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MONZON, J. RAUL, ROBIN BASILE, STEVEN HENEGHAN, VIDYA UDUPI, AND ALLAN GREEN. Lipolysis in adipocytes isolated from deep and superficial subcutaneous adipose tissue. Obes Res. 2002;10:266 -269. Objective: Abdominal subcutaneous adipose tissue (SAT) occurs in two depots separated by a fascial plane: deep SAT and superficial SAT. In a recent study it was demonstrated that the amount of deep SAT has a much stronger relationship to insulin resistance than does superficial SAT. Because insulin resistance may be related to fatty acid release from adipose tissue, we hypothesized that the two SAT depots may have a different lipolytic activity. Research Methods and Procedures:To test this hypothesis, we obtained samples of deep and superficial SAT from patients undergoing elective abdominal surgery. The rate of lipolysis was determined in the collagenase-digested adipocytes obtained from the two fat depots by measuring glycerol release in the presence and absence of isoproterenol. In addition, the relative concentration of hormone-sensitive lipase was determined in both SAT depots by Western blot analysis. Results: Our results showed that the rate of isoproterenolstimulated lipolysis was ϳ20% higher in cells from deep SAT compared with those from superficial SAT, indicating that the deep SAT is more lipolytically active. The concentration of hormone-sensitive lipase did not differ between the two adipose tissue depots. Discussion: These findings suggest that the higher lipolytic activity of deep SAT may account for its stronger association with insulin resistance. The mechanism seems to be independent of differences in hormone-sensitive lipase concentration.

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PreambleA number of factors, including reimbursement, have produced a demand for endoscopy to be performed in an office-based setting compared with a hospital or ambulatory center setting. Many gastrointestinal endoscopy procedures can be performed safely in the office setting. To ensure that patients undergoing an endoscopy in an office setting have the appropriate level of safety and quality, standards of care must be set and met. These standards should be similar to, if not the same as, the standards set for an institutional setting.