Metabolic effects of liposuction- yes or no?

Klein et al. report that abdominal liposuction in 15 overweight women did not produce any significant change in metabolic abnormalities associated with obesity. We analyzed the metabolic effects of ultrasound-assisted megalipoplasty in eight premenopausal obese women (mean [±SD] body-mass index [the weight in kilograms divided by the square of the height in meters], 42.0±7.0). Measurements of body composition with dual-energy x-ray absorptiometry, insulin resistance (with the homeostasis-model assessment method),1 leptin, C-reactive protein, interleukin-6, resistin, and adiponectin were taken before and 1, 3, 28, and 180 days after ultrasound-assisted megalipoplasty. Ultrasound-assisted megalipoplasty reduced fat mass from 48.9±10.2 kg to 41.0±8.1 kg at day 3, and no further changes were seen. The greatest amounts of fat were removed from the lower limbs. The changes in insulin resistance and cytokine levels after the procedure are depicted in Figure 1Figure 1Insulin Resistance and Cytokine Levels in Eight Premenopausal Obese Women with Peripheral Fat Distribution, before and after Ultrasound-Assisted Megalipoplasty (UAM).. An acute reduction in insulin sensitivity occurred postoperatively, with related changes in the adipocytokines involved in insulin action. In the recovery phase, we observed improvement in insulin resistance in association with a reduction in leptin levels, consistent with loss of fat mass, as reported by others.2 We suggest that the metabolic effects of ultrasound-assisted megalipoplasty may be influenced by fat distribution and the length of follow-up.