢组的询问是一种策略，可以揭示独特的生物标志物，以区分脂水肿、淋巴水肿和肥胖。方法采用偏倚代谢组学方法对38例bmi匹配的超重患者与脂性水肿、淋巴水肿和脂性水肿患者进行比较。机器学习识别生物标志物以区分疾病，并在每种疾病的198名患者的验证队列中进一步检查。对基线临床和人口统计学变量进行了调整。结果血浆代谢组学首次揭示了尿酸作为一种生物标志物，能够很好地区分BMI升高患者的表型相似疾病。在64例脂水肿患者的验证队列中，尿酸（5.05 mg/dL）与64例淋巴水肿患者（5.4 mg/dL）和70例没有这些情况的超重患者(4.6 mg/dL, p <；0.05)。尿酸与胱抑素c比值在三组之间的差异(脂水肿：5.2；淋巴水肿:6.3;超重：4.0,p <；0.01);然而，在调整肾功能后，其意义就失去了。结论代谢组学分析显示尿酸可区分脂肪水肿、淋巴水肿、脂肪水肿和肥胖个体。在一个验证队列中，虽然尿酸在脂水肿和淋巴水肿中较高，但通过胱抑素c清除调节的尿酸显示，在肾功能不全的情况下，尿酸作为区分脂水肿和淋巴水肿的一个不太有用的标志物。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Obesity Medicine Medicine-Public Health, Environmental and Occupational Health

CiteScore

5.50

自引率

0.00%

发文量

审稿时长

40 days

期刊介绍： The official journal of the Shanghai Diabetes Institute Obesity is a disease of increasing global prevalence with serious effects on both the individual and society. Obesity Medicine focusses on health and disease, relating to the very broad spectrum of research in and impacting on humans. It is an interdisciplinary journal that addresses mechanisms of disease, epidemiology and co-morbidities. Obesity Medicine encompasses medical, societal, socioeconomic as well as preventive aspects of obesity and is aimed at researchers, practitioners and educators alike.