Acute and 1-month effect of small-volume suction lipectomy on insulin sensitivity and cardiovascular risk

• Published in: International Journal of Obesity 2006-08, Vol.30 (8), p.1217-1222
• Main Authors: Davis, D.A, Pellowski, D.M, Donahoo, W.T
• Format: Article
• Language: English
• Subjects: Abdomen; adipocytes; adipose tissue; Adult; anthropometric measurements; Biological and medical sciences; biomarkers; Blood Glucose - metabolism; Body fat; Cardiovascular disease; cardiovascular diseases; Cardiovascular Diseases - blood; Cardiovascular Diseases - epidemiology; clinical trials; Cytokines - blood; Dermatology; Diabetes; Epidemiology; Fatty acids; Fatty Acids, Nonesterified - blood; Feeding. Feeding behavior; Female; Fundamental and applied biological sciences. Psychology; Glucose; Glucose Tolerance Test; Health Promotion and Disease Prevention; Health risks; Humans; Hypertension; Hypotheses; inflammation; Insulin; Insulin - metabolism; Insulin resistance; Internal Medicine; leptin; Lipectomy; Liposuction; Medical sciences; Medicine; Medicine & Public Health; menopause; Metabolic Diseases; Metabolism; Middle Aged; middle-aged adults; Miscellaneous; Obesity; Obesity - blood; Obesity - metabolism; Obesity - surgery; original-article; Overweight; Public Health; Public health. Hygiene; Public health. Hygiene-occupational medicine; Risk Factors; surgery; Time Factors; Vertebrates: anatomy and physiology, studies on body, several organs or systems; Weight control; women
• ISSN: 0307-0565; 1476-5497
• DOI: 10.1038/sj.ijo.0803120

Objective: The most common surgical procedure for obesity is liposuction, the majority of which are small-volume procedures. The effect of large-volume liposuction on cardiovascular risk and insulin sensitivity has been variable. This study was performed to evaluate the effect of the more common, smaller-volume liposuction on insulin sensitivity, inflammatory mediators, and cardiovascular risk factors. Subjects and study design: In all, 15 overweight or obese premenopausal women underwent metabolic evaluation prior to, 1 day following and 1 month following suction lipectomy of the abdomen. Metabolic evaluation included assessment of free fatty acids, glucose, insulin, insulin sensitivity by frequently sampled i.v. glucose tolerance test, and adipokines (IL-6, angiotensin II, leptin, PAI-1, adiponectin, and TNF-alpha). Results: Free fatty acids did not change acutely although there was an almost 30% decrease in free fatty acids at 1 month. Fasting insulin levels decreased at one month from 8.3 +/- 1.1 to 5.6 +/- 1.3 microunit/ml (P = 0.006). Insulin sensitivity by i.v. glucose tolerance test did not change at 1 month (4.0 +/- 0.8 to 5.0 +/- 0.7, P=0.12) although with subgroup analysis insulin sensitivity improved in obese but not overweight participants. Several adipokines worsened acutely (IL-6 increased 15 fold and angiotensin II increased 67%), but there was no change in PAI-1, and other adipokines (adiponectin, leptin, and TNF-alpha) decreased. At the 1-month follow-up, all adipokines were similar to baseline. Conclusion: This study provides little evidence supporting increased or decreased cardiovascular risk although there is evidence supporting improved insulin sensitivity at one month, especially in obese women.