Background: Metabolic syndrome is a group of pathological processes which involve insulin resistance, a biochemical and molecular disorder. Obesity appears to be the most frequent clinical component in metabolic syndrome. Subcutaneous fat, independent from visceral fat, is still controversial as a marker of the pathophysiology of insulin resistance.
Methods: An open parallel-group clinical trial was performed of 12 women (age 30–40 years), with BMI from 30–33 kg/m2 and fasting glucose ≤110 mg/dl. 6 women were included in the “liposuction plus diet” group, and 6 were included in the “diet-only” group. Metabolic profile, including insulin tolerance test (ITT), leptin and tumor necrosis factor alpha (TNFα), was performed at baseline, 1 and 6 months in both groups. Subcutaneous and visceral fat was quantified with spiral tomography at baseline and after 6 months. Friedman and Wilcoxon test were used for intra-group differences, Mann-Whitney U for differences between groups, and Spearman test for correlation, with significance set atP<0.05.
Results: No difference existed between groups regarding clinical characteristics and metabolic profile. In the liposuction group, the increase in insulin sensitivity was (3.8±0.86, 3.1±0.85, 4.5±1.02 %/min,P=0.08. Insulin sensitivity did not correlate with subcutaneous fat, leptin, or TNFα. Leptin diminished at 1 month (52.7±6.04 vs 31.6±11.9),P=0.028, and correlated with the subcutaneous fat (r=0.957). In the diet-only group, TNFα diminished at 6 months,P=0.046.
Conclusion: Subcutaneous abdominal fat correlates with leptin; nevertheless, it is a weak marker for TNFα and insulin sensitivity.
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