Calf skinfold measurements as a diagnostic tool for lipodystrophy syndromes: a cross-sectional study.

BACKGROUND: Lipodystrophy syndromes (LS) are characterized by reduced body fat and associated metabolic complications, such as insulin resistance and diabetes. The diagnosis of LS can be challenging in clinical settings. Skinfold measurement and body composition assessment using DEXA are commonly used for screening and diagnosis. This study aimed to identify alternative easy-to-use body composition parameters for diagnosing LS in clinical settings. METHODS: This cross-sectional study included patients with genetically confirmed congenital generalized lipodystrophy (CGL) and familial partial lipodystrophy (FPL), with 62 matched healthy controls. Comprehensive data, including medical history, body composition, laboratory measurements, and imaging parameters, were collected. The receiver operating characteristic (ROC) curve was constructed using genetic test results, the gold standard for diagnosing genetic lipodystrophy, as the reference, and the sensitivity and specificity of calf skinfold measurements were measured with those of the genetic tests. RESULTS: We included 62 patients with a mean age of 32 ± 18 (2-68) years, of whom 69.3% were women. The prevalence of diabetes mellitus (70%) and hypertriglyceridemia (83%) were also high. All body composition parameters significantly differed, except for calf skinfold measurements, which were similar between the CGL and FPL patients (p = 0.270). The ROC curve analysis identified a new cutoff point for calf skinfold measurement of <8 mm, with high diagnostic accuracy. CONCLUSIONS: This study identified calf skinfold measurements <8 mm as an accurate diagnostic tool for CGL and FPL. Notably, clinical accessibility to calf skinfold will favor its widespread use, standardization, and inclusion in physical examination protocols, improving lipodystrophy detection and diagnosis.