Assessment of metabolic response after lipoabdominoplasty in normal to overweight women

ABSTRACT

Lipoabdominoplasty [LEAP] is a cosmetic body contouring procedure used to improve abdominal type of obesity which is implicated in the development of different metabolic; especially insulin resistance; metabolic syndrome, and cardiovascular risks. The aim of the present study was undertaken to investigate the different effects [LEAP] on carbohydrate, lipid metabolism and inflammatory markers as well as the relationship of these changes with insulin resistance in normal to overweight women suffering from abdominal obesity. A total of 16 non-diabetic normal to overweight women [BMI 25.77kg/m[2] +/- 1.3] with a mean age of 34.25 +/- 4.17 years were studied. Before LEAP all demographic data regarding age, smoking and medical history of diabetes or hypertension were obtained. Complete physical examination including measurement of blood pressure [BP] both systolic [SBP] and diastolic [DBP], anthropometric measurements including waist [WC] and hip circumferences, height, weight and calculation of waist to hip ratios [WHR] and body mass index [BMI] were performed. 12-14 hours lasting samples were collected to measure fasting blood glucose [FBS], insulin, total cholesterol [TC], high density lipoprotein [HDL-C], low-density lipoprotein [LDL-C], triglyceride [TG], C-Reactive protein [CRP], apolipoprotein Al [Apo A1], apolipoprotein B [Apo B], lipid risk ratios and Homostaic Model Assessment Index [HOMA-I] were calculated. All measurements and physical examinations were repeated one and six months after the operation. Data were analyzed with SPSS-11 software using student 't' test and Pearson correlation test. LEAP decreased body weight, BMI, WC and WHR significantly one month postoperatively which showed slight nonsignificant increase six months later. SBP, DBP, TC, HDL-C, LDL-C, Apo A1, and CRP did not change significantly throughout the study, TG and Apo B decreased Mgnificantly one month after LBAP but its levels returned nearly to preoperative values six months later. All the changes occurred were independent on insulin resistance throughout she study as evidenced by the nonsignificant correlations of the previous parameters with HOMA-I; as a measure of insulin resistance. LBAP transiently improved but had no lasting effects on some but not all metabolic and lipid risk factors. These changes were independent on insulin resistance. Decreasing adipose tissue mass alone by cosmetic body contouring operations will not achieve the metabolic benefits of weight loss and should be followed by conventional dietary and exercise programs therapy