Original Article
International Journal of Obesity (2006) 30, 1217–1222. doi:10.1038/sj.ijo.0803120; published online 7 March 2006
Acute and 1-month effect of small-volume suction lipectomy on insulin sensitivity and cardiovascular risk
D A Davis1, D M Pellowski1, D A Davis2 and W T Donahoo3
- 1Departments of Dermatology, Otolaryngology, and Pathology, University of Arkansas for Medical Sciences, Arkansas, USA
- 2Department of Dermatology, Lovelace Hospital, Albuquerque, NM, USA
- 3Department of Medicine, University of Vermont, Burlington, VT, USA
Correspondence: Dr WT Donahoo, Section of Endocrinology, Diabetes, and Metabolism, University of Vermont, 89 Beaumont Ave, Given C-331, Burlington, VT 05405-0068, USA. E-mail: William.Donahoo@uvm.edu
Received 15 December 2004; Revised 11 July 2005; Accepted 7 August 2005; Published online 7 March 2006.
Abstract
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-
).
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 8.3
1.1 to 5.61.3 
U/ml (P=0.006). Insulin sensitivity by i.v. glucose tolerance test did not change at 1 month (4.00.8 to 5.00.7, P=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-) 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.
Keywords:
suction lipectomy, liposuction, insulin sensitivity, obesity, leptin, adipokines
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