Effect of liposuction on insulin resistance and vascular inflammatory markers in obese women

Giugliano, Giovanni; Nicoletti, Gianfranco; Grella, E; Giugliano, Francesco; Esposito, Katherine; Scuderi, Nicolò; D’Andrea, Francesco

doi:10.1016/j.bjps.2003.12.010

Cited by 137 publications

(100 citation statements)

References 22 publications

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“…Furthermore, subjects with high BMI (30-45 kg/m 2 ) has been reported to have significantly lower insulin sensitivity, as measured by the homeostasis model assessment of insulin resistance (HOMA IR), and serum adiponectin than non-obese subjects (P ¼ 0.01). 33 In addition, subjects with high IR (above the median HOMA IR) showed significantly greater differences in blood pressure levels between non-carriers and carriers of the T894 allele. 36 These workers also reported that G894T genotype and IR also showed a combined effect on the prevalence of parental hypertension, with non-carriers versus carriers in the high IR group.…”

Section: Discussionmentioning

confidence: 96%

“…BMI is known to have an effect on blood pressure and atherosclerosis and insulin sensitivity. [30][31][32][33] The interaction between L/F polymorphism of E-selectin gene and BMI on blood pressure has been reported. 34 Another report showed the significant association of eNOS gene variant TÀ786C polymorphism in men with hypercholesterolaemia and obesity in Caucasians.…”

Section: Discussionmentioning

confidence: 99%

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Association analysis of endothelial nitric oxide synthase gene polymorphism with primary hypertension in a Singapore population

et al. 2006

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Vascular endothelial cells produce nitric oxide (NO), which contributes to the regulation of blood pressure and regional blood flow. Endothelial nitric oxide synthase (eNOS) gene polymorphisms are associated with coronary artery disease, but their linkage with primary hypertension is controversial. A total of 103 individuals with primary hypertension and 104 normotensive control subjects were studied in Singapore. The specific genotypes for G894T missense variant in exon 7, variable number tandem repeats (VNTR) in intron 4 (eNOS 4A/B/C) and TÀ786C in the promoter were isolated using allele-specific gene amplification and restriction fragment length polymorphism to examine the association of genotype and allelic frequency in both groups. Logistic regression analysis was also used to detect the association between genotypes and hypertension. Five genotypes of intron 4 VNTR (AA, AB, BB, AC and BC) were observed. Intron 4 B/B genotype was significantly associated with the hypertension group (P ¼ 0.035), but disequilibrium of G894T and TÀ786C was absent between the two groups (P ¼ 0.419 and P ¼ 0.227), respectively. The overall distribution of allelic frequency differed significantly between the two groups, with four-repeat allele (4A) of intron 4 more frequent in the normotensive group than the hypertensive group (P ¼ 0.019). Logistic regression analysis showed that intron 4 B/B genotype was significantly associated with systolic blood pressure of individuals with body mass index greater than 25 kg/m 2 (P ¼ 0.04). In conclusion, the eNOS 4 B/B genotype is a genetic susceptibility factor for primary hypertension in a Singapore population.

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Section: Discussionmentioning

confidence: 96%

Section: Discussionmentioning

confidence: 99%

Association analysis of endothelial nitric oxide synthase gene polymorphism with primary hypertension in a Singapore population

et al. 2006

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“…In particular, removal of visceral adipose tissue (VAT) by omentectomy results in decreased glucose and insulin levels in humans, 40 whereas removal of subcutaneous adipose tissue (SAT) by liposuction does not always result in an improvement in glucose and lipid metabolism. 41,42 The causative mechanism is attributed to the release of free fatty acids from VAT, which, by draining into the portal vein, exerts adverse effects on hepatic metabolism. However, there is no clear proof of such a causal link between VAT and insulin resistance.…”

Section: Upper Body Fatmentioning

confidence: 99%

Body composition phenotypes in pathways to obesity and the metabolic syndrome

et al. 2010

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Dynamic changes in body weight have long been recognized as important indicators of risk for debilitating diseases. While weight loss or impaired growth can lead to muscle wastage, as well as to susceptibility to infections and organ dysfunctions, the development of excess fat predisposes to type 2 diabetes and cardiovascular diseases, with insulin resistance as a central feature of the disease entities of the metabolic syndrome. Although widely used as the phenotypic expression of adiposity in population and gene-search studies, body mass index (BMI), that is, weight/height 2 (H 2 ), which was developed as an operational definition for classifying both obesity and malnutrition, has considerable limitations in delineating fat mass (FM) from fat-free mass (FFM), in particular at the individual level. After an examination of these limitations within the constraints of the BMI-FM% relationship, this paper reviews recent advances in concepts about health risks related to body composition phenotypes, which center upon (i) the partitioning of BMI into an FM index (FM/H 2 ) and an FFM index (FFM/H 2 ), (ii) the partitioning of FFM into organ mass and skeletal muscle mass, (iii) the anatomical partitioning of FM into hazardous fat and protective fat and (iv) the interplay between adipose tissue expandability and ectopic fat deposition within or around organs/tissues that constitute the lean body mass. These concepts about body composition phenotypes and health risks are reviewed in the light of race/ethnic variability in metabolic susceptibility to obesity and the metabolic syndrome.

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“…[14][15][16] One large-volume lipectomy study has demonstrated that 6 months following the procedure there was a significant decrease in IL-6, TNF-a and CRP, whereas there was a significant increase in adiponectin. 17 However, another recent study found no effect of largevolume liposuction on either insulin sensitivity (measured by staged hyperinsulinemic euglycemic clamp) or inflammatory mediators (adiponectin, TNF-a, IL-6, and C-reactive protein). 18 It has been proposed that the failure of adipogenesis and lack of appropriate storage for lipid might be a major etiology in insulin resistance and type 2 diabetes, 19 and thus the resultant 'lipid overflow'…”

mentioning

confidence: 97%

“…As the few studies that have examined the effects of suction lipectomy on obesity-related complications have evaluated the effect with large-volume lipectomy, 13,17,18,20,21 we undertook this study in order to assess the effect of smallvolume suction lipectomy of the abdomen on adipokines, insulin sensitivity, and cardiovascular risk. Both the acute (1 day) and longer-term (1 month) effects of suction lipectomy on adipokines and insulin sensitivity were evaluated.…”

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confidence: 99%

Acute and 1-month effect of small-volume suction lipectomy on insulin sensitivity and cardiovascular risk

2006

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Objective: The most common surgical procedure for obesity is liposuction, the majority of which are small-volume procedures. The effect of large-volume liposuction on cardiovascular risk and insulin sensitivity has been variable. This study was performed to evaluate the effect of the more common, smaller-volume liposuction on insulin sensitivity, inflammatory mediators, and cardiovascular risk factors. Subjects and study design: In all, 15 overweight or obese premenopausal women underwent metabolic evaluation prior to, 1 day following and 1 month following suction lipectomy of the abdomen. Metabolic evaluation included assessment of free fatty acids, glucose, insulin, insulin sensitivity by frequently sampled i.v. glucose tolerance test, and adipokines (IL-6, angiotensin II, leptin, PAI-1, adiponectin, and TNF-a). Results: Free fatty acids did not change acutely although there was an almost 30% decrease in free fatty acids at 1 month. Fasting insulin levels decreased at one month from 8.371.1 to 5.671.3 mU/ml (P ¼ 0.006). Insulin sensitivity by i.v. glucose tolerance test did not change at 1 month (4.070.8 to 5.070.7, P ¼ 0.12) although with subgroup analysis insulin sensitivity improved in obese but not overweight participants. Several adipokines worsened acutely (IL-6 increased 15 fold and angiotensin II increased 67%), but there was no change in PAI-1, and other adipokines (adiponectin, leptin, and TNF-a) decreased. At the 1-month follow-up, all adipokines were similar to baseline. Conclusion: This study provides little evidence supporting increased or decreased cardiovascular risk although there is evidence supporting improved insulin sensitivity at one month, especially in obese women.

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Effect of liposuction on insulin resistance and vascular inflammatory markers in obese women

Cited by 137 publications

References 22 publications

Association analysis of endothelial nitric oxide synthase gene polymorphism with primary hypertension in a Singapore population

Association analysis of endothelial nitric oxide synthase gene polymorphism with primary hypertension in a Singapore population

Body composition phenotypes in pathways to obesity and the metabolic syndrome

Acute and 1-month effect of small-volume suction lipectomy on insulin sensitivity and cardiovascular risk

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