Total and regional body composition and energy expenditure in multiple symmetric lipomatosis

Aims: The aim of the present study was to investigate possible alterations in body composition and resting energy expenditure (REE) in type 1 multiple symmetric lipomatosis (MSL). Subjects and methods: Thirteen men aged from 40 to 78 years affected by type I MSL were compared with 13 healthy control subjects. Fat mass (FM) and fat-free mass (FFM) were determined by DEXA using both standard analysis and specifically for the lipomatous region. REE was measured by indirect calorimetry. Results: FM was higher in MSL subjects at proximal arm level, but significantly lower at distal leg level than in controls (left 1.63±0.55 vs. 2.26±0.49 kg, P<0.05; right 1.63±0.53 vs. 2.40±0.54 kg, P<0.01). Arm FFM was similar in the two groups, while distal leg FFM was significantly lower in MSL cases (left: 7.8±1.3 vs. 8.7±0.8 kg, P<0.05; right: 8.0±1.5 vs. 9.2±0.9 kg, P<0.05). FFM strongly correlated with REE (r:0.86;P<0.001). REE, expressed as an absolute value and adjusted for FFM (1830±215 vs. 1675±120 kcal, P<0.05) was higher in MSL patients. Conclusion: In conclusion, MSL patients had a marked FFM and FM atrophy in the lower segments of the legs and an altered energy expenditure (hypermetabolism).