The effects of the surgical removal of subcutaneous adipose tissue on energy expenditure and adipocytokine concentrations in obese women

Busetto, Luca; Bassetto, Franco; Zocchi, Michele; Zuliani, Francesca; Nolli, Maria Luisa; Pigozzo, Sabrina; Coin, Alessandra; Mazza, Marco; Sergi, Giuseppe; Mazzoleni, Francesco; Enzi, Giuliano

doi:10.1016/j.numecd.2006.09.009

« Previous Next »Nutrition, Metabolism & Cardiovascular Diseases
Volume 18, Issue 2 , Pages 112-120, February 2008

The effects of the surgical removal of subcutaneous adipose tissue on energy expenditure and adipocytokine concentrations in obese women

Luca Busetto
- Department of Medical and Surgical Sciences, Obesity Unit, University of Padova, Via Giustiniani 2, 35128 Padova, Italy
- Corresponding author. Tel./fax: +39 049 821 2149.
Franco Bassetto
- Institute of Plastic Surgery, University of Padova, Via Giustiniani 2, 35128 Padova, Italy
Michele Zocchi
- Institute of Plastic Surgery, University of Padova, Via Giustiniani 2, 35128 Padova, Italy
Francesca Zuliani
- Institute of Plastic Surgery, University of Padova, Via Giustiniani 2, 35128 Padova, Italy
Maria Luisa Nolli
- Anesthesiology and Intensive Care Unit, University Hospital of Padova, Via Giustiniani 2, 35128 Padova, Italy
Sabrina Pigozzo
- Department of Medical and Surgical Sciences, Obesity Unit, University of Padova, Via Giustiniani 2, 35128 Padova, Italy
Alessandra Coin
- Department of Medical and Surgical Sciences, Obesity Unit, University of Padova, Via Giustiniani 2, 35128 Padova, Italy
Marco Mazza
- Department of Medical and Surgical Sciences, Obesity Unit, University of Padova, Via Giustiniani 2, 35128 Padova, Italy
Giuseppe Sergi
- Department of Medical and Surgical Sciences, Obesity Unit, University of Padova, Via Giustiniani 2, 35128 Padova, Italy
Francesco Mazzoleni
- Institute of Plastic Surgery, University of Padova, Via Giustiniani 2, 35128 Padova, Italy
Giuliano Enzi
- Department of Medical and Surgical Sciences, Obesity Unit, University of Padova, Via Giustiniani 2, 35128 Padova, Italy

Received 23 May 2006; received in revised form 9 August 2006; accepted 22 September 2006. published online 02 April 2007.

Abstract

Objective

To analyze the effects of the surgical removal of subcutaneous adipose tissue by ultrasound-assisted megalipoplasty (UAM) on energy expenditure and adipocytokine concentrations in obese women.

Methods

Fifteen premenopausal obese women with BMI 37.5±6.3kg/m² (range: 30.7–53.6kg/m²) underwent UAM. Body composition (by DEXA), resting metabolic rate (REE) by indirect calorimetry, insulin resistance (by the HOMA method), leptin, C-reactive protein, interleukin-6, resistin and adiponectin were measured before and 1, 3, 28 and 180days after the procedure.

Results

UAM significantly reduced fat mass at day 3, without further changes in the following days. REE increased at day 3 after UAM, returned to baseline levels at day 28 and significantly declined at day 180. Leptin levels transiently increased after UAM and then declined according to fat mass reduction. C-reactive protein, interleukin-6 and resistin levels acutely increased after UAM and then returned to the baseline levels. Adiponectin levels acutely declined after the procedure and then stabilized to a plasma level slightly lower than at baseline. Insulin resistance deteriorated in the acute post-operative phase and then improved.

Conclusion

The surgical removal of subcutaneous fat was associated to an acute inflammatory reaction with high REE and insulin-resistance. Later on, the metabolic effects of fat mass removal appeared, with a reduction of leptin levels and REE and an improvement of insulin resistance.

Keywords: Human adipose tissue, Insulin resistance, Metabolism, Obesity