STEATOPYGIA: CAUSES, IDENTIFICATION AND TREATMENT - MEDICINE - 2024

The esteatopigia is a condition in which the fatty acid composition of the fatty tissue accumulates in exaggerated form in the pelvic girdle. This is most prominent in the subcutaneous tissue of the buttocks and femur.

It is a predominant genetic characteristic in women, generally of the African tribes: Khoisan and Bantues. In men it is possible to find this condition, but in a lower proportion.

African woman with steatopygia

At present, it is common to find the association of steatopygia in those who suffer from morbid obesity. However, there are substantial differences between them.

In steatopygia, adipose tissue is embedded between criss-cross sheets of connective tissue, regularly attached to each other. On the other hand, in morbid obesity, the accumulation of fat is found between the gluteus maximus and gluteus medius muscles.

Causes

The causes of steatopygia are purely genetic, although some studies have shown that they have a hormonal component. Therefore, estrogens favor the accumulation of fat in the areas described.

The name of steatopygia is common in people with morbid obesity to describe excess fat in the gluteal-femoral area. However, it is necessary to highlight that steatopygia in itself is not synonymous with obesity.

Identification of steatopygia

Lumbar hyperlordosis is usually present in steatopygia. This is a consequence of the excessive accumulation of abdominal adipose tissue that shifts the center of gravity. In turn, pull your spine forward for balance.

This is coupled with an excessive accumulation of adipose tissue in the gluteal-femoral region. In most cases, steatopygia presents a localized lipodystrophy (cellulitis) that is compact or hard.

Generally, it presents alterations in the patient's footprint and knee positioning inward or excessively backward as a positional compensation.

Treatment

It appears - more than a disease - as a genetic characteristic that entails a defect in the body scheme.

Generally, medical treatment is aesthetic, through the lysis of fat focused on the gluteal-femoral area and, occasionally, through surgical interventions.

In the case of footprint alterations, plantar support is recommended to improve circulation by changing the body axis.

Other generalities

In the circles of biological anthropology, steatopygia is explained through the theory that this condition is nothing more than an adaptive physiological characteristic of women in very hot environments.

Likewise, this fat deposited strongly only in the middle of the trunk of the body allows the extremities to be thin enough to expel heat more efficiently during periods of intense heat.

Another theory suggests that the fat accumulated in the body can produce hormones necessary for menstruation and fertility. It can also be a sign of beauty to attract men in the reproductive act.

Effect on Scintigraphic quality

In 2004, a study by Elgazzar, Elsaid, Omar, and Al-Maskery, called Potential pitfalls of steatopygia on bone imaging using Tc99m MDP and role of SPECT, aimed to determine the effects of steatopygia on the appearance of the lumbar spine in bone scan and the role of SPECT.

SPECT is a Single Photon Emission Computed Tomography (named for its acronym in English).

In the aforementioned study, a bone scan was performed, which included a bone scan of the whole body, point views and SPECT of the lumbar spine. For this, a double-headed gamma camera was used in thirty obese adult patients.

The study authors explained the method as:

“Each patient was injected intravenously with 0.25 mCi / kg (9.25 Mbq of Tc-99m MDP), and their weight and height were recorded for each patient. A full body scan was performed with a matrix size of 256 X 1024 and a speed of 8 min / meter. It was performed using 128 X 128 matrix size, 20 32 second projections and elliptical orbit around the lumbar spine. Views were acquired using 256 X 256 matrix size for 1000K ".

Study results

The results showed that steatopygia can affect the quality of the bone scan, which can lead to misdiagnoses.

This was evidenced by finding twenty patients with steatopygia who showed attenuation in the lower vertebrae of the lumbar spine.

Likewise, decreased uptake in the lower lumbar spine and edge effects were observed in flat images that simulate abnormalities.

The study carried out by Elgazzar et al. Concluded that the presence of steatopygia should be taken into consideration in the interpretation of examinations of obese patients, to avoid diagnostic difficulties.

"The addition of SPECT of the lumbar spine to flat images improves diagnostic accuracy in obese patients, overcoming the steatopygia effect observed throughout the body and spot images of flat images."

References

1. Steatopygia. Taken from bionity.com
2. Elgazzar, H.; Elsaid, M.; Omar, A. and Al-Maskery, IB (2004). Potential pitfalls of steatopygia on bone imaging using Tc99m MDP and role of SPECT. 8th Asia oceania congress of nuclear medicine and biology final program abstracts, (p. 246). China. Taken from inis.iaea.org
3. Steatopygia. (2017). Wikipedia, The Free Encyclopedia. Taken from es.wikipedia.org.
4. Krut, LH and Singer, R. (1963). Steatopygia: The fatty acid composition of subcutaneous adipose tissue in the Hottentot. AmJ Phys. Anthropol., 21: 181-187.
5. Mosner, E.; Bryan JM; Stull MA and Shippee R. A comparison of actual and apparent lumbar lordosis in black and white adult females. Taken from ncbi.nlm.nih.gov.