Metabolic effects of lipectomy and of adipose tissue transplantation

Abstract

Objective: The goal of this study was to review the metabolic effects of fat transplantation.Methods: Fat (adipose tissue [AT]) transplantation has been performed extensively for many years in the cosmetic reconstruction industry. However, not all fats are equal. White, brown, and beige AT differ in energy storage and use. Brown and beige AT consume glucose and lipids for thermogenesis and, theoretically, may provide greater metabolic benefit in transplantation. Here, the authors review the metabolic effects of AT transplantation.Results: Removal of subcutaneous human AT does not have beneficial metabolic effects. Most studies find no benefit from visceral AT transplantation and some studies report harmful effects. In contrast, transplantation of inguinal or subcutaneous AT in mice has positive effects. Brown AT transplant studies have variable results depending on the model but most show benefit. Conclusions:Many technical improvements have optimized fat grafting and transplantation in cosmetic surgery. Transplantation of subcutaneous AT has the potential for significant metabolic benefits, although there are few studies in humans or using human AT. Brown AT transplantation is beneficial but not readily feasible in humans thus ex vivo "beiging" may be a useful strategy. AT transplantation may provide clinical benefits in metabolic disorders, especially in the setting of lipodystrophy.

Subcutaneous white adipose tissue independently regulates burn-induced hypermetabolism via immune-adipose crosstalk

“… 30 , 31 However, transplantation of visceral WAT has produced deleterious effects, 15 , 32 while BAT transplantation has produced variable results, albeit mostly favorable. 33 Given its strong physiological influence and ease of translation to the clinic, we chose subcutaneous iWAT as the donor tissue.…”

From scarcity to solutions: Therapeutic strategies to restore adipose tissue functionality in rare disorders of lipodystrophy

“…A study of 20 individuals with CGL2 revealed reduced lifespan by more than 30 years, with infectious disease listed as the cause of death in one‐third of individuals 21 . Additionally, although fat transplantation has been extensively performed for reconstructive and cosmetic surgery, a recent review of the literature by Davis and colleagues identified no studies reporting on the metabolic outcomes of human‐to‐human adipose tissue transplants 22 . Side effects of transplant can also include significant bleeding, infection, graft reabsorption/loss, peritonitis, bowel adhesions and fat embolism 22 …”

“…21 Additionally, although fat transplantation has been extensively performed for reconstructive and cosmetic surgery, a recent review of the literature by Davis and colleagues identified no studies reporting on the metabolic outcomes of human-to-human adipose tissue transplants. 22 Side effects of transplant can also include significant bleeding, infection, graft reabsorption/loss, peritonitis, bowel adhesions and fat embolism. 22 Additionally, further elegant transplantation studies in lipodystrophic A-ZIP/F-1 transgenic mice raised the question as to whether adipose restoration was even strictly required to improve metabolic health in lipodystrophy.…”

“…22 Side effects of transplant can also include significant bleeding, infection, graft reabsorption/loss, peritonitis, bowel adhesions and fat embolism. 22 Additionally, further elegant transplantation studies in lipodystrophic A-ZIP/F-1 transgenic mice raised the question as to whether adipose restoration was even strictly required to improve metabolic health in lipodystrophy. Curiously, transplantation of adipose tissue from leptindeficient ob/ob mice had no beneficial effect to glucose, insulin or triglyceride levels of lipodystrophic A-ZIP/F-1 transgenic mice.…”

Changes in Lipid Metabolism Enzymes in Rat Epididymal Fat after Chronic Central Leptin Infusion Are Related to Alterations in Inflammation and Insulin Signaling

“…It is important to distinguish between subcutaneous and visceral adipose tissue actions. These tissues differ in their expression patterns of different factors, with partial or total removal of visceral fat being shown to improve insulin sensitivity in rodents [ 2 ], whereas transplantation of subcutaneous fat is reported to generate positive effects on metabolic processes [ 3 ].…”