Impact of Large-Volume Liposuction on Serum Lipids in Orientals: A Pilot Study

Abstract

Recent advances in liposuction techniques now make it possible to remove considerable amounts of subcutaneous adipose tissue. However, the metabolic consequences of this procedure are not well documented. The aim of this study was to identify the effects from the surgical removal of subcutaneous fat on the body weights and serum lipids of patients who have undergone large-volume liposuction. In this study, eleven consecutive patients with a minimum aspirate volume of 5,000 ml were evaluated, and their serum lipids were measured at a postoperative 2-month follow-up assessment. Tumescent fluid was infiltrated using the superwet technique. The liposuction device used was a Liposlim power-assisted liposuction system. The amount of solution infiltrated and the volume of aspirate were measured. Pre- and postoperative serum lipids, body weights, and body mass indices were compared. Statistical analysis was performed on lipid profile changes and aspirate volumes using Spearman's correlations. The average volumes of infiltrate and aspirate were 7,241 and 6,790 ml, respectively. Mean body weight decreased from 64.5 +/- 18.8 to 59.9 s +/- 17.8 kg (p < 0.01). The change in body weight per 1 l of aspirate volume was 0.67 +/- 0.10 kg/l. The mean body mass index dropped from 23.8 +/- 4.4 to 22.0 +/- 4.2 kg/m(2) (p < 0.01), and the mean total serum cholesterol levels from 168.2 +/- 23.6 to 162.9 +/- 26.5 mg/dl, an average of 3.2%. The mean low-density lipoprotein (LDL) decreased from 94.3 +/- 20.5 to 89.5 +/- 19.0 mg/dl, a 5.1% drop, and the mean high-density lipoprotein (HDL) decreased from 55.8 +/- 9.5 to 53.7 +/- 10.7 mg/dl, a 3,8% drop. The mean HDL/LDL proportion increased from 62.6 +/- 20.9% to 63.5 +/- 22.4%, averaging 1.4%. However, no significant correlation was found between the aspirated volume of fat and lipid profile change. In conclusion, over a 2-month period, large-volume liposuction reduced weight and total cholesterol level and increased the HDL/LDL ratio. The authors hope to discover whether the therapeutic impact of liposuction is long-lasting, and to determine whether it reduces the morbidity and mortality associated with obesity.

Non‐invasive cryolipolysis™ for subcutaneous fat reduction does not affect serum lipid levels or liver function tests

“…Furthermore, humans are able to clear very substantial lipid loads without discernable changes in serum values [10,11]. Finally, it is well documented that over the first few months after major liporeduction procedures serum lipid levels are actually reduced [12,13].…”

Lower body adipose tissue removal decreases glucose tolerance and insulin sensitivity in mice with exposure to high fat diet

“…We, therefore, performed 2 secondary studies to determine whether IngX-induced metabolic impairments were sustained following an extended experimental duration, 13 weeks, or was exacerbated in mice with existing glucose intolerance. While pronounced short-term metabolic improvements have been demonstrated with LBSAT removal, 61 many have demonstrated that large volume removal of LBSAT in obese humans results in minimal metabolic improvement, with short term decreases in circulating lipids and fasting insulin, 17,[19][20][21]62 but no long-term differences. 16 In the present study IngX-induced metabolic effects were sustained, yet to some extent attenuated, in both Chow and HFD mice after a longer experiment duration.…”

“…21 The lack of effect following liposuction, however, may be related to the fact that subjects were morbidly obese prior to and after the procedure. Other studies that have either concluded that liposuction was with 19,20 or without effect [16][17][18] were also confounded by wide variations in BMI (24 to 50), age (18-50 C years), duration of study (12 weeks to years) and amount of adipose tissue removed (5)(6)(7)(8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19)(20). [16][17][18][19][20] Although liposuction/lipectomy remains a useful tool to evaluate the role of LBSAT in relation to metabolic abnormalities, human data remains inconsistent due, in part, to variability in experimental approach and study populations.…”

“…[10][11][12][13][14] It has been proposed that lower body subcutaneous adipose tissue (LBSAT) functions as a "metabolic sink," storing lipids that might otherwise lead to disturbances in nonadipose tissues. 15 Although metabolic outcomes associated with LBSAT removal in humans have been investigated, [16][17][18][19][20] the "metabolic sink" postulate has not been systematically examined, in part, due to inherent experimental limitations in humans. Large volume reduction of LBSAT, via liposuction, does not alter insulin sensitivity or circulating markers of inflammation in humans.…”

The Effects of Liposuction Removal of Subcutaneous Abdominal Fat on Lipid Metabolism are Independent of Insulin Sensitivity in Normal-Overweight Individuals

“…However, in most studies, AL did not have prominent metabolic effects in terms of insulin sensitivity and pro-inflammatory adipo-cytokines [18][19][20]; nevertheless, some authors have reported transient benefits [21][22][23][24][25][26][27]. Further, the impact of liposuction on FFA and, particularly, in the lipid and lipoprotein profile is not yet fully documented, the available results being either incomplete or inconsistent [16][17][18][19][20][21][22][23][24][25][26][27][28][29][30].…”