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Published in: Aesthetic Plastic Surgery 6/2005

01-12-2005

Changing the Metabolic Profile by Large-Volume Liposuction: A Clinical Study Conducted with 123 Obese Women

Authors: Francesco D’Andrea, M.D., Roberto Grella, M.D., Maria Rosaria Rizzo, M.D., Elisa Grella, M.D., Rodolfo Grella, M.D., Gianfranco Nicoletti, M.D., Michelangela Barbieri, M.D., Giuseppe Paolisso, M.D.

Published in: Aesthetic Plastic Surgery | Issue 6/2005

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Abstract

Adipose tissue is a metabolically active tissue. The hypertrophic fat cells of obese patients produce increased quantities of leptin and tumor necrosis factor-α (TNF-α) and are less sensitive to insulin. This study aimed to determine whether aspirating large amounts of these subcutaneous fat cells by large-volume liposuction (LVL), could change the metabolic profile in 123 obese women. All the patients had a main central body fat distribution (waist–hip ratio, 0.91±0.01) and a body mass index of 32.8 ± 0.8 kg/m). They were studied for 90 days after LVL to determine their changes in insulin sensitivity, resting metabolic rate, serum adipocytokines, and inflammatory marker levels. During 3 months of follow-up evaluation, LVL resulted in a significantly improved insulin sensitivity, resting metabolic rate, serum adipocytokines, and inflammatory marker levels. Such parameters correlate with a decrease in fat mass and waist–hip ratio. Interestingly, no significant changes were seen between the first (21 days) and second (90 days) metabolic determinations after LVL. However, these findings, confirm other preliminary data published previously, and could change the actual role of LVL in the multidisciplinary treatment of obesity.
Literature
1.
go back to reference Ahima RS, Flier JS: Adipose tissue as an endocrine organ. Trends Endocrinol Metab 11:327, 2000 Ahima RS, Flier JS: Adipose tissue as an endocrine organ. Trends Endocrinol Metab 11:327, 2000
2.
go back to reference Ahima RS, Prabakaran D, Mantzoros C, et al.: Role of leptin in the neuroendocrine response to fasting. Nature 382:250, 1996PubMedCrossRef Ahima RS, Prabakaran D, Mantzoros C, et al.: Role of leptin in the neuroendocrine response to fasting. Nature 382:250, 1996PubMedCrossRef
3.
go back to reference Baskin ML, Ard J, Franklin F, Allison DB: Prevalence of obesity in the United States. Obes Rev 6:5, 2005PubMedCrossRef Baskin ML, Ard J, Franklin F, Allison DB: Prevalence of obesity in the United States. Obes Rev 6:5, 2005PubMedCrossRef
4.
go back to reference Bastard JP, Maachi M, van Nhieu JT, Jardel C, Bruckert E, Grimaldi A, Robert JJ, Capeau J, Hainque B: Adipose tissue content correlates with resistance to insulin activation of glucose uptake both in vivo and in vitro. J Clin Endocrinol Metab 87:2084–2089, 2002PubMedCrossRef Bastard JP, Maachi M, van Nhieu JT, Jardel C, Bruckert E, Grimaldi A, Robert JJ, Capeau J, Hainque B: Adipose tissue content correlates with resistance to insulin activation of glucose uptake both in vivo and in vitro. J Clin Endocrinol Metab 87:2084–2089, 2002PubMedCrossRef
6.
go back to reference Bouret SG, Simerly RB: Leptin and development of hypothalamic feeding circuits. Endocrinology 145:2521, 2004 Bouret SG, Simerly RB: Leptin and development of hypothalamic feeding circuits. Endocrinology 145:2521, 2004
7.
go back to reference Busetto L, Bassetto F, Nolli M: Metabolic effects of liposuction: Yes or no. N Engl J Med 351:1355, 2004 Busetto L, Bassetto F, Nolli M: Metabolic effects of liposuction: Yes or no. N Engl J Med 351:1355, 2004
8.
go back to reference Chlouverakis C, Hojnicki D: Effect of fat cell size on its sensitivity to insulin measured by a new method. Steroids Lipids Res 5:351, 1974PubMed Chlouverakis C, Hojnicki D: Effect of fat cell size on its sensitivity to insulin measured by a new method. Steroids Lipids Res 5:351, 1974PubMed
9.
go back to reference DeFronzo RA, Tobin JD, Andres R: The glucose clamp technique: A method for the quantification of beta cell sensitivity to glucose and of tissue sensitivity of insulin. Am J Physiol 237:E214, 1979PubMed DeFronzo RA, Tobin JD, Andres R: The glucose clamp technique: A method for the quantification of beta cell sensitivity to glucose and of tissue sensitivity of insulin. Am J Physiol 237:E214, 1979PubMed
10.
go back to reference Farooqi IS, Keogh JM, Kamath S, et al: Partial leptin deficiency and human adiposity. Nature 414:34, 2001PubMedCrossRef Farooqi IS, Keogh JM, Kamath S, et al: Partial leptin deficiency and human adiposity. Nature 414:34, 2001PubMedCrossRef
11.
go back to reference Fernandez-Real JM, Lopez-Bermejo A, Casamitjana R, et al.: Novel interactions of adiponectin with the endocrine system and inflammatory parameters. J Clin Endocrinol Metab 88:2714–2718. 2003PubMedCrossRef Fernandez-Real JM, Lopez-Bermejo A, Casamitjana R, et al.: Novel interactions of adiponectin with the endocrine system and inflammatory parameters. J Clin Endocrinol Metab 88:2714–2718. 2003PubMedCrossRef
12.
go back to reference Ferrara CM, Goldberg AP: Limited value of the homeostasis model assessment to predict insulin resistance in older men with impaired glucose tolerance. Diabetes Care 24:245, 2001PubMedCrossRef Ferrara CM, Goldberg AP: Limited value of the homeostasis model assessment to predict insulin resistance in older men with impaired glucose tolerance. Diabetes Care 24:245, 2001PubMedCrossRef
13.
14.
go back to reference Giese SY, Bulan EJ, Commons GW, et al.: Improvements in cardiovascular risk profile with large-volume liposuction: A pilot study. Plast Reconstr Surg 108:510, discussion 520, 2001PubMedCrossRef Giese SY, Bulan EJ, Commons GW, et al.: Improvements in cardiovascular risk profile with large-volume liposuction: A pilot study. Plast Reconstr Surg 108:510, discussion 520, 2001PubMedCrossRef
15.
go back to reference Giugliano G, Nicoletti G, Grella E, et al.: Effect of liposuction on insulin resistance and vascular inflammatory markers in obese women. Br J Plast Surg 57:190, 2004PubMedCrossRef Giugliano G, Nicoletti G, Grella E, et al.: Effect of liposuction on insulin resistance and vascular inflammatory markers in obese women. Br J Plast Surg 57:190, 2004PubMedCrossRef
16.
go back to reference Gonzalez-Ortiz M, Robles-Cervantes JA, Cardenas-Camarena L, et al.: The effects of surgically removing subcutaneous fat on the metabolic profile and insulin sensitivity in obese women after large-volume liposuction treatment. Horm Metab Res 34:446, 2002PubMedCrossRef Gonzalez-Ortiz M, Robles-Cervantes JA, Cardenas-Camarena L, et al.: The effects of surgically removing subcutaneous fat on the metabolic profile and insulin sensitivity in obese women after large-volume liposuction treatment. Horm Metab Res 34:446, 2002PubMedCrossRef
17.
go back to reference Halaas JL, Gajiwala KS, Maffei M, Cohen SL, et al.: Weight-reducing effects of the plasma protein encoded by the obese gene. Science 269:543, 1995PubMedCrossRef Halaas JL, Gajiwala KS, Maffei M, Cohen SL, et al.: Weight-reducing effects of the plasma protein encoded by the obese gene. Science 269:543, 1995PubMedCrossRef
18.
go back to reference Hoffstedt J, Arvidsson E, Sjolin E, Wahlen K, Arner P: Adipose tissue adiponectin production and adiponectin serum concentration in human obesity and insulin resistance. J Clin Endocrinol Metab 89:1391–1396, 2004PubMedCrossRef Hoffstedt J, Arvidsson E, Sjolin E, Wahlen K, Arner P: Adipose tissue adiponectin production and adiponectin serum concentration in human obesity and insulin resistance. J Clin Endocrinol Metab 89:1391–1396, 2004PubMedCrossRef
19.
go back to reference Hotamisligil GS, Shargill NS, Spiegelman BM: Adipose expression of tumor necrosis factor-alpha: Direct role in obesity-linked insulin resistance. Science 259:87, 1993PubMedCrossRef Hotamisligil GS, Shargill NS, Spiegelman BM: Adipose expression of tumor necrosis factor-alpha: Direct role in obesity-linked insulin resistance. Science 259:87, 1993PubMedCrossRef
20.
go back to reference Karnieli E, Barzilai A, Rafaeloff R, et al: Distribution of glucose transporters in membrane fractions isolated from human adipose cells: Relation to cell size. J Clin Invest 78:1051, 1986PubMedCrossRef Karnieli E, Barzilai A, Rafaeloff R, et al: Distribution of glucose transporters in membrane fractions isolated from human adipose cells: Relation to cell size. J Clin Invest 78:1051, 1986PubMedCrossRef
21.
go back to reference Klein S, Fontana L, Young L, et al: Absence of an effect of liposuction on insulin action and risk factors for coronary heart disease. N Engl J Med 350:2549, 2004PubMedCrossRef Klein S, Fontana L, Young L, et al: Absence of an effect of liposuction on insulin action and risk factors for coronary heart disease. N Engl J Med 350:2549, 2004PubMedCrossRef
22.
go back to reference Mari A, Pacini G, Brazzale AR, et al.: Comparative evaluation of simple insulin sensitivity methods based on the oral glucose tolerance test. Diabetologia 48:748, 2005 Mari A, Pacini G, Brazzale AR, et al.: Comparative evaluation of simple insulin sensitivity methods based on the oral glucose tolerance test. Diabetologia 48:748, 2005
23.
go back to reference Olefsky JM. Insensitivity of large adipocytes to the antilipolytic effects of insulin. J Lipid Res 18:459, 1977PubMed Olefsky JM. Insensitivity of large adipocytes to the antilipolytic effects of insulin. J Lipid Res 18:459, 1977PubMed
24.
go back to reference Olefsky JM: Mechanism of decreased responsiveness of large adipocytes. Endocrinology 100:1169, 1977PubMedCrossRef Olefsky JM: Mechanism of decreased responsiveness of large adipocytes. Endocrinology 100:1169, 1977PubMedCrossRef
25.
go back to reference Pelleymounter MA, Cullen MJ, Backer MB, et al: Effects of obese gene product on body weight regulation in ob/ob mice. Science 269:540, 1995PubMedCrossRef Pelleymounter MA, Cullen MJ, Backer MB, et al: Effects of obese gene product on body weight regulation in ob/ob mice. Science 269:540, 1995PubMedCrossRef
26.
go back to reference Rashid MN, Fuentes F, Touchon RC, Wehner PS: Obesity and the risk for cardiovascular disease. Prev Cardiol 6:42–47, 2003PubMedCrossRef Rashid MN, Fuentes F, Touchon RC, Wehner PS: Obesity and the risk for cardiovascular disease. Prev Cardiol 6:42–47, 2003PubMedCrossRef
27.
go back to reference Robles-Cervantes JA, Yanez-Diaz S, Cardenas-Camarena L: Modification of insulin, glucosa, and cholesterol levels in nonobese women undergoing liposuction. Ann Plast Surg 52:64, 2004PubMedCrossRef Robles-Cervantes JA, Yanez-Diaz S, Cardenas-Camarena L: Modification of insulin, glucosa, and cholesterol levels in nonobese women undergoing liposuction. Ann Plast Surg 52:64, 2004PubMedCrossRef
28.
go back to reference Valsamakis G, McTernan Pg P, Chetty R, Al Daghri N, Field A, Hanif W, Barnett Ah A, Kumar S: Modest weight loss and reduction in waist circumference after medical treatment are associated with favorable changes in serum adipocytokines. Metabolism 53:430–434, 2004PubMedCrossRef Valsamakis G, McTernan Pg P, Chetty R, Al Daghri N, Field A, Hanif W, Barnett Ah A, Kumar S: Modest weight loss and reduction in waist circumference after medical treatment are associated with favorable changes in serum adipocytokines. Metabolism 53:430–434, 2004PubMedCrossRef
29.
go back to reference Voros G, Maquoi E, Collen D, Lijnen HR: Influence of membrane-bound tumor necrosis factor (TNF)-alpha on obesity and glucose metabolism. J Thromb Haemost 2:507–513, 2004PubMedCrossRef Voros G, Maquoi E, Collen D, Lijnen HR: Influence of membrane-bound tumor necrosis factor (TNF)-alpha on obesity and glucose metabolism. J Thromb Haemost 2:507–513, 2004PubMedCrossRef
Metadata
Title
Changing the Metabolic Profile by Large-Volume Liposuction: A Clinical Study Conducted with 123 Obese Women
Authors
Francesco D’Andrea, M.D.
Roberto Grella, M.D.
Maria Rosaria Rizzo, M.D.
Elisa Grella, M.D.
Rodolfo Grella, M.D.
Gianfranco Nicoletti, M.D.
Michelangela Barbieri, M.D.
Giuseppe Paolisso, M.D.
Publication date
01-12-2005
Publisher
Springer-Verlag
Published in
Aesthetic Plastic Surgery / Issue 6/2005
Print ISSN: 0364-216X
Electronic ISSN: 1432-5241
DOI
https://doi.org/10.1007/s00266-005-0089-x

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