Madelung’s Disease: Analysis of Clinical Characteristics, Fatty Mass Distribution, Comorbidities and Treatment of 54 Patients in China

Figures & data

Table 1 Demographic and General Clinical Characteristics of Participants with Multiple Symmetric Lipomatosis

Variables	Mean ± SD/N (%)	Normal Range
Age (years)	56.65 ± 7.93
Sex
Male	53 (98.15%)
Female	1 (1.85%)
Height (cm)	169.36 ± 6.17
Body weight (kg)	68.92 ± 12.16
BMI (kg/m^2)	24.02 ± 4.05	18.50–24.00
SBP (mmHg)	141.58 ± 17.58	90.00–140.00
DBP (mmHg)	83.31 ± 11.75	60.00–90.00
Alb (g/L)	39.89 ± 6.04	40.00–55.00
Total bilirubin (μmol/L)	22.72 ± 15.96	3.00–22.00
Direct bilirubin (μmol/L)	8.17 ± 6.91	0–8.00
Indirect bilirubin (μmol/L)	14.41 ± 9.90
ALT (U/L)	29.51 ± 28.92	9.00–50.00
AST (U/L)	36.13 ± 36.29	15.00–40.00
γ-GT (U/L)	124.82 ± 212.03	10.00–60.00
TG (mmol/L)	1.16 ± 0.72	0.30–1.92
TC (mmol/L)	4.52 ± 1.21	2.32–5.62
HDL (mmol/L)	1.47 ± 0.56	0.80–1.80
LDL (mmol/L)	2.50 ± 0.80	1.90–3.12
Glu (mmol/L)	5.89 ± 2.28	3.90–6.16
BUN (mmol/L)	5.49 ± 5.79	3.10–8.00
Scr (μmol/L)	77.05 ± 37.18	31.00–132.00
UA (μmol/L)	370.61 ± 81.94	89.20–416.00
eGFR (mL/min/1.73 m^2)	96.52 ± 18.68	> 90.00

Notes: Continuous variables are shown as the means ± SDs unless otherwise indicated. Proportions are expressed as percentages.

Abbreviations: BMI, body mass index; SBP, systolic blood pressure; DBP, diastolic blood pressure; Alb, albumin; ALT, alanine transaminase; AST, aspartate transaminase; γ-GT, glutamyl transpeptidase; TG, triglyceride; TC, total cholesterol; HDL, high-density lipoprotein; LDL, low-density lipoprotein; Glu, glucose; BUN, blood urea nitrogen; Scr, serum creatinine; UA, uric acid; eGFR, estimated glomerular filtration rate.

Table 2 History of Alcohol and Smoking in Participants with Multiple Symmetric Lipomatosis

Variables	Mean ± SD/N (%)
History of alcohol
No	7 (12.96)
Yes	47 (87.04)
Alcohol consumption time (years)	24.13 ± 13.15
Alcohol amount (g/d)	180.00 ± 118.82
Type of alcohol
No	7 (12.96)
liquor	46 (85.19)
Beer	1 (1.85)
Abstinence time
No	43 (79.63)
Less than 1 year	6 (11.11)
More than 1 year	5 (9.26)
History of smoking
No	12 (22.22)
Yes	42 (77.78)
Smoking time (years)	21.24 ± 14.69
Smoking amount (cigarettes/day)	16.24 ± 13.13

Table 3 The Location of Fat Deposits in Patients with Multiple Symmetric Lipomatosis

Location of fat deposits	Number of Patients (%) (n=54)
Neck	54 (100)
Back	10 (18.52)
Shoulders	7 (12.93)
Pectoral	6 (11.11)
Arms	6 (11.11)
Supraclavicular fossa	4 (7.41)
Face	3 (5.56)
Abdominal	3 (5.56)
Submandibular region	3 (5.56)
Retroauricular region	2 (3.70)
Forearm	2 (3.70)
Thighs	2 (3.70)
Mediastinal	1 (1.85)
Perineum	1 (1.85)

Notes: In this study, all patients had fat deposits in the neck, and some patients had fat deposits in other parts of the body at the same time, leading to a double count in this table.

Figure 1 Donhauser’s classification in patients with multiple symmetric lipomatosis.

Table 4 Comorbidities in Patients with Multiple Symmetric Lipomatosis

Comorbidities	Total (n=54)
Endocrine system	44 (81.48)*
Hyperlipidemia	18 (33.33)
Hyperuricemia	16 (29.63)
Diabetes mellitus	14 (25.93)
Impaired fasting glucose	5 (9.26)
Obesity (BMI ≥ 28.0)	9 (16.67)
Hypothyroidism	3 (5.56)
Digestive system	42 (77.78)*
Abnormal liver function	40 (74.07)
Alcoholic cirrhosis	11 (20.37)
Hepatic steatosis	4 (7.41)
Splenomegaly	12 (22.22)
History of acute pancreatitis	1 (1.85)
Gallstone	5 (9.26)
Cholecystitis	3 (5.56)
Cardiovascular system	24 (44.44)*
Hypertension	23 (42.59)
Coronary heart disease	3 (5.56)
Pulmonary hypertension	1 (1.85)
Atrial fibrillation	3 (5.56)
Chronic pulmonary heart disease	1 (1.85)
Nervous system	9 (16.67)*
Cerebral infarction	4 (7.41)
Diabetic neuropathy	2 (3.70)
Alcoholic peripheral neuropathy	2 (3.70)
Hematencephalon	2 (3.70)
Carotid stenosis	1 (1.85)
Encephalanalosis	1 (1.85)
Respiratory system	7 (12.96)*
COPD	2 (3.70)
Emphysema	4 (7.41)
OSAS	2 (3.70)
Urinary system	24 (44.44) *
eGFR > 90 mL/min/1.73 m^2	7 (12.96)
60 ≤ eGFR<90 mL/min/1.73 m^2	15 (27.79)
30 ≤ eGFR<60 mL/min/1.73 m^2	1 (1.85)
15 ≤ eGFR<30 mL/min/1.73 m^2	0 (0)
eGFR<15 mL/min/1.73 m^2	1 (1.85)
Malignant tumor	11 (20.37) *
Gastric cancer	3 (5.56)
Liver cancer	1 (1.85)
Lung cancer	2 (3.70)
Thyroid cancer	2 (3.70)
Esophageal carcer	1 (1.85)
Laryngeal cancer	1 (1.85)
Renal cell carcinoma	1 (1.85)

Notes: *The number of patients with diseases in each system is not the sum of the number of diseases included in the system. Each patient may have multiple systemic diseases at the same time or multiple diseases in a certain system; consequently, the data in this table may include double counting.

Abbreviations: COPD, chronic obstructive pulmonary disease; OSAS, obstructive sleep apnea hypopnea syndrome.

Table 5 The Operation Type and Postoperative Recurrence in Patients with Multiple Symmetric Lipomatosis

Treatment	Number of Patients (%)
No surgical treatment	16 (29.63)
Lipectomy	38 (70.37)
Postoperative recurrence	15 (39.47)
No postoperative recurrence	23 (60.53)