title: Fatty acid uptake and blood flow in adipose tissue compartments of morbidly obese subjects with or without type 2 diabetes: effects of bariatric surgery.
abstract: Body fat accumulation, distribution, and metabolic activity are factors in the pathophysiology of obesity and type 2 diabetes (T2D). We investigated adipose blood flow, fatty acid uptake (FAU), and subcutaneous and visceral fat cellularity in obese patients with or without T2D. A total of 23 morbidly obese (mean body mass index = 42 kg/m2) patients were studied before and 6 mo after bariatric surgery; 15 nonobese subjects served as controls. Positron emission tomography was used to measure tissue FAU (with18F-FTHA) and blood flow (with H215O); MRI was used for fat distribution and fat biopsy for adipocyte size. Obese subjects had subcutaneous hyperplasia and hypertrophy and lower blood flow; when expressed per cell, flow was similar to controls. FAU into subcutaneous and visceral depots was increased in the obese; per unit tissue mass, however, FAU was similar to controls but reduced in skeletal muscle. Fatty acid fractional extraction in subcutaneous fat and muscle was only increased in obese patients with T2D. We conclude that surgery reduces subcutaneous fat hyperplasia and hypertrophy; subcutaneous blood flow and FAU decrease in absolute terms and per cell while fractional FAU remains unchanged in T2D. In the obese, subcutaneous blood flow is a determinant of FAU and is coupled with cellularity; efficiency of FAU is enhanced in subcutaneous fat and muscle in T2D.
authors.affiliation: Turku PET Centre, University of Turku, Turku, Finland.
authors.forename: Prince
authors.initials: P
authors.lastname: Dadson
authors.affiliation: National Research Council Institute of Clinical Physiology, Pisa, Italy.
authors.forename: Ele
authors.initials: E
authors.lastname: Ferrannini
authors.affiliation: Turku PET Centre, University of Turku, Turku, Finland.|National Research Council Institute of Clinical Physiology, Pisa, Italy.
authors.forename: Linda
authors.initials: L
authors.lastname: Landini
authors.affiliation: Turku PET Centre, Turku University Hospital, Turku, Finland.
authors.forename: Jarna C
authors.initials: JC
authors.lastname: Hannukainen
authors.affiliation: Turku PET Centre, University of Turku, Turku, Finland.
authors.forename: Kari K
authors.initials: KK
authors.lastname: Kalliokoski
authors.affiliation: Turku PET Centre, University of Turku, Turku, Finland.|Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland.
authors.forename: Maija
authors.initials: M
authors.lastname: Vaittinen
authors.affiliation: Turku PET Centre, University of Turku, Turku, Finland.
authors.forename: Henri
authors.initials: H
authors.lastname: Honka
authors.affiliation: Turku PET Centre, University of Turku, Turku, Finland.
authors.forename: Henry K
authors.initials: HK
authors.lastname: Karlsson
authors.affiliation: Turku PET Centre, University of Turku, Turku, Finland.
authors.forename: Jetro J
authors.initials: JJ
authors.lastname: Tuulari
authors.affiliation: Department of Endocrinology, Turku University Hospital, Turku, Finland.
authors.forename: Minna
authors.initials: M
authors.lastname: Soinio
authors.affiliation: Division of Digestive Surgery and Urology, Department of Acute and Digestive Surgery, Turku University Hospital, Turku, Finland.
authors.forename: Paulina
authors.initials: P
authors.lastname: Salminen
authors.affiliation: Medical Imaging Center, Turku University Hospital, Department of Radiology, University of Turku and Turku University Hospital, Turku, Finland; and.
authors.forename: Riitta
authors.initials: R
authors.lastname: Parkkola
authors.affiliation: Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland.|Institute of Public Health and Clinical Nutrition, Department of Clinical Nutrition and Obesity Center, Kuopio University Hospital, Kuopio, Finland.
authors.forename: Jussi
authors.initials: J
authors.lastname: Pihlajamäki
authors.affiliation: National Research Council Institute of Clinical Physiology, Pisa, Italy.
authors.forename: Patricia
authors.initials: P
authors.lastname: Iozzo
authors.affiliation: Turku PET Centre, University of Turku, Turku, Finland; pirjo.nuutila@utu.fi.|Department of Endocrinology, Turku University Hospital, Turku, Finland.
authors.forename: Pirjo
authors.initials: P
authors.lastname: Nuutila
mesh_terms: D017667:Adipocytes / Q000378:metabolism / Q000473:pathology; D000273:Adipose Tissue / Q000098:blood supply* / Q000378:metabolism* / Q000473:pathology; D050154:Adiposity; D000328:Adult; D050110:Bariatric Surgery; D050218:Body Fat Distribution; D003924:Diabetes Mellitus, Type 2 / Q000150:complications / Q000378:metabolism / Q000503:physiopathology; D005227:Fatty Acids / Q000378:metabolism*; D005260:Female; D006801:Humans; D050152:Intra-Abdominal Fat / Q000098:blood supply / Q000378:metabolism / Q000473:pathology; D050356:Lipid Metabolism; D008875:Middle Aged; D018482:Muscle, Skeletal / Q000378:metabolism / Q000473:pathology; D009767:Obesity, Morbid / Q000150:complications / Q000378:metabolism / Q000503:physiopathology / Q000601:surgery; D012039:Regional Blood Flow; D050151:Subcutaneous Fat / Q000098:blood supply / Q000378:metabolism / Q000473:pathology
chemical_list: D005227:Fatty Acids
keywords: adipose tissue; bariatric surgery; blood flow; fatty acid uptake; obesity; positron emission tomography; type 2 diabetes