Role of Subcutaneous Abdominal Fat on Cardiac Function and Proinflammatory Cytokines in Premenopausal Obese Women

Marfella, Raffaele; Grella, Roberto; Rizzo, Maria Rosaria; Barbieri, Michelangela; Grella, Rodolfo; Ferraraccio, Franca; Cacciapuoti, Federico; Mazzarella, Gennaro; Ferraro, Nicola; D’Andrea, Francesco; Paolisso, Giuseppe; Nicoletti, Gianfranco

doi:10.1097/sap.0b013e3181955cdb

Cited by 23 publications

(33 citation statements)

References 29 publications

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“…Pro-inflammatory visceral adipocytes produce a variety of neurohormonal signals, including interleukin-6, and PAI-1 [6], which mediate hepatic insulin resistance [21], cardiac remodeling, and heart failure [22, 23]. In fact, cardiovascular function and clinical outcomes are associated with the extent and neurohormonal activity of visceral fat [7, 8, 11, 24], such that obese individuals without pro-inflammatory visceral adipose tissue remain metabolically neutral [25]. Ultimately, cardiovascular risk may depend more on insulin resistance than on BMI [26], with insulin resistance driving incident heart failure in non-obese individuals to a greater degree than in metabolically healthy obese [9].…”

Section: Discussionmentioning

confidence: 99%

Insulin Resistance, Subclinical Left Ventricular Remodeling, and the Obesity Paradox

Shah

Abbasi

Heydari

et al. 2013

Journal of the American College of Cardiology

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Objectives We assessed in the Multi-Ethnic Study of Atherosclerosis (MESA) whether impaired fasting glucose, insulin resistance, and waist-to-hip ratio had effects on cardiac remodeling, independent of obesity. Background Recent studies suggest that central obesity and insulin resistance may be primary mediators of obesity-related cardiac remodeling independent of body mass index (BMI). Methods We investigated 4,364 individuals without diabetes in MESA. Impaired fasting glucose (IFG: 100-125 mg/dl) or insulin resistance (by homeostatic model assessment of insulin resistance, HOMA-IR) and waist-to-hip ratio (WHR) were used for cardiometabolic phenotyping. Multivariate linear regression analysis was used to determine the effects of the cardiometabolic markers on LV remodeling, assessed primarily through the LV mass-to-volume ratio obtained by cine cardiac magnetic resonance imaging. Results Individuals with IFG were more likely to be older, hypertensive, with increased prevalence of cardiometabolic risk factors regardless of BMI. In each quartile of BMI, individuals with above-median HOMA-IR, above-median WHR, or IFG had a higher LV mass-to-volume ratio (p<0.05 for all). HOMA-IR (p<0.0001), WHR (p<0.0001), and the presence of IFG (p=0.04), but not BMI (p=0.24), were independently associated with LV mass-to-volume ratio after adjustment for age, gender, hypertension, race, and dyslipidemia. Conclusions Insulin resistance and waist-to-hip ratio are associated with concentric LV remodeling independent of BMI. These results support the emerging hypothesis that the cardiometabolic phenotype, defined by insulin resistance and central obesity, may play a critical role in LV remodeling independently of BMI.

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Section: Discussionmentioning

confidence: 99%

Insulin Resistance, Subclinical Left Ventricular Remodeling, and the Obesity Paradox

Shah

Abbasi

Heydari

et al. 2013

Journal of the American College of Cardiology

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“…However, the reasons behind the increase in the liver expressions of Hnf1a and Hnf4a after surgical removal of adipose tissue are still unclear. The expression of Hnf4a was postulated to be down-regulated by cytokines [42], and removal of adipose tissue was shown to be reflected by a decrease in the circulating levels of proinflammatory cytokines [43,44]. Thus, it can be hypothesized that surgical removal of adipose tissue in rats may result in a decrease in cytokine levels, which in turn enhances the expression of Hnf4a gene.…”

Section: Discussionmentioning

confidence: 99%

Up-Regulation Mttp and Apob Gene Expression in Rat Liver is Related to Post-Lipectomy Hypertriglyceridemia

Dettlaff-Pokora

Śledziński

Świerczyński

2015

Cell Physiol Biochem

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Background/Aims: The aim of this study was to explain the molecular basis for elevated concentrations of circulating triglycerides (TAGs) after partial surgical removal of adipose tissue (lipectomy) in rats. Methods: The levels of mRNA and protein: a) involved in synthesis of fatty acids and TAGs; b) participating in TAG-rich lipoproteins assembly and secretion; and c) transcription factors essential for maintaining TAG homeostasis were determined by RT-PCR and Western Blot in the livers of control and lipectomized rats. Results: Partial lipectomy was associated with increase: a) in serum and liver concentration of TAGs, and b) in the liver levels of mRNA of microsomal TAG transfer protein (MTP) and apolipoprotein B-100 (ApoB-100). These changes were tightly associated with up-regulation of Hnf1a and Hnf4a gene expression in the liver. Lipectomy was also reflected by a significant increase in the expression of genes encoding: a) fatty acid synthase (FASN), b) glycerol 3-phosphate acyltransferase 1 (GPAT1), diacylglycerol acyltransferases 1 and 2 (DGAT1 and DGAT2), c) spot 14 protein (S14) and SREBP-1 in the liver. Conclusion: Coordinated up-regulation of Mttp, Apob, Hnf1a, Hnf4a, Fasn, Gpam and Dgat (1 and 2) gene expressions may contribute to the increase in circulating and liver concentrations of TAGs after lipectomy in an experimental rat model.

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“…Otherwise, a stable nutritional biochemical pattern was documented throughout the observation period (Table 2). Table 3 summarizes the findings from the literature concerning the impact of liposuction and abdominoplasty on metabolic variables [2][3][4][5][6][7][8][9][10][11][12].…”

Section: Resultsmentioning

confidence: 99%

C-Reactive Protein Decrease After Postbariatric Abdominoplasty

Junior¹,

Modolin²,

Faintuch

et al. 2011

Inflammation

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In a prospective study, indices of glucose homeostasis, lipid profile, and systemic inflammation were monitored after an aesthetic abdominoplasty, aiming to scrutinize the possible metabolic benefits for abdominal fat removal. Premenopausal females with substantial weight loss (N=40) undergoing circumferential abdominoplasty (index group, n=20) or augmentation mammoplasty with mastopexy (controls, n=20) were recruited. All of them originally underwent Roux-en-Y gastric bypass. Variables included BMI, white blood cell count, C-reactive protein, hemoglobin, total cholesterol and fractions, triglycerides, glucose, and HbA1c. Follow-up reached 20.3 ± 13.6 months for index cases and 29.5 ± 17.4 months for controls. The metabolic and inflammatory indices improved after the bariatric surgery. Subsequent monitoring indicated a stable body weight and biochemical profile in both groups. The exceptions were HDL cholesterol and C-reactive protein, which respectively increased and diminished after the abdominoplasty, consistent with an inflammatory and metabolic advantage for this operation. This is the first long-term study in a weight-stable population to point out such a pattern after abdominoplasty.

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Role of Subcutaneous Abdominal Fat on Cardiac Function and Proinflammatory Cytokines in Premenopausal Obese Women

Cited by 23 publications

References 29 publications

Insulin Resistance, Subclinical Left Ventricular Remodeling, and the Obesity Paradox

Insulin Resistance, Subclinical Left Ventricular Remodeling, and the Obesity Paradox

Up-Regulation Mttp and Apob Gene Expression in Rat Liver is Related to Post-Lipectomy Hypertriglyceridemia

C-Reactive Protein Decrease After Postbariatric Abdominoplasty

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