ThP8.2 - Degree of Lymphatic dysfunction in severe obesity

Abstract Aim Obesity can affect the lymphatic system through a multitude of ways with patients presenting to lymphoedema clinics. The aim of this present study is to assess the degree of lymphatic dysfunction through Lymphoscinigraphy (LSG) scans in severely obese patients. Methods All obese patients who presented with leg swelling and underwent LSG scans were included in the study. Based on NICE guidelines they were graded as class 1 (BMI of 30-34.9 kg/m2), class 2 (35-39.9 kg/m2) and class 3 (40 kg/m2 or more). Severity of their Lymphoedema were categorised as mild (uptake 5-8%), moderate (uptake 2-5%), and severe (Uptake <2%) in accordance with the worst affected leg. These two variables were then compared. Results Of the 133 patients with BMI provided, the average BMI was 37.18Kg/m2. 54.89% of patients with BMI provided were classed as Obese.19 (26.03%) of these patients were classed as class 1 obesity and of these 68% had severe Lymphoedema. 14 (19.18%) were classed as class 2 obesity and 28% had severe Lymphoedema. 40 (54.79%) were classed as class 3 obesity and 28% had severe Lymphoedema. Conclusion Majority (75%) of obese patients had lymphatic dysfunction on LSG scans. Majority (62%) had mild to moderate Lymphatic dysfunction. Only 38% of patients with severe Obesity (40 kg/m2 or more) had severe Lymphatic dysfunction. Lymphoedema in Obesity is often not constitutional lymphoedema.