HealthDay News — Extreme obesity may contribute to lower-extremity lymphedema, results from a small study suggest.

Average BMI was significantly greater for those with confirmed lymphedema (70.1 versus 42.0 kg/m2, P<0.001) among 15 obese patients with enlargement of the legs, Arin K. Greene, MD, from Children’s Hospital Boston, and colleagues reported in the New England Journal of Medicine.

“Our findings suggest that obesity, which affects one-third of the population in the United States, may be a cause of lower-extremity lymphedema. As BMI increases, there might be a threshold above which lymphatic flow becomes impaired,” the researchers wrote.

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All patients included in the study were referred for bilateral enlargement of the lower extremities. Twelve were women, the mean age was 58 and the mean BMI was 51.4 kg/m2. No patients had a history of primary (idiopathic) lymphedema, inguinal lymphadenectomy or radiation, or ulceration of a lower extremity.

Patients underwent lymphoscintigraphy, which has a specificity of 100% and a sensitivity of 92%, to detect lymphedema. Abnormal lymphatic draining consistent with lymphedema was detected in five patients. 

All patients with a BMI higher than 59 kg/m² had lymphedema, while lymphatic function was normal for all those with a BMI below 54 kg/m².

“Although lymphedema is typically progressive, we speculate that major weight loss (e.g., after a bariatric procedure) might reverse lymphatic insufficiency in obese patients with this condition,” the researchers wrote.

Greene A et al. N Engl J Med. 2012; 366: 2136-2137.