The Effect of Abdominal Contouring on Metabolic Syndrome and Insulin Resistance | ||
| The Egyptian Journal of Plastic and Reconstructive Surgery | ||
| Article 8, Volume 47, Issue 3, July 2023, Pages 207-212 PDF (29.24 K) | ||
| Document Type: Original Article | ||
| DOI: 10.21608/ejprs.2023.309719 | ||
| Authors | ||
| Abraham Shawky* 1; Nesma H Ahmed2; Ahmed Abdel Salam1; Salah Mohammed1; Mohamed S Badawy1 | ||
| 1The Department of Plastic, Reconstructive & Maxillofacial Surgery. Ain Shams Faculty of Medicine; Ain Shams University | ||
| 2Department of Internal Medicine, Endocrinology & Metabolism, Faculty of Medicine, Ain Shams University | ||
| Abstract | ||
| Background: The deep layers of abdominal subcutaneous adipose tissue (SAT) behave functionally like the visceral adipose tissue (VAT). Both aggravate insulin resistance and affect the metabolic profile in a similar manner. So, the removal of Abdominal subcutaneous tissue in abdominal contouring surgeries as liposuction and lipo-abdominoplasty can positively affect insulin resistance and the metabolic profile. Objective: To assess the effect of abdominal contouring on metabolic syndrome and insulin resistance. Patients and Methods: 50 female patients with localized abdominal obesity i.e. skin pinch ³3cm, Metabolic syndrome i.e. three or more of the following criteria: (waist circumference ³35 inches, waist-hip ratio above 0.85, blood pressure ³130/85 mmHg, fasting triglyceride (TG) level ³150mg/dl, fasting high-density lipoprotein (HDL) cholesterol level £50mg/dl and fasting blood sugar ³100mg/dl) and insulin resistance i.e. fasting glucose ³l00mg/dL, 2-hour plasma glucose ³140mg/dl, fasting insulin level ³5mIU/mL and HbA1C between 5.7- 6.4%. Patients were divided into two groups, Group I (n=25); the lipo-abdominoplasty group and Group II (n=25); the liposuction only group. The change in the metabolic profile and insulin resistance was followed 3- and 6-months post operatively by measuring waist circumference, waist-hip ratio, blood pressure, fasting triglyceride, fasting high-density lipoprotein (HDL) cholesterol level, fasting blood sugar, fasting insulin, and fasting glucose level using specific laboratory equation called Homeostasis Model Assessment (HOMA- IR). Results: For both groups, there is a significant improvement in glycaemic and lipid profile for all studied patients together with weight loss and BMI. but there was no difference in glycemic or lipid profile between both groups. Waist/hip < br />ratio was significantly improved in lipo-abdominoplasty group < br />more than liposuction only group. There was no relation between amount of resected fat and the improvement in glycemic and lipid profile for all patients. Conclusion: As a part of body contouring surgeries, liposuction and lipo-abdominoplasty could play a role in improvement of insulin resistance and metabolic syndrome in patients with localized abdominal obesity. So, one time, it may not only be considered as an aesthetic procedure to improve the individual body image, but also it can be approved by the authorities and insurance companies as it affects the wellbeing. | ||
| Keywords | ||
| Abdominoplasty; Liposuction; Fat; Obesity; Metabolic profile | ||
| References | ||
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DHAWAN D. and SHARMA S.: Abdominal Obesity, Adipokines and Non-communicable Diseases. The Journal of steroid biochemistry and molecular biology, 203: 105737, 2020. 2- Papaetis G.S., Papakyriakou P. and Panagiotou T.N.: Central obesity, type 2 diabetes and insulin: Exploring a pathway full of thorns. Archives of medical science: AMS, 11 (3): 463-482, 2015. 3- SWARUP S., GOYAL A., GRIGOROVA Y. and ZELTSER R.: Metabolic Syndrome. In StatPearls. StatPearls Publishing, 2021. 4- Deacon C.F.: Physiology and Pharmacology of DPP-4 in Glucose Homeostasis and the Treatment of Type 2 Diabetes. Frontiers in Endocrinology, 10: 80, 2019. 5- Verkouter I., Noordam R., le Cessie S., van Dam R.M., Lamb H.J., Rosendaal F.R., van Heemst D. and de Mutsert R.: The Association between Adult Weight Gain and Insulin Resistance at Middle Age: Mediation by Visceral Fat and Liver Fat. Journal of Clinical Medicine, 8 (10): 1559, 2019. 6- Bjornstad P. and Eckel R.H.: Pathogenesis of Lipid Disorders in Insulin Resistance: A Brief Review. Current Diabetes Reports, 18 (12): 127, 2018. 7- Arabpour-Dahoue M., Mohammadzadeh E., Avan A., Nezafati P., Nasrfard S. and Ghazizadeh H.: Leptin level decreases after treatment with the combination of Radiofrequency and Ultrasound cavitation in response to the reduction in adiposity. Diabetes & metabolic syndrome, 13 (2): 1137-1140, 2019. 8- Pruksapong C., Chamnanchanunt S., Thanachartwet V., Desakorn V., Nakawiro D., Sahassananda D. and Rojnuckarin P.: Association of Body Dysmorphic Disorder with Leptin Levels in Patients with Normal Weight Undergoing Liposuction: A Matched Case Study. Plastic and reconstructive surgery. Global Open, 7 (10): e2482, 2019. 9- De Lucia Rolfe E., Ong K.K., Sleigh A., Dunger D.B. and Norris S.A.: Abdominal fat depots associated with insulin resistance and metabolic syndrome risk factors in black African young adults. BMC Public Health, 15: 1013, 2015. 10- Gibas-Dorna M., Turkowski P., Bernatek M., Mikrut K., Kupsz J. and Pia¸tek J.: Liposuction-induced metabolic alterations the effect on insulin sensitivity, adiponectin, leptin and resistin. Journal of Medical Science, 84 (4): 249-256, 2015. 11- Kim S.H., Chung J.H., Song S.W., Jung W.S., Lee Y.A. and Kim H.N.: Relationship between deep subcutaneous abdominal adipose tissue and metabolic syndrome: A case control study. Diabetology & Metabolic Syndrome, 12 (8): 10, 2016. 12- Ghafoor L., Entezari V., Fallah A. and Hajian A.: Lipoabdominoplasty and the leptin hormone. Annals of Medicine and Surgery, 68: 102633, 2021. 13- Freeman A.M. and Pennings N.: Insulin Resistance. In StatPearls. StatPearls Publishing, 2021. 14- American Diabetes Association; 2. Classification and Diagnosis of Diabetes (2021): Standards of Medical Care in Diabetes-2021. Diabetes Care 1 January, 44 (Supplement 1): S15-S33, 2021. 15- Casadei K. and Kiel J.: Anthropometric Measurement. In Stat Pearls. Stat Pearls Publishing, 2021. 16- Gibas-Dorna M., Szulin´ska M., Turkowski P., Kupsz J., Sowin´ska A., Mikrut K., Bernatek M. and Piatek J.: The Effect of VASER Abdominal Liposuction on Metabolic Profile in Overweight Males. American Journal of Men's Health, 11 (2): 284-293, 2017. 17- Ramos-Gallardo G., Pérez Verdin A., Fuentes M., Godínez Gutiérrez S., Ambriz-Plascencia A.R., González-García I., Gómez-Fonseca S.M., Madrigal R., González-Reynoso L.I., Figueroa S., Toscano Igartua X. and Jiménez Gutierrez D.F.: Effect of abdominoplasty in the lipid profile of patients with dyslipidemia. Plastic surgery international, 861348, 2013. | ||
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