Following Lipectomy to Understand Adipose Tissue Re-accumulation
| Status: | Completed |
|---|---|
| Conditions: | Women's Studies |
| Therapuetic Areas: | Reproductive |
| Healthy: | No |
| Age Range: | 35 - 60 |
| Updated: | 1/12/2017 |
| Start Date: | January 2008 |
| End Date: | December 2014 |
Regional Fat Re-accumulation Following Lipectomy in Pre- and Post-menopausal Women
The typical female pattern of accumulating fat in the hips and thighs has long been thought
to confer less risk for disease than the typical male abdominal fat pattern. However, leg
fat may not simply be benign with respect to disease risk, but may in fact protect against
cardiovascular disease risk. Although the mechanism for this is unknown, the investigators
hypothesize that removing a portion of this important fat depot (via liposuction) could
increase disease risk. Such unfavorable results may or may not be transient depending on an
individual's ability to defend their fat mass. Because sex hormones appear to play a role in
regional fat accumulation, the investigators hypothesize that estrogen-deficient
postmenopausal women may have an augmented abdominal fat accumulation and an attenuated hip
and thigh re-accumulation compared to premenopausal women following lipectomy and compared
to non-surgical controls. As a result, the increased abdominal fat accumulation may worsen
disease risk in postmenopausal women. Menopause-related differences in fat storage at
baseline are also expected to determine the degree to which lipectomy alters disease risk
and the propensity for AT re-accumulation.
to confer less risk for disease than the typical male abdominal fat pattern. However, leg
fat may not simply be benign with respect to disease risk, but may in fact protect against
cardiovascular disease risk. Although the mechanism for this is unknown, the investigators
hypothesize that removing a portion of this important fat depot (via liposuction) could
increase disease risk. Such unfavorable results may or may not be transient depending on an
individual's ability to defend their fat mass. Because sex hormones appear to play a role in
regional fat accumulation, the investigators hypothesize that estrogen-deficient
postmenopausal women may have an augmented abdominal fat accumulation and an attenuated hip
and thigh re-accumulation compared to premenopausal women following lipectomy and compared
to non-surgical controls. As a result, the increased abdominal fat accumulation may worsen
disease risk in postmenopausal women. Menopause-related differences in fat storage at
baseline are also expected to determine the degree to which lipectomy alters disease risk
and the propensity for AT re-accumulation.
Lipectomy is the most frequently performed aesthetic surgery in the U.S. today and is
considered permanent, by The American Society for Aesthetic Plastic Surgery, but no long
term follow-up studies have been done to verify this assertion. Indeed, animal studies
suggest rapid adipose tissue (AT) re-accumulation after lipectomy is common and may even be
accompanied by unfavorable changes in disease risk. Recent studies in humans have focused on
abdominal lipectomy as a means of reducing metabolic disease risk in obese premenopausal
women. However, none of these studies evaluated AT re-accumulation or reported long-term (>6
mo) changes in metabolic outcomes, and none have evaluated the effect of removing femoral AT
despite this being a common site for lipectomy in women and despite the apparent
cardioprotective benefit of lower body adiposity. Further, none of these studies included
postmenopausal women who are at an increased risk of abdominal AT accumulation. It is the
investigator's overall working hypothesis that removal of femoral AT by lipectomy may worsen
metabolic disease risk (as measured by postprandial lipemia) in estrogen-deficient
postmenopausal women who, in contrast to premenopausal women, will accumulate AT in the
abdominal rather than the femoral region. The global aims of this study are to determine
whether: 1) there are menopause-related differences in regional (abdominal vs. femoral) AT
re-accumulation following lipectomy; and 2) changes (removal and regain) in femoral AT mass
alter postprandial triglyceride clearance and storage of meal-derived fatty acids. Further,
the investigators postulate that menopause-related differences in postprandial lipemia and
handling of dietary fatty acids will determine the degree to which femoral lipectomy worsens
these parameters. Pre- and postmenopausal women (n=80) will be randomly assigned to either
femoral lipectomy or control (no surgery). All eligible volunteers will undergo testing at
the beginning of the study and at 2, 8, and 14 months following lipectomy. Measurements will
include body composition assessments, meal tests and AT biopsies to assess lipectomy-related
changes in: 1) abdominal and femoral fat mass; 2) systemic postprandial triglyceride
excursions; and 3) storage of dietary fatty acids in AT. These studies are designed to
evaluate the effect of femoral lipectomy on regional AT re-accumulation and metabolic
disease risk in pre- and postmenopausal women.
considered permanent, by The American Society for Aesthetic Plastic Surgery, but no long
term follow-up studies have been done to verify this assertion. Indeed, animal studies
suggest rapid adipose tissue (AT) re-accumulation after lipectomy is common and may even be
accompanied by unfavorable changes in disease risk. Recent studies in humans have focused on
abdominal lipectomy as a means of reducing metabolic disease risk in obese premenopausal
women. However, none of these studies evaluated AT re-accumulation or reported long-term (>6
mo) changes in metabolic outcomes, and none have evaluated the effect of removing femoral AT
despite this being a common site for lipectomy in women and despite the apparent
cardioprotective benefit of lower body adiposity. Further, none of these studies included
postmenopausal women who are at an increased risk of abdominal AT accumulation. It is the
investigator's overall working hypothesis that removal of femoral AT by lipectomy may worsen
metabolic disease risk (as measured by postprandial lipemia) in estrogen-deficient
postmenopausal women who, in contrast to premenopausal women, will accumulate AT in the
abdominal rather than the femoral region. The global aims of this study are to determine
whether: 1) there are menopause-related differences in regional (abdominal vs. femoral) AT
re-accumulation following lipectomy; and 2) changes (removal and regain) in femoral AT mass
alter postprandial triglyceride clearance and storage of meal-derived fatty acids. Further,
the investigators postulate that menopause-related differences in postprandial lipemia and
handling of dietary fatty acids will determine the degree to which femoral lipectomy worsens
these parameters. Pre- and postmenopausal women (n=80) will be randomly assigned to either
femoral lipectomy or control (no surgery). All eligible volunteers will undergo testing at
the beginning of the study and at 2, 8, and 14 months following lipectomy. Measurements will
include body composition assessments, meal tests and AT biopsies to assess lipectomy-related
changes in: 1) abdominal and femoral fat mass; 2) systemic postprandial triglyceride
excursions; and 3) storage of dietary fatty acids in AT. These studies are designed to
evaluate the effect of femoral lipectomy on regional AT re-accumulation and metabolic
disease risk in pre- and postmenopausal women.
Inclusion Criteria:
- post-menopausal (no menses for 12mo or oophorectomy w/ follicle-stimulating hormone
(FSH)>30 IU/L) OR- pre-menopausal (regular menses 28+/-3d)
- BMI >20 and <30 kg/m2)
- weight stable (+/- 2kg in past 2mo)
- non-smoking
- no use of hormone therapies or oral contraceptives
- actively seeking liposuction of the hips and thighs
- good femoral lipectomy candidates as determined by cosmetic surgeon
Exclusion Criteria:
- severe hypertriglyceridemia (>400 mg/dL)
- medications known to affect lipid metabolism
- elevated resting blood pressure (Systolic >140 mm Hg,Diastolic >90 mm Hg)
- history of lipectomy or gastric bypass surgery
- body dysmorphic disorder
- pregnant, lactating or intention of becoming pregnant
- indication of high surgical risk (e.g., abnormal resting ECG, history of
thromboembolism, valvular heart disease)
We found this trial at
1
site
13001 E 17th Pl
Aurora, Colorado 80045
Aurora, Colorado 80045
(303) 724-5000
University of Colorado Anschutz Medical Campus Located in the Denver metro area near the Rocky...
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