title: Metabolic effects of large-volume liposuction for obese healthy women: a meta-analysis of fasting insulin levels.
abstract: BACKGROUND
  Obesity is increasingly frequent in our society and is associated closely with metabolic disorders. As some studies have suggested, removal of fat tissue through liposuction and dermolipectomies may be of some benefit in the improvement of metabolic indices. This article aimed to review the published literature on this topic and to evaluate metabolic variations meta-analytically after liposuction, dermolipectomy, or both.
  
  
  METHODS
  Through a literature search with the PubMed/Medline database, 14 studies were identified. All articles were analyzed, and several metabolic variables were chosen in the attempt to meta-analyze the effect of adipose tissue removal through the various studies. All statistical calculations were performed with Review Manager (RevMan), version 5.0.
  
  
  RESULTS
  Several cardiovascular and metabolic variables are described as prone to variations after body-contouring procedures when a significant amount of adipose tissue has been excised. Four of the studies included in the analysis reported improvements in all the parameters examined. Seven articles showed improvement in some variables and no improvement in others, whereas three studies showed no beneficial variation in any of the considered indicators after body-contouring procedures. Fasting plasma insulin was identified as the only variable for which a meta-analysis of five included studies was possible. The meta-analysis showed a statistically significant reduction in fasting plasma insulin resulting from large-volume liposuction in obese healthy women.
  
  
  CONCLUSIONS
  Many beneficial metabolic effects resulting from dermolipectomy and liposuction procedures are described in the literature. In particular, fasting plasma insulin and thus insulin sensitivity seem to be positively influenced. Further research, including prospective clinical studies, is necessary for better exploration of the effects that body-contouring plastic surgery procedures have on metabolic parameters.
authors.affiliation: Laboratory of Orthopaedic Pathophysiology and Regenerative Medicine & First Department, Rizzoli Orthopaedic Institute, Viale A. Aldini, 23, 40136, Bologna, Italy, borianifilippo@gmail.com.
authors.forename: Filippo
authors.initials: F
authors.lastname: Boriani
authors.forename: Riccardo
authors.initials: R
authors.lastname: Villani
authors.forename: Paolo Giovanni
authors.initials: PG
authors.lastname: Morselli
mesh_terms: D005260:Female; D006801:Humans; D007328:Insulin / Q000097:blood*; D007333:Insulin Resistance / Q000502:physiology; D015187:Lipectomy; D009765:Obesity / Q000097:blood* / Q000628:therapy*
chemical_list: D007328:Insulin