The effects of the surgical removal of subcutaneous adipose tissue on energy expenditure and adipocytokine concentrations in obese women.
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+/-6.3 kg/m(2) (range: 30.7-53.6 kg/m(2)) 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 180 days 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.


CONCLUSIONS
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.
Busetto
Luca
L
Department of Medical and Surgical Sciences, Obesity Unit, University of Padova, Via Giustiniani 2, 35128 Padova, Italy.
Bassetto
Franco
F
Zocchi
Michele
M
Zuliani
Francesca
F
Nolli
Maria Luisa
ML
Pigozzo
Sabrina
S
Coin
Alessandra
A
Mazza
Marco
M
Sergi
Giuseppe
G
Mazzoleni
Francesco
F
Enzi
Giuliano
G
D054392:Adipokines / Q000097:blood*; D052242:Adiponectin / Q000097:blood; D000293:Adolescent; D000328:Adult; D001786:Blood Glucose / Q000378:metabolism; D001823:Body Composition; D001835:Body Weight; D002097:C-Reactive Protein / Q000378:metabolism; D002153:Calorimetry, Indirect; D004734:Energy Metabolism; D005260:Female; D006801:Humans; D007333:Insulin Resistance; D015850:Interleukin-6 / Q000097:blood; D020738:Leptin / Q000097:blood; D015187:Lipectomy; D008875:Middle Aged; D009765:Obesity / Q000097:blood / Q000000981:diagnostic imaging / Q000378:metabolism / Q000601:surgery*; D017697:Premenopause; D052243:Resistin / Q000097:blood; D012720:Severity of Illness Index; D050151:Subcutaneous Fat / Q000000981:diagnostic imaging / Q000378:metabolism / Q000601:surgery*; D013997:Time Factors; D016896:Treatment Outcome; D018084:Ultrasonography, Interventional
C499918:ADIPOQ protein, human; D054392:Adipokines; D052242:Adiponectin; D001786:Blood Glucose; C508600:IL6 protein, human; D015850:Interleukin-6; D020738:Leptin; C499624:RETN protein, human; D052243:Resistin; D002097:C-Reactive Protein