In morbid obesity, metabolic abnormalities and adhesion molecules correlate with visceral fat, not with subcutaneous fat: effect of weight loss through surgery.
BACKGROUND
Decrease of both visceral fat (surgery, physical exercise) and subcutaneous fat (liposuction) is accompanied by improvement of insulin sensitivity.


METHODS
In this study, metabolic variables (glucose, insulin, high-density lipoprotein-cholesterol, triglycerides, aspartate aminotransferase, alanine aminotransferase, uric acid, ferritin) and adhesion molecules (ICAM-1, entothelin-1, E-selectin) were determined in 126 morbidly obese subjects before and 1 year after bariatric restrictive surgery (laparoscopic gastric banding) and correlated with anthropometric measures, i.e., body mass index (BMI) and waist circumference (waist), and with echographic measures of thickness of visceral (usVT) and subcutaneous (usST) abdominal fat.


RESULTS
Under basal conditions and after 1 year, metabolic variables correlated with BMI and waist (r from 0.157 to 0.507, p from 0.0182 to 0.0001) and with usVT (r from 0.211 to 0.512, p from 0.05 to 0.0001); insulin also correlated with usST, and adhesion molecules only correlated with BMI and usVT (r from 0.341 to 0.502, p from 0.0066 to 0.0001). Changes of metabolic variables correlated with changes of BMI and waist (r from 0.163 to 0.356, p from 0.0328 to 0.0001) and with usVT changes (r from 0.211 to 0.361, p from 0.0339 to 0.0002); changes of adhesion molecules only correlated with BMI and usVT changes (r from 0.227 to 0.361, p from 0.0444 to 0.0108). Changes of metabolic variables and of adhesion molecules virtually never correlated with changes of usST.


CONCLUSIONS
These data indicate that in morbid obesity, most metabolic abnormalities are associated with visceral fat and that their improvements after weight loss are associated with decrease of visceral fat.
Pontiroli
Antonio E
AE
Ospedale San Paolo, Università degli Studi di Milano, Via A di Rudinì 8, 20142, Milan, Italy. antonio.pontiroli@unimi.it
Frigè
Francesca
F
Paganelli
Michele
M
Folli
Franco
F
D000293:Adolescent; D000328:Adult; D000368:Aged; D001786:Blood Glucose; D050218:Body Fat Distribution; D015992:Body Mass Index; D001835:Body Weight; D019040:E-Selectin / Q000097:blood; D019332:Endothelin-1 / Q000097:blood; D005260:Female; D015391:Gastroplasty / Q000379:methods*; D006801:Humans; D007328:Insulin; D018799:Intercellular Adhesion Molecule-1 / Q000097:blood; D050152:Intra-Abdominal Fat / Q000000981:diagnostic imaging / Q000378:metabolism*; D008297:Male; D008875:Middle Aged; D009767:Obesity, Morbid / Q000378:metabolism*; D012044:Regression Analysis; D050507:Subcutaneous Fat, Abdominal / Q000378:metabolism*; D014463:Ultrasonography; D015431:Weight Loss; D055815:Young Adult
D001786:Blood Glucose; D019040:E-Selectin; D019332:Endothelin-1; D007328:Insulin; D018799:Intercellular Adhesion Molecule-1