title: The effects of the surgical removal of subcutaneous adipose tissue on energy expenditure and adipocytokine concentrations in obese women.
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+/-6.3 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.
authors.affiliation: Department of Medical and Surgical Sciences, Obesity Unit, University of Padova, Via Giustiniani 2, 35128 Padova, Italy.
authors.forename: Luca
authors.initials: L
authors.lastname: Busetto
authors.forename: Franco
authors.initials: F
authors.lastname: Bassetto
authors.forename: Michele
authors.initials: M
authors.lastname: Zocchi
authors.forename: Francesca
authors.initials: F
authors.lastname: Zuliani
authors.forename: Maria Luisa
authors.initials: ML
authors.lastname: Nolli
authors.forename: Sabrina
authors.initials: S
authors.lastname: Pigozzo
authors.forename: Alessandra
authors.initials: A
authors.lastname: Coin
authors.forename: Marco
authors.initials: M
authors.lastname: Mazza
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Sergi
authors.forename: Francesco
authors.initials: F
authors.lastname: Mazzoleni
authors.forename: Giuliano
authors.initials: G
authors.lastname: Enzi
mesh_terms: 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
chemical_list: 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