Liposuction-induced metabolic alterations – the effect on insulin sensitivity, adiponectin, leptin and resistin

Magdalena Gibas-Dorna; Piotr Turkowski; Małgorzata Bernatek; Kinga Mikrut; Justyna Kupsz; Jacek Piątek

doi:10.20883/medical.e7

Authors

Magdalena Gibas-Dorna Department of Physiology, Poznan University of Medical Sciences, Poland
Piotr Turkowski Samir Ibrahim Mandala Beauty Clinic, Poznan, Poland
Małgorzata Bernatek Chair of Social Medicine, Poznan University of Medical Sciences, Poland
Kinga Mikrut Department of Physiology, Poznan University of Medical Sciences, Poland
Justyna Kupsz Department of Physiology, Poznan University of Medical Sciences, Poland
Jacek Piątek Department of Physiology, Poznan University of Medical Sciences, Poland

DOI:

https://doi.org/10.20883/medical.e7

Keywords:

liposuction, insulin sensitivity, adiponectin, leptin, resistin, metabolic outcomes

Abstract

Liposuction surgically removes subcutaneous abdominal tissue (SAT) and has almost no effect on visceral abdominal tissue (VAT) depot. However, some authors suggest that deep layers of SAT are functionally similar to VAT and the amount of deep subcutaneous abdominal adipose tissue is strongly related to insulin resistance in a manner nearly identical to that of visceral adiposity. Moreover, SAT determines leptin secretion which indirectly reflects the level of insulin sensitivity in the body. Thus, the immediate removal of SAT could potentially affect metabolic profile of a patient. The current data are conflicting and cannot bring a clear evidence suggesting that liposuction itself results in important metabolic outcomes and, on the other hand, cannot exclude such a possibility. This review summarizes the liposuction-induced metabolic changes with regard to release of major adipokines and insulin sensitivity.

Downloads

Download data is not yet available.

References

Kershaw EE, Flier JS. Adipose Tissue as an Endocrine Organ. J Clin Endocrinol & Metab. 2004;89(6):2548–2556.

Siemińska L. Adipose tissue. Pathophysiology, distribution, sex differences and the role in inflammation and cancerogenesis. Pol J Endocrinol. 2007;58(4):330–342.

Alberti KG, Zimmet PZ. Definition, diagnosis and classification of diabetes mellitus and its complications. Part 1: diagnosis and classification of diabetes mellitus provisional report of a WHO consultation. Diabet Med. 1998;15:539–553.

Wajchenberg BL. Subcutaneous and visceral adipose tissue: their relation to the metabolic syndrome. Endocr Rev. 2000;21(6):697–738.

Abate N, Garg A, Peshock RM, Stray-Gundersen J, Grundy SM. Relationships of generalized and regional adiposity to insulin sensitivity in men. J Clin Invest. 1995;96:88–98.

Park KS, Rhee BD, Lee KU, Kim SY, Lee HK, Koh CS, Min HK. Intraabdominal fat is associated with decreased insulin sensitivity in healthy young men. Metabolism. 1991;40:600–603.

Rendell M, Hulthen UL, Tornquist C, Groop L, Mattiasson I. Relationship between abdominal fat compartments and glucose and lipid metabolism in early postmenopausal women. J Clin Endocrinol Metab. 2001;86:744 –749.

Cnop M, Landchild MJ, Vidal J, Havel PJ, Knowles NG, Carr DR, Wang F, Hull RL, Bovko EJ, Retzlaff BM, Walden CE, Knopp RH, Kahn SE. The concurrent accumulation of intra-abdominal and subcutaneous fat explains the association between insulin resistance and plasma leptin concentrations: distinct metabolic effects of two fat compartments. Diabetes. 2002;51:1005–1015.

Rohrich RJ, Kenkel JM, Janis JE, Beran SJ, Fodor PB. An update on the role of subcutaneous infiltration in suction assisted lipoplasty. Plast Reconstr Surg. 2003;111:926–7.

American Society for Aesthetic Plastic Surgery. ASAPS Statistics on cosmetic surgery. New York: American Society for Aesthetic Plastic Surgery, 2003.

Kelley DE, Thaete FL, Troost F, Huwe T, Goodpaster BH. Subdivisions of subcutaneous abdominal adipose tissue and insulin resistance. Am J Physiol Endocrinol Metab. 2000;278:E941–E948.

Perez RA. Liposuction and diabetes type 2 development risk reduction in the obese patient. Med Hypotheses. 2007;68(2):393–396.

Commons GW, Halperin B, Chang CC. Large-volume liposuction: a review of 631 consecutive cases over 12 years. Plast Reconstr Surg. 2001;108:1753–1763.

Hernandez TL, Kittelson JM, Law CK, Ketch LL, Stob NR, Lindstrom RC, Scherzinger A, Stamm ER, Eckel RH. Fat Redistribution Following Suction Lipectomy: Defense of Body FAT and Patterns of Restoration. Obesity. 2011;19:1388–1395.

Giugliano G, Nicoletti G, Grella E, Giugliano F, Esposito K, Scuderi N, D´Andrea F Effect of liposuction on insulin resistance and vascular inflammatory markers in obese women. Br J Plast Surg. 2004;57(3):190–194.

Giese SY, Bulan EJ, Commons GW, Spear SL, Yanovski JA. Improvements in cardiovascular risk profile with large-volume liposuction: a pilot study. Plast Reconstr Surg. 2001;108:510–520.

González-Ortiz M, Robles-Cervantes JA, Cárdenas-Camarena L, Bustos-Saldańa R, Martínez-Abundis E. The effects of surgically removing subcutaneous fat on the metabolic profile and insulin sensitivity in obese women after large-volume liposuction treatment. Horm Metab Res. 2002;34:446–449.

D’Andrea F, Grella R, Pizzo MR, Grella E, Nicoletti G, Barbieri M, Paolisso G. Changing the metabolic profile by large-volume liposuction: a clinical study conducted with 123 obese women. Aest Plast Surg. 2005;29(6):472–8; discussion 479–80, 481.

Rizzo MR, Paolisso G, Grella R, Barbieri M, Grella E, Ragno E, Grella R, Nicoletti G, D'Andrea F. Is dermolipectomy effective in improving insulin action and lowering inflammatory markers in obese women? Clin Endocrinol. 2005;63(3):253–258.

Klein S, Fontana L, Young VL, Coggan AR, Kilo C, Patterson PW, Mohammed BS. Absence of an effect of liposuction on insulin action and risk factors for coronary heart disease. N Engl J Med. 2004;350(25):2549–57.

Weber RV, Buckley MC, Fried SK, Kral JG. Subcutaneous lipectomy causes a metabolic syndrome in hamsters. Am J Physiol Regul Integr Comp Physiol. 2000; 279: R936–R943.

Diez JJ, Iglesias P. The role of the novel adipocyte-derived hormone adiponectin in human disease. Eur J Endocrinol. 2003;148:293–300.

Lihn AS, Pedersen SB, Richelsen B. Adiponectin: action, regulation and association to insulin sensitivity. Obes Rev. 2005;6(1):13–21.

Moroi M, Akter S, Nakazato R, Kunigasa T, Masai H, Furuhashi T, Fukusa H, Koda E, Sugi K, Jesmin S. Lower ratio of high-molecular-weight adiponectin level to total may be associated with coronary high-risk plaque. BMC Research Notes. 2013;6:83. http://www.biomedcentral.com/1756–0500/6/83.

Heidemann C, Sun Q, van Dam RM, Meigs JB, Hang C, Tworoger SS, Mantzoros CS, Hu FB. Total and high-molecular-weight adiponectin and resistin in relation to the risk for type 2 diabetes in women. Ann Intern Med. 2008;149(5):307–16.

Yang WS, Lee WJ, Funahashi T, Tanaka S, Matsuzawa Y, Chao CL, Chi-Ling Chen CL, Tai TY, Lee-Ming Chuang LM. Weight reduction increases plasma levels of an adipose-derived anti-inflammatory protein, Adiponectin. J Clin Endocrinol Metab. 2001;86(8):3815- 3819 (Erratum. 2002, J. Clin Endocrinol Metab. 2001;87:1626.

Giugliano G, Nicoletti G, Grella E, Giugliano F, Esposito K, Scuderi N, D´Andrea F. Effect of liposuction on insulin resistance and vascular inflammatory markers in obese women. Br J Plast Surg. 2004;57(3):190–194.

Maher A, Kamel I. Effect of large-volume abdominal liposuction on serum adiponectin level and its metabolic consequences in obese women. Egypt J Plast Reconstr Surg. 2009;33(2):201–208.

Mohammed BS, Cohen S, Reeds D, Young VL, Klein S. Long-term effects of large-volume liposuction on metabolic risk factors for coronary heart disease. Obesity. 2008;16(12):2648–2651.

Berggren JR, Hulver MW, Houmard JA. Fat as an endocrine organ: influence of exercise. J App Physiol. 2005;99(2):757–764.

Solis MY, Artioli GG, Montag E, Painelli V, Saito FL, Lima FR, Roschel H, Gualano B, Lancha AH, Benatti FB. The liposuction-induced effects on adiponectin and selected cytokines are not affected by exercise training in women. Int J Endocrinol. 2014;2014:315382.

Correira MLG, Morgan DA, Mitchell JL, Sivitz WI, Mark AL., Haynes WG. Role of corticotrophin-releasing factor in effects of leptin on sympathetic nerve activity and arterial pressure. Hypertension. 2001;38:384–388.

Barzilai N, Wang J, Massilon D, Vuguin P, Hawkins M, Rossetti L. Leptin selectively decreases visceral adiposity and enhances insulin action. J Clin Invest. 1997;100:3105–3110

Borer KT. Counterregulation of insulin by leptin as key component of autonomic regulation of body weight. World J Diabetes. 2014;5:606–629.

Harris RB. Direct and indirect effects of leptin on adipocyte metabolism. Biochim Biophys Acta. 2014;1842(3):414–23.

Muller G, Ertl J, Gerl M, Preibisch G. Leptin impairs metabolic actions of insulin in isolated rat adipocytes. J Biol Chem. 1997; 272:10585–10593.

Yildiz BO, Haznedaroglu IC. Rethinking leptin and insulin action: therapeutic opportunities for diabetes. Int J Biochem Cell Biol. 2006; 38(5–6):820–830.

Kellerer M, Lammers R, Fritsche A, Strack V, Machicao F, Borboni P, Ullrich A, Haring HU. Insulin inhibits leptin receptor signalling in HEK293 cells at the level of janus kinase-2: a potential mechanism for hyperinsulinaemia- associated leptin resistance. Diabetologia. 2001;44:1125–1132.

Jequier E. Leptin signaling, adiposity, and energy balance. Ann N Y Acad Sci. 2002;967:379–88.

Enriori PJ, Sinnayah P, Simonds SE, Garcia Rudaz C, Cowley MA. Leptin action in the dorsomedial hypothalamus increases sympathetic tone to brown adipose tissue in spite of systemic leptin resistance. J Neurosci. 2011;31:12189–12197.

Wang Z, Zhou YT, Kakuma T, Lee Y, Kalra SP, Kalra PS, Pan W, Unger RH. Leptin resistance of adipocytes in obesity: role of suppressors of cytokine signaling. Biochem Biophys Res Commun. 2000;277:20–26.

Schreiber JE, Singh NK, Shermak MA. The effect of liposuction and diet on ghrelin, adiponectin, and leptin levels in obese Zucker rats. Plast Reconstr Surg. 2006;117(6):1829–1835.

Talisman R, Belinson N, Modan-Moses D, Canti H, Orenstein A, Barzilai Z, Parret G. The Effect of Reduction of the Peripheral Fat Content by Liposuction-Assisted Lipectomy (SAL) on Serum Leptin Levels in the Postoperative Period: A Prospective Study. Aest Plast Surg. 2001;25(4):262–265.

Salem ES, Serry ZM, Tawfik MS, HF Aboel Magd, Youssef SS. The photo biological effect of low level laser therapy on serum level of leptin, cholesterol and triglycerides in overweight and obese females. Arab J Nuc Sci Apel. 2013;46(3):307–312.

Danilla S, Longton C, Valenzuela K, Cavada G, Norambuena H, Tabilo C, Erazo C, Benitez S, Sepulveda S, Schulz R, Andrades P. Suction-assisted lipectomy fails to improve cardiovascular metabolic markers of disease: A meta-analysis. Journal of Plastic, Reconstructive & Aesthetic Surgery. 2013;66:1557–1563.

Shuldiner AR, Yang R, Gong DW. Resistin, obesity, and insulin resistance—the emerging role of the adipocyte as an endocrine organ. N Engl J Med. 2001;345:1345–1346.

Li J, Yu X, Pan W, Unger RH. Gene expression profile of rat adipose tissue at the onset of high-fat-diet obesity. Am J Phys Endocrinol Metab. 2002;282:E1334–E1341.

Patel L, Buckels AC, Kinghorn IJ, Murdock PR, Holbrook JD, Plumpton C, Macphee CH, Smith SA. Resistin is expressed in human macrophages and directly regulated by PPAR gamma activators. Biochem Biophys Res Commun. 2003;300:472–476.

Kusminski CM, da Silva NF, Creely SJ, Fisher FM, Harte AL, Baker AR, Kumar S, McTernan PG. The in vitro effects of resistin on the innate immune signaling pathway in isolated human subcutaneous adipocytes. J Clin Endocrinol Metab. 2007;92:270–276.

Osawa H, Yamada K, Onuma H, Murakami A, Ochi M, Kawata H, Nishimiya T, Niiya T, Shimizu I, Nishida W, Hashiramoto M, Kanatsuka A, Fujii Y, Ohashi J, Makino H. The G/G genotype of a resistin single-nucleotide polymorphism at –420 increases type 2 diabetes mellitus susceptibility by inducing promoter activity through specific binding of Sp1/3. Am J Hum Genet. 2004;75:678–686.

Steppan CM, Bailey ST, Bhat S, Brown EJ, Banerjee RR, Wright CM, Patel HR, Ahima RS, Lazar MA. The hormone resistin links obesity to diabetes. Nature. 2001;409:307–312.

Chen BH, Song Y, Ding EL, Roberts CK, Manson JE, Rifai N,. Buring JE, Gaziano JM, Liu S. Circulating levels of resistin and risk of type 2 diabetes in men and women: results from two prospective cohorts. Diabetes. 2009;32:329–334.

Won JC, Park CY, Lee WY, Lee ES, Oh SW, Park SW. Association of plasma levels of resistin with subcutaneous fat mass and markers of inflammation but not with metabolic determinants or insulin resistance. J Korean Med Sci. 2009;24:695–700.

Azuma K Katsukawa F, Oguchi S, Murata M, Yamazaki H, Shimada A, Saruta T. Correlation between serum resistin level and adiposity in obese individuals. Obes Res. 2003;11:997–1001.

Ma GE, Liu P, Lei H, Chen J, Liu ZJ. Effect of liposuction on adipokines, inflammatory markers and insulin resistance. Zhonghua Zheng Xing Wai Ke Za Zhi. 2010;26(1):26–8.

Ramos-Gallardo G, Pérez Verdin A, Fuentes M, Godinez Gutierrez S, Ambriz-Plascencia AR, Gonzalez-Garcia I, Gomez-Fonseca SM, Madrigal R, Gonzalez-Reynoso LI, Figueroa S, Toscano Igaruta X, Jimenez Gutierrez DF. Effect of abdominoplasty in the lipid profile of patients with dyslipidemia. Plast Surg Int. 2013;2013:861348.