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Subcutaneous fat cell volume influenced insulin sensitivity more than fat mass
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Decreases in the volume of subcutaneous fat cells following bariatric surgery in women with obesity improved insulin sensitivity more than reductions in fat mass, according to research published in Diabetes Care.
Changes in the relationship between adipocyte size and fat mass could therefore improve insulin sensitivity after weight loss, and reducing the size of fat cells might constitute a target, according to the researchers from Sweden.
“We show that marked weight reduction is associated with a decrease in fat cell volume, but not number, in subcutaneous adipose tissue, which is significantly associated with improvements in insulin sensitivity,” the researchers wrote.
Daniel P. Andersson, MD, of the Karolinska Institutet in Stockholm, Sweden, and colleagues studied 62 women with obesity before and after Roux-en-Y gastic bypass (RYGB).
The investigators measured volume and number of fat cells in abdominal subcutaneous adipose tissue prior to surgery and 2 years following. They assessed regional body fat mass by dual-energy X-ray absorptiometry and insulin sensitivity by hyperinsulinemic-euglycemic clamp, along with plasma glucose, insulin and lipid profile.
Patients experienced a 33% reduction in body weight following surgery; the loss was accompanied by decreased adipocyte volume but not number. In the measured regions, fat mass decreased and all metabolic parameters had improved following RYGB (P<.0001).
Decreased subcutaneous fat cell size was strongly associated with improved insulin sensitivity (P=.0057); for regional changes in fat mass, a weak association was observed among changes in visceral fat mass, insulin sensitivity and triglycerides.
Following weight loss, the curve-linear relationship between fat cell size and fat mass was altered (P=.03).
“Measuring fat cell size might have important implications,” the researchers wrote. “Degree of obesity is usually just defined by the amount, and sometimes distribution, of body fat. Other parameters are needed to better classify subtypes of obesity that have different impacts on the risk of developing type 2 diabetes and other obesity complications.”
Disclosures: This study was supported by grants from the Swedish Research Council, Diabetes
Program at Karolinska Institutet, Swedish Diabetes Association, Erling-Persson Family Foundation, Novo Nordisk Foundation and the European Association for the Study of Diabetes/Lilly.
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