Fat redistribution following suction lipectomy: defense of body fat and patterns of restoration. Modification of subcutaneous adipose tissue by a methylxanthine formulation: a double-blind controlled study. Effect of Distinct Lifestyle Interventions on Mobilization of Fat Storage Pools: CENTRAL Magnetic Resonance Imaging Randomized Controlled Trial The effects of the surgical removal of subcutaneous adipose tissue on energy expenditure and adipocytokine concentrations in obese women. Long-term beneficial effect of a 16-week very low calorie diet on pericardial fat in obese type 2 diabetes mellitus patients. Effects of sex on the change in visceral, subcutaneous adipose tissue and skeletal muscle in response to weight loss Expression of tumor necrosis factor (TNF)-alpha protein in the subcutaneous and visceral adipose tissue in correlation with adipocyte cell volume, serum TNF-alpha, soluble serum TNF-receptor-2 concentrations and C-peptide level. Differential effects of rosiglitazone and metformin on adipose tissue distribution and glucose uptake in type 2 diabetic subjects. Effects of acupuncture therapy on abdominal fat and hepatic fat content in obese children: a magnetic resonance imaging and proton magnetic resonance spectroscopy study. Effect of nutritional counselling on hepatic, muscle and adipose tissue fat content and distribution in non-alcoholic fatty liver disease. Changes of renal sinus fat and renal parenchymal fat during an 18-month randomized weight loss trial. Women gain weight and fat mass despite lipectomy at abdominoplasty and breast reduction. Vitamin D3 increases in abdominal subcutaneous fat tissue after supplementation with vitamin D3. Effect of Surgically Removing Subcutaneous Fat by Abdominoplasty on Leptin Concentrations and Insulin Sensitivity Effect of marked weight loss on adiponectin gene expression and plasma concentrations. Subcutaneous adipose tissue remodeling during the initial phase of weight gain induced by overfeeding in humans. Fast adipose tissue (FAT) assessment by MRI. Addition of Exercise Increases Plasma Adiponectin and Release from Adipose Tissue. Body fat distribution, incident cardiovascular disease, cancer, and all-cause mortality. Weight-loss diet alone or combined with resistance training induces different regional visceral fat changes in obese women Impact of weight loss with or without exercise on abdominal fat and insulin resistance in obese individuals: a randomised clinical trial. Insulin–Leptin–Visceral Fat Relation During Weight Loss One year of caloric restriction in humans: feasibility and effects on body composition and abdominal adipose tissue.
No r and omized studies in humans have examined whether fat returns after removal or where it returns . We undertook a prospect i ve , r and omized-controlled trial of  suction lipectomy in nonobese women to determine if adipose tissue ( AT ) is defended and if so , the anatomic pattern of redistribution . Healthy women with disproportionate AT depots ( lower abdomen , hips , or thighs ) were enrolled . Baseline body composition measurements included dual-energy X-ray absorptiometry ( DXA ) ( a priori primary outcome ) , abdominal/limb circumferences , subcutaneous skinfold thickness , and magnetic resonance imaging ( MRI ) ( torso/thighs ) . Participants ( n = 32 ; 36 ± 1 year ) were r and omized to small-volume liposuction ( n = 14 , mean BMI : 24 ± 2 kg/m(2 ) ) or control ( n=18 , mean BMI : 25 ± 2 ) following baseline . Surgery group participants underwent liposuction within 2 - 4 weeks . Identical measurements were repeated at 6 weeks , 6 months , and 1 year later . Participants agreed not to make lifestyle changes while enrolled . Between-group differences were adjusted for baseline level of the outcome variable . After 6 weeks , percent body fat ( % BF ) by DXA was decreased by 2.1 % in the lipectomy group and by 0.28 % in the control group ( adjusted difference ( AD ) : -1.82 % ; 95 % confidence interval ( CI ) : -2.79 % to -0.85 % ; P = 0.0002 ) . This difference was smaller at 6 months , and by 1 year was no longer significant ( 0.59 % ( control ) vs. -0.41 % ( lipectomy ) ; AD : -1.00 % ; CI : -2.65 to 0.64 ; P = 0.23 ) . AT reaccumulated differently across various sites . After 1 year the thigh region remained reduced ( 0.77 % ( control ) vs. -1.83 % ( lipectomy ) ; AD : -2.59 % ; CI : -3.91 to -1.28 ; P = 0.0001 ) , but AT reaccumulated in the abdominal region ( 0.64 % ( control ) vs. 0.42 % ( lipectomy ) ; AD : -0.22 ; CI : -2.35 to 1.91 ; P = 0.84 ) . Following suction lipectomy , BF was restored and redistributed from the thigh to the abdomen BACKGROUND Excessive subcutaneous adipose tissue is typically treated by physically removing the fat through liposuction , but cost and accessibility have popularized alternative treatments for reducing adipose tissue thickness . OBJECTIVE The purpose of this study was to test the absolute and relative effectiveness of a liposome-encapsulated caffeine-based cream in modifying subcutaneous adipose tissue . METHODS Forty-one patients consented and completed the double-blind , single-center , placebo-controlled study . Caliper measurements , tape measurements , and photographs were taken over a 2-month period . RESULTS Both concentrations of the cream were found to significantly reduce the thickness of the adipose tissue in all areas of the body . In addition , the more concentrated cream was significantly more effective than the less concentrated cream in the areas of the hips and the triceps . CONCLUSION The caffeine-based liposome-encapsulated cream significantly reduced the thickness of the subcutaneous fat over a 2-month period Background : We aim ed to assess whether distinct lifestyle strategies can differentially affect specific body adipose depots . Methods : We performed an 18-month r and omized controlled trial among 278 sedentary adults with abdominal obesity ( 75 % ) or dyslipidemia in an isolated workplace with a monitored provided lunch . Participants were r and omized  to isocaloric low-fat or Mediterranean/low-carbohydrate ( MED/LC ) diet+28 g walnuts/day with/without added moderate physical activity ( PA ; 80 % aerobic ; supervised/free gym membership ) . Overall primary outcome was body fat redistribution , and the main specific end point was visceral adipose tissue ( VAT ) . We further followed the dynamics of different fat depots ( deep and superficial subcutaneous , liver , pericardial , muscle , pancreas , and renal sinus ) by magnetic resonance imaging . Results : Of 278 participants ( age , 48 years , 89 % men , body mass index , 30.8 kg/m2 ) , 86 % completed the trial with good adherence . The low-fat group preferentially decreased reported fat intake ( −21.0 % versus −11.5 % for the MED/LC ; P<0.001 ) , and the MED/LC group decreased reported carbohydrates intake ( −39.5 % versus −21.3 % for the low-fat group ; P<0.001 ) . The PA+ groups significantly increased the metabolic equivalents per week versus the PA− groups ( 19.0 versus 2.1 ; P=0.009 ) . Whereas final moderate weight loss was indifferent , exercise attenuated the waist circumference rebound with the greatest effect in the MED/LCPA+ group ( P<0.05 ) . VAT ( −22 % ) , intrahepatic ( −29 % ) , and intrapericardial ( −11 % ) fats declines were higher than pancreatic and femur intermuscular fats ( 1 % to 2 % ) loss . Independent of weight loss , PA+ with either diet had a significantly greater effect on decreasing VAT ( mean of difference , −6.67cm2 ; 95 % confidence interval , −14.8 to −0.45 ) compared with PA−. The MED/LC diet was superior to the low-fat diet in decreasing intrahepatic , intrapericardial , and pancreatic fats ( P<0.05 for all ) . In contrast , renal sinus and femoral intermuscular fats were not differentially altered by lifestyle interventions but by weight loss per se . In multivariate models further adjusted for weight loss , losing VAT or intrahepatic fat was independently associated with improved lipid profile , losing deep subcutaneous adipose tissue with improved insulin sensitivity , and losing superficial subcutaneous adipose tissue remained neutral except for an association with decreased leptin . Conclusions : Moderate weight loss alone inadequately reflects the significant lifestyle effects on atherogenic and diabetogenic fat depots . The MED/LC diet mobilizes specific ectopic fat depots , and exercise has an independent contribution to VAT loss . Fat depots exhibit diverse responsiveness and are differentially related to cardiometabolic markers . Distinct lifestyle protocol s may uniquely induce fat mobilization from specific anatomic sites . Clinical Trial Registration : URL : https://www . clinical trials.gov . Unique identifier : NCT01530724 OBJECTIVE To analyze the effects of the surgical removal of subcutaneous adipose tissue by ultrasound-assisted megalipoplasty ( UAM ) on energy expenditure and adipocytokine concentrations in obese women . METHODS Fifteen premenopausal obese women with BMI 37.5+/-6.3 kg/m(2 ) ( range : 30.7 - 53.6 kg/m(2 ) ) underwent UAM .  Body composition ( by DEXA ) , resting metabolic rate ( REE ) by indirect calorimetry , insulin resistance ( by the HOMA method ) , leptin , C-reactive protein , interleukin-6 , resistin and adiponectin were measured before and 1 , 3 , 28 and 180 days after the procedure . RESULTS UAM significantly reduced fat mass at day 3 , without further changes in the following days . REE increased at day 3 after UAM , returned to baseline levels at day 28 and significantly declined at day 180 . Leptin levels transiently increased after UAM and then declined according to fat mass reduction . C-reactive protein , interleukin-6 and resistin levels acutely increased after UAM and then returned to the baseline levels . Adiponectin levels acutely declined after the procedure and then stabilized to a plasma level slightly lower than at baseline . Insulin resistance deteriorated in the acute post-operative phase and then improved . CONCLUSION The surgical removal of subcutaneous fat was associated to an acute inflammatory reaction with high REE and insulin-resistance . Later on , the metabolic effects of fat mass removal appeared , with a reduction of leptin levels and REE and an improvement of insulin resistance Pericardial fat accumulation has been associated with an increased cardiovascular risk . A very low calorie diet ( VLCD ) improves the cardiovascular risk profile in patients with type 2 diabetes mellitus ( T2DM ) , by improving the metabolic profile , heart function , and triglyceride ( TG ) stores in (non)adipose tissues . However , long-term effects of a VLCD on pericardial fat volume and tissue-specific TG accumulation have not been documented . The aim of this study was therefore to assess the effects of a 16-week VLCD and of subsequent 14 months follow-up on a regular diet on pericardial fat in relation to other TG stores in obese T2DM patients . We included 14 obese patients with insulin-treated T2DM ( mean ± s.e.m . : age 53 ± 2 years ; BMI 35 ± 1 kg/m(2 ) ) . Pericardial fat and other (non)adipose TG stores were measured using magnetic resonance ( MR ) imaging and proton spectroscopy before and after a 16-week VLCD and after a 14-month follow-up without dietary interventions . A 16-week VLCD  reduced body weight , pericardial fat , hepatic TG content , visceral and subcutaneous abdominal fat volumes to 78 , 83 , 16 , 40 , and 53 % of baseline values respectively , ( all P < 0.05 ) . After an additional 14 months of follow-up on a regular diet , the reduction in pericardial fat volume sustained , despite a substantial regain in body weight , visceral abdominal fat , and hepatic TG content ( respectively 90 , 83 and 73 % of baseline values ) . In conclusion , VLCD-induced  weight loss in obese T2DM patients is accompanied by a substantial decrease in pericardial fat volume , which is sustained even after subsequent weight regain OBJECTIVE : To examine the influence of sex on whole body and regional subcutaneous , visceral , total adipose tissue ( AT ) , skeletal muscle ( SM ) , and lean tissue in response to weight loss induced by diet alone ( DO ) or the combination of diet and aerobic ( DA ) or resistance exercise ( DR ) . DESIGN : Sixty upper‐body obese men and women were r and omly assigned to one of three treatments : DO , DA , or DR . All tissues were measured using a whole body , magnetic resonance imaging protocol . RESULTS : Within each group reductions were observed for body weight ( ~11 kg ) , subcutaneous and visceral AT ( P<0.01 ) . After controlling for pretreatment differences in tissue size , reductions in total adiposity , total and regional subcutaneous and visceral adipose tissue were not different between sexes ( P>0.1 ) . Independent of sex , the reduction in visceral AT was greater than subcutaneous AT ( P<0.05 ) in response to DO and DA . With the exception of DA women , the reduction in abdominal subcutaneous AT was greater ( P<0.05 ) than lower‐body subcutaneous AT in response to diet and exercise , but not diet alone , in both sexes ( P>0.05 ) . Independent of sex , skeletal muscle mass was preserved within the exercise groups ( P>0.05 ) but not diet alone ( P<0.05 ) . Peak VO2 ( l/min ) improved in the DA groups as did muscular strength in the DR groups ( P<0.01 ) . CONCLUSIONS : These findings indicate that in response to diet or diet and exercise‐induced weight loss , reductions in total adiposity , subcutaneous and visceral adipose tissue distribution are not different in obese men and women . Independent of sex , the combination of diet and exercise results in a preservation of skeletal muscle mass , a preferential reduction of abdominal subcutaneous AT , and improved functional capacity by comparison to diet alone OBJECTIVE The aim of the study was to evaluate the expression of tumor necrosis factor (TNF)-alpha protein in the subcutaneous and visceral adipose tIssue in correlation with adipocyte cell Volume , serum TNF-alpha , soluble TNF-receptor-2 ( sTNFR-2 ) and indirect parameters of insulin resistance in overweight/obese and lean healthy persons . DESIGN A cross-sectional case-control study was used . PATIENTS Twenty-eight overweight/obese prob and s with normal glucose tolerance ( BMI > 27 kg/m(2 ) ) and 15 lean people ( BMI < 25 kg/m(2 ) ) , all of them undergoing planned surgical operation , participated in the study . METHODS Two to four grams of subcutaneous and visceral adipose tIssue were removed and studied using semi-quantitative immunohistochemical staining of the TNF-alpha protein . Serum TNF-alpha , sTNFR-2 ( ELISA ) and fasting C-peptide ( RIA )  were measured . RESULTS TNF-alpha protein was expressed in adipocytes of both depots . The expression was evaluated visually and found to be greater in the obese patients . Significantly higher serum TNF-alpha ( 5.58+/-0.87 pg/ml vs 4.21+/-0.55 , mean+/-s.d . , P<0.01 , Mann-Whitney ) and sTNFR-2 levels ( 7.84+/-3.56 ng/ml vs 4.59+/-1.35 , P=0.005 ) were found in the obese subgroup in correlation with the fasting C-peptide level ( r=0.49 , P=0.003 ; and r=0.74 , P=0.001 ) and the C-peptide/ blood glucose ratio ( r=0.47 , Spearman , P=0.005 ; and r=0.70 , P=0.001 ) . The cell Volume of both adipocyte depots was found to have a significant positive correlation with serum TNF-alpha and sTNFR-2 levels in the total group of patients ( subcutaneous : r=0.52 , P=0.0003 ; r=0.69 , P<0.0001 ; visceral : r=0.65 , P<0.0001 ; r=0.63 , P<0.0001 ) and in both subgroups . CONCLUSIONS Adipocyte cell Volume of both the subcutaneous and visceral fat depots may be determinants of TNF-alpha , sTNFR-2 production and obesity-linked insulin resistance We evaluated the effects of rosiglitazone ( 4 mg b.i.d . ) and metformin ( 1 g b.i.d . ) monotherapy for 26 weeks on adipose tissue insulin-stimulated glucose uptake in patients ( n = 41 ) with type 2 diabetes . Before and after the treatment , glucose uptake was measured using 2-[(18)F]fluoro-2-deoxyglucose and positron emission tomography and adipose tissue masses were quantified using magnetic resonance imaging . Rosiglitazone improved insulin-stimulated whole-body glucose uptake by 44 % ( P < 0.01 vs. placebo ) . Mean body weight was unchanged in the rosiglitazone group , while it decreased by 2.0 kg in the metformin group ( P < 0.05 vs. placebo ) . In visceral adipose tissue , glucose uptake increased by 29 % ( from 17.8 + /- 2.0 to 23.0 + /- 2.6 micro mol x kg(-1 ) x min(-1 ) , P < 0.05 vs. placebo ) in the rosiglitazone group but to a lesser extent ( 17 % ) in the metformin group ( from 16.2 + /- 1.5 to 18.9 + /- 1.7 micro mol x kg(-1 ) x min(-1 ) , P < 0.05 vs. baseline ) . Because the visceral adipose tissue mass simultaneously decreased with both treatments ( P < 0.05 ) , no change was observed in total visceral glucose uptake per depot . Rosiglitazone significantly enhanced glucose uptake in the femoral subcutaneous area , either when expressed per tissue mass ( from 10.8 + /- 1.2 to 17.1 + /- 1.7 micro mol x kg(-1 ) x min(-1 ) , P < 0.01 vs. placebo ) or per whole-fat depot ( P < 0.05 vs. placebo ) . In conclusion , metformin treatment result ed in improvement of glycemic control without enhancement of peripheral insulin sensitivity . The improved insulin sensitivity of the nonabdominal subcutaneous adipose tissue during treatment with rosiglitazone partly explains the enhanced whole-body insulin sensitivity and underlies the central role of adipose tissue for action of peroxisome proliferator-activated receptor gamma agonist in vivo OBJECTIVES The aim of this study was to use magnetic resonance imaging ( MRI ) together with proton magnetic resonance spectroscopy ( (1)H-MRS ) to study the influence of acupuncture therapy on abdominal fat and hepatic fat content in obese children . DESIGN The design was a longitudinal , clinical intervention study of acupuncture therapy . SUBJECTS SUBJECTS were 10 healthy , obese children ( age : 11.4 ± 1.65 years , body-mass index [ BMI ] : 29.03 ± 4.81 kg/m(2 ) ) . MEASUREMENTS Measurements included various anthropometric parameters , abdominal fat ( assessed by MRI ) and hepatic fat content ( assessed by (1)H-MRS ) at baseline and after 1 month of acupuncture therapy . RESULTS One ( 1 ) month of acupuncture therapy significantly reduced the subjects ' BMI by 3.5 % ( p = 0.005 ) , abdominal visceral adipose tissue ( VAT ) volume by 16.04 % ( p < 0.0001 ) , abdominal total adipose tissue volume by 10.45 % ( p = 0.001 ) , and abdominal visceral to subcutaneous fat ratio by 10.59 % ( p = 0.007 ) . Decreases in body weight ( -2.13 % ) , waist circumference ( -1.44 % ) , hip circumference ( -0.33 % ) , waist-to-hip ratio ( WHR ) ( -0.99 % ) , abdominal subcutaneous adipose tissue ( SAT ) volume ( -5.63 % ) , and intrahepatic triglyceride ( IHTG ) content ( -9.03 % ) were also observed , although these were not significant ( p > 0.05 ) . There was a significant correlation between the level of abdominal fat ( SAT , VAT ) and anthropometric parameters ( weight , BMI , waist circumferences , hip circumferences ) . There was no statistically significant correlation between IHTG and anthropometric parameters or abdominal fat content . CONCLUSIONS The first direct experimental evidence is provided demonstrating that acupuncture therapy significantly reduces BMI and abdominal adipose tissue by reducing abdominal VAT content without significant changes in body weight , waist circumference , hip circumference , WHR , abdominal SAT , or IHTG content . Thus , the use of acupuncture therapy to selectively target a reduction in abdominal VAT content should become more important and more popular in the future AIM To assess the effectiveness of the current UK clinical practice in reducing hepatic fat ( IHCL ) . METHODS Whole body MRI and (1)H MRS were obtained , before and after 6 mo nutritional counselling , from liver , soleus and tibialis muscles in 10 subjects with non-alcoholic fatty liver disease ( NAFLD ) . RESULTS A 500 Kcal-restricted diet result ed in an average weight loss of 4 % ( -3.4 kg , ) accompanied by significant reductions in most adipose tissue ( AT ) depots , including subcutaneous ( -9.9 % ) , abdominal subcutaneous ( -10.2 % ) and intra-abdominal-AT ( -11.4 % ) . Intramyocellular lipids ( IMCL ) were significantly reduced in the tibialis muscle ( -28.2 % ) . Decreases in both IHCL ( -39.9 % ) and soleus IMCL ( -12.2 % ) content were also observed , although these were not significant . Several individuals showed dramatic decreases in IHCL , while others paradoxically showed increases in IHCL content . Changes in body composition were accompanied by improvements in certain liver function tests : serum aspartate aminotransferase ( AST ) and alanine aminotransferase ( ALT ) . Significant correlations were found between decreases in IHCL and reductions in both intra-abdominal and abdominal subcutaneous AT . Improvements in liver function tests were associated with reductions in intra-abdominal AT , but not with changes in IHCL . CONCLUSION This study shows that even a very modest reduction in body weight achieved through lifestyle modification can result in changes in body fat depots and improvements in LFTs BACKGROUND & AIMS Data regarding the role of kidney adiposity , its clinical implication s , and its dynamics during weight-loss are sparse . We investigated the effect of long-term weight-loss induced intervention diets on dynamics of renal-sinus-fat , an ectopic fat depot , and % renal-parenchymal-fat , lipid accumulation within the renal parenchyma . METHODS We r and omized 278 participants with abdominal obesity/dyslipidemia to low-fat or Mediterranean/low-carbohydrate diets , with or without exercise .  We quantified renal-sinus-fat and % renal-parenchymal-fat by whole body magnetic-resonance-imaging .  RESULTS Participants ( age = 48 years ; 89 % men ; body-mass-index = 31 kg/m2 ) had 86 % retention to the trial after 18 months . Both increased renal-sinus-fat and % renal-parenchymal-fat were directly associated with hypertension , and with higher abdominal deep-subcutaneous-adipose-tissue and visceral-adipose-tissue ( p of trend < 0.05 for all ) after adjustment for body weight . Higher renal-sinus-fat was associated with lower estimated-glomerular-filtration-rate and with higher microalbuminuria and % HbA1C beyond body weight . After 18 months of intervention , overall renal-sinus-fat ( -9 % ; p < 0.05 vs. baseline ) but not % renal-parenchymal-fat ( -1.7 % ; p = 0.13 vs. baseline ) significantly decreased , and similarly across the intervention groups . Renal-sinus-fat and % renal-parenchymal-fat changes were correlated with weight-loss per-se ( p < 0.05 ) . In a model adjusted for age , sex , and visceral-adipose-tissue changes , 18 months reduction in renal-sinus-fat associated with decreased pancreatic , hepatic and cardiac fats ( p < 0.05 for all ) and with decreased cholesterol/high-density lipoprotein-cholesterol ( HDL-c ) ( β = 0.13 ; p = 0.05 ) , triglycerides/HDL-c ( β = 0.13 ; p = 0.05 ) , insulin ( β = 0.12 ; p = 0.05 ) and gamma glutamyl transpeptidase ( β = 0.24 ; p = 0.001 ) , but not with improved renal function parameters or blood pressure . Decreased intake of sodium was associated with a reduction in % renal-parenchymal-fat , after adjustment for 18 months weight-loss ( β = 0.15 ; p = 0.026 ) and hypertension ( β = 0.14 ; p = 0.04 ) . CONCLUSIONS Renal-sinus-fat and renal-parenchymal-fat are fairly related to weight-loss . Decreased renal-sinus-fat is associated with improved hepatic parameters , independent of changes in weight or hepatic fat , rather than with improved renal function or blood pressure parameters . CLINICAL TRIALS . GOVIDENTIFIER NCT01530724 OBJECTIVES In animal models , fat removal results in compensatory weight gain . No study has reported measurement of weight following lipectomy in humans . We have examined changes in weight in patients who underwent lipectomy .  METHODS In a retrospective analysis , 16 patients who had abdominoplasty and 17 patients who underwent bilateral breast reduction were compared with 16 patients who had carpal tunnel syndrome release . Following this , a prospect i ve study was carried out on 7 subjects awaiting abdominoplasty and 12 subjects awaiting bilateral breast reduction surgery .  RESULTS In the retrospective study , all three patient groups gained weight following surgery . The abdominoplasty group was heavier before surgery and showed greatest weight gain but there was no statistically significant difference in weight gain between the groups . In the prospect i ve study , the abdominoplasty group had a mean fat removal of 1.77 kg and breast reduction group had a mean of 3.22 kg . Eighteen months following surgery the abdominoplasty group showed a significant mean increase in body weight ( mean increase : 4.82 kg ) and body mass index ( BMI ) ( mean increase : 1.66 kg/m(2 ) ) . In the bilateral breast reduction group , there was a non-significant mean gain in weight ( mean increase : 0.67 kg ) and BMI ( mean increase : 0.21 kg/m(2 ) ) . CONCLUSIONS Patients undergoing lipectomy during abdominoplasty and bilateral breast reduction will gain weight in the long term . This weight gain probably reflects the expected gain in weight without surgery as a similar finding is observed in patients who have undergone surgery without lipectomy  . These results highlight the limitation of lipectomy as a weight control measure OBJECTIVE The objective was to assess the amount of vitamin D3 stored in adipose tissue after long-term supplementation with high dose vitamin D3 . DESIGN A cross-sectional study on 29 subjects with impaired glucose tolerance who had participated in a r and omized controlled trial with vitamin D3 20 000 IU ( 500 μg ) per week vs placebo for 3 - 5 years . METHODS Abdominal subcutaneous fat tissue was obtained by needle biopsy for the measurements of vitamin D3 and 25-hydroxyvitamin D3 ( 25(OH)D3 ) . Body fat was measured with dual-energy X-ray absorptiometry , and serum 25(OH)D3 level was quantified . RESULTS In the subjects given vitamin D3 , the median concentrations of serum 25(OH)D3 , fat vitamin D3 , and fat 25(OH)D3 were 99 nmol/l , 209 ng/g , and 3.8 ng/g , respectively ; and correspondingly in the placebo group 62 nmol/l , 32 ng/g , and 2.5 ng/g . If assuming an equal amount of vitamin D3 stored in all adipose tissue in the body , the median body store was 6.6 mg vitamin D3 and 0.12 mg 25(OH)D3 in those given vitamin D3 . CONCLUSIONS Subcutaneous adipose tissue may store large amounts of vitamin D3 . The clinical importance of this storage needs to be determined The aim of this study was to identify the effect of surgically removing subcutaneous fat by abdominoplasty on leptin concentrations and insulin sensitivity . An open clinical trial with a noninterventional parallel group was carried out in 12 obese women . After r and omization , 6 volunteers were selected for abdominoplasty  , and the other 6 women were considered as the noninterventional group . A metabolic profile , including leptin concentrations , and insulin tolerance test to assess insulin sensitivity were performed on all volunteers before intervention or nonintervention and 40–50 days afterward . A significant reduction in body mass index ( 30.7 ± 0.9 versus 29.6 ± 0.7 kg/m2 ; P = 0.02 ) and in leptin concentrations ( 41.3 ± 10.6 versus 32.0 ± 10.2 ng/mL ; P = 0.02 ) was observed after abdominoplasty . Insulin sensitivity did not change after intervention . In conclusion , surgically removing subcutaneous fat by abdominoplasty  decreased leptin concentrations , with no change in insulin sensitivity OBJECTIVE Adiponectin is the most abundant protein secreted by adipose tissue and is inversely associated with adiposity and insulin resistance . The aim of this study was to evaluate the hypothesis that marked weight loss , induced by gastric bypass surgery ( GBS ) , would increase adiponectin gene expression in both upper and lower subcutaneous body fat and increase plasma adiponectin concentration . RESEARCH METHODS AND PROCEDURES Adiponectin subcutaneous abdominal and femoral adipose tissue gene expression , determined by using quantitative reverse transcriptase-polymerase chain reaction , and adiponectin plasma concentrations , determined by using enzyme-linked immunosorbent assay , were evaluated in six extremely obese women ( BMI = 57.1 + /- 4.1 kg/m2 ) before and 1 year after GBS . RESULTS After GBS , subjects lost 36 + /- 5 % of their initial body weight and showed increased insulin sensitivity , manifested by a marked decrease in homeostasis model assessment of insulin resistance from 10.7 + /- 4.1 to 1.4 + /- 0.3 ( p < 0.05 ) . Adiponectin gene expression increased 8- to 15-fold in subcutaneous abdominal and femoral adipose tissues ( p < 0.05 ) . Plasma adiponectin concentrations increased from 5.2 + /- 0.9 to 8.4 + /- 1.2 mug/mL ( p < 0.05 ) . DISCUSSION These data show that marked weight loss induced by GBS increases adiponectin gene expression in both upper- and lower-body subcutaneous fat . The increase in adipose tissue adiponectin production result ed in an increase in plasma adiponectin concentrations , which likely contributed to the decrease in insulin resistance observed after weight loss CONTEXT Deciphering the early processes occurring in adipose tissue during weight gain is a major issue for underst and ing the development of fat mass and obesity . Experimental overfeeding in humans is a unique situation to tackle these events . OBJECTIVE Our aim was to identify the pathways involved in sc adipose tissue remodeling during the initial phase of weight gain . RESEARCH DESIGN AND METHODS Forty-four healthy men were involved in an overfeeding protocol with a lipid-enriched diet ( + 760 kcal/d ) for 2 months .  Subcutaneous abdominal adipose tissue biopsies were taken for histology , transcriptomics , and Western blotting in the basal state , after 14 d , and at the end of the protocol . RESULTS Overfeeding significantly increased body weight ( + 2.5 kg ) and fat mass . Reorganization of gene expression patterns occurred in adipose tissue with an up-regulation of numerous genes involved in lipid metabolism and storage , followed by clusters of genes related to angiogenesis and extracellular matrix remodeling . Histological examination showed increased microvascular density and connective tissue deposition after 56 d of overfeeding , with no changes in the number of macrophages or inflammatory cells . Inhibition of the canonical Wnt/β-catenin signaling pathway and induction of the renin-angiotensin system might be implicated in the remodeling of sc adipose tissue . CONCLUSIONS We characterize the coordinated and time-dependent processes that occur in human adipose tissue during the early phase of weight gain in healthy subjects and identify pathways representing potential targets in pathologies of adipose development , including obesity We report a method of fast adipose tissue ( FAT ) assessment to characterize the quantity , and distribution of abdominal adipose tissue . Whole-volume coverage of the abdomen was obtained using 31 contiguous transverse T(1)-weighted images from 16 obese females . A radiologist manually traced all adipose tissue volumes in the images , while a physiologist used an automated method to measure adipose tissue in a single image at the level of the umbilicus . Automated analysis of the umbilicus-level image was significantly correlated with values obtained by manual analysis of the entire abdomen ( p < 0 . 001 ) . There was good agreement between the automated umbilicus-level image method and the manual whole abdomen method for subcutaneous adipose tissue ( r(2 ) = 0.958 ) , visceral adipose tissue ( r(2 ) = 0 . 753 ) , and total adipose tissue ( r(2 ) = 0.941 ) . The automated method required 6 min vs 2 h for the manual method INTRODUCTION Adiponectin is an adipose tissue-derived anti-inflammatory protein that is down-regulated in obesity . The effects of caloric restriction and exercise-induced weight loss on adiponectin are not clear . PURPOSE To determine whether addition of aerobic exercise training to caloric restriction has additive effects over caloric restriction alone on circulating adiponectin concentrations and adiponectin release from abdominal and gluteal adipose tissue . METHODS Overweight or obese ( body mass index , 25 - 40 kg·m(-2 ) ; waist > 88 cm ) postmenopausal women were r and omized to 20-wk caloric restriction with and without aerobic exercise ( CR + EX , n = 48 ; and CR , n = 22 ) . Blood sample s were collected for measuring plasma adiponectin concentration , and abdominal and gluteal subcutaneous adipose tissue biopsies were performed in a subgroup to determine in vitro adiponectin release , before and after the interventions . RESULTS The interventions elicited similar amounts of weight loss ( CR + EX , -11.3 ± 4.6 kg ; CR,-11.2 ± 3.4 kg ) and fat loss ( CR + EX , -8.0 ± 3.5 kg ; CR , -7.4 ± 2.7 kg ) . The two groups had differential changes in plasma adiponectin concentrations ( for interaction , P = 0.014 ) ; CR + EX increased ( 6.9 ± 3.9 to 8.5 ± 4.9 μg·mL(-1 ) ; P = 0.0001 ) , whereas CR did not alter ( 6.4 ± 4.4 to 6.5 ± 4.5 μg·mL(-1 ) ; P = 0.42 ) plasma adiponectin . Likewise , adiponectin release from abdominal and gluteal subcutaneous adipose tissue increased with CR + EX ( P = 0.0076 and P = 0.089 , respectively ) but did not change with CR ( P = 0.13 and P = 0.95 , respectively ) . CONCLUSION Despite similar reductions in body weight and fat mass , the addition of aerobic exercise to caloric restriction increased plasma adiponectin concentrations , which may be partly explained by increased adiponectin release from abdominal and gluteal subcutaneous adipose tissue OBJECTIVES The aim of this study was to determine whether ectopic fat depots are prospect ively associated with  cardiovascular disease , cancer , and all-cause mortality .  BACKGROUND The morbidity associated with excess body weight varies among individuals of similar body mass index . Ectopic fat depots may underlie this risk differential . However , prospect i ve studies of directly measured fat are limited . METHODS Participants from the Framingham Heart Study ( n = 3,086 ; 49 % women ; mean age of 50.2 years ) underwent assessment of fat depots ( visceral adipose tissue , pericardial adipose tissue , and periaortic adipose tissue ) using multidetector computed tomography and were followed up longitudinally for a median of 5.0 years . Cox proportional hazards regression models were used to examine the association of each fat depot ( per 1 SD increment ) with the risk of incident cardiovascular disease , cancer , and all-cause mortality after adjustment for st and ard risk factors , including body mass index . RESULTS Overall , there were 90 cardiovascular events , 141 cancer events , and 71 deaths . After multivariable adjustment , visceral adipose tissue was associated with cardiovascular disease ( hazard ratio : 1.44 ; 95 % confidence interval : 1.08 to 1.92 ; p = 0.01 ) and cancer ( hazard ratio : 1.43 ; 95 % confidence interval : 1.12 to 1.84 ; p = 0.005 ) . Addition of visceral adipose tissue to a multivariable model that included body mass index modestly improved cardiovascular risk prediction ( net reclassification improvement of 16.3 % ) . None of the fat depots were associated with all-cause mortality . CONCLUSIONS Visceral adiposity is associated with incident cardiovascular disease and cancer after adjustment for clinical risk factors and generalized adiposity . These findings support the growing appreciation of a pathogenic role of ectopic fat Background : Quantification of abdominal fat and its regional distribution has become increasingly important in assessing the cardiovascular risk . Objective : To examine the effects of 16 weeks of a hypocaloric diet with a caloric restriction of 500 Kcal per day ( WL ) or the same dietary intervention plus resistance training ( WL+RT ) on regional variation of abdominal visceral ( visceral adipose tissue ( VAT ) ) and subcutaneous ( subcutaneous adipose tissue ( SAT ) ) fat loss . Second , to identify the single-image that best represents total magnetic resonance imaging measurements of total VAT and SAT volume before and after WL or WL+RT intervention . Design : A total of 34 obese ( body mass index : 30–40 kg m−2 ) women , aged 40–60 years , were r and omized to three groups : a control group ( C ; n=9 ) , a diet group ( WL ; n=12 ) and a diet plus resistance training group ( WL+RT ; n=13 ) with the same caloric restriction as group WL and a 16-week supervised whole-body RT of two sessions per week . Results : WL+RT programs lead to significant changes in the location of highest mean VAT area from L3-L4 to L2-L3 discal level from pre- to post- intervention , whereas after WL the greatest relative VAT losses were located at L5-S1 . Similar decreases in the SAT areas at all discal levels were observed after WL and WL+RT . Conclusion : Different weight loss regimes may lead to different distribution of VAT . Sites located significantly above ( cranial to ) L4-L5 ( that is , ∼5–6 cm above L4-L5 or at L2-L3 discal level ) provided superior prediction of total abdominal VAT volume , whereas more caudal slices provide better prediction of subcutaneous fat , not only before but also after either WL or WL+RT Evidence supports an important contribution of abdominal obesity and inflammation to the development of insulin resistance ( IR ) and CVD . Weight loss in obese individuals can reduce inflammation and , consequently , IR , but the role of training remains unclear . The aim of this study was to evaluate the effects of  body weight reduction with and without exercise over abdominal fat tissue ( primary outcome ) and IR . In this r and omised clinical trial , forty-eight obese individuals ( age 31·8 ( SD 6·0 ) years , BMI 34·8 ( SD 2·7 ) kg/m2 ) were r and omised to either a diet-only group ( DI ) or a diet and exercise group ( DI þ EXE ) . Treatment was maintained until 5 % of the initial body weight was lost . At baseline and upon completion , the following parameters were analysed : biochemical parameters such as glycaemia and insulin for the determination of homeostasis model assessment of insulin resistance ( HOMA-IR ) , high-sensitivity C-reactive protein ( hs-CRP ) and abdominal computed tomography for the determination of visceral and subcutaneous adipose tissue . A total of thirteen individuals dropped out before completing the weight-loss intervention and did not repeat the tests . In both the DI ( n 18 ) and DI þ EXE ( n 17 ) groups , we observed significant and similar decreases of visceral adipose tissue ( difference between means : 7·9 ( 95 % CI 29·5 , 25·2 ) cm2 , P¼0·36 ) , hs-CRP ( difference between means : 20·06 ( 95 % CI 20·19 , 0·03 ) mg/l , P¼0·39 ) and HOMA ( difference between means : 20·04 ( 95 % CI 20·17 , 0·08 ) , P¼0·53 ) . In the present study , 5 % weight loss reduced abdominal fat and IR in obese individuals and exercise did not add to the effect of weight loss on the outcome variables Introduction The relation between insulin-leptin-visceral fat axis during weight loss has not been studied previously . Aims To evaluate the insulin , leptin , and abdominal adiposity relation during weight loss in patients with upper body obesity . Methodology Twenty volunteers ( 7 men , 13 women ) with mean age 50.6 ± 6.3 ( SD ) and upper body obesity ( weight 105.4 ± 12.3 kg , BMI 35.9 ± 2.5 kg/m 2 ) were recruited . Participants were enrolled in a one-arm clinical study using a calorie-deficient diet and an escalating dose regimen of sibutramine , starting with 5 mg daily and increasing in 5-mg increments to 20 mg per day . Body weight , insulin , leptin , glucose , lipids , abdominal computed tomography ( CT ) , and total body electrical conductance ( TOBEC ) were measured serially at weeks 0 , 4 , 8 , 12 , and 24 . Results Eighteen patients completed the 6-month study : one man and one woman discontinued because of adverse events . With diet and sibutramine  , body weight was significantly and continuously reduced throughout the 6-month study . There was a 16.0 % ( p = 0.0001 ) reduction in body weight ( p < 0.001 ) and 22.5 % ( p = 0.0001 ) decrease in total body fat mass . Abdominal CT scans showed a 28.3 % ( p = 0.0001 ) reduction in total abdominal fat , a 26.0 % ( p = 0.0001 ) reduction in subcutaneous fat ( p < 0.001 ) , and a 31.0 % ( p = 0.0003 ) reduction in visceral fat ( p < 0.001 ) . There was a 32.0 % ( p = 0.0008 ) reduction in leptin levels and 37.9 % ( p = 0.0001 ) reduction in insulin levels between baseline and week 4 , but no further significant reduction in leptin and insulin levels was observed for the duration of the study . There was a significant correlation between insulin and leptin concentrations throughout the study ( p = 0.0001 ) . Leptin was presented as a function of insulin measured at the same time . Significant associations between visceral abdominal fat , subcutaneous fat , and leptin were also observed . Conclusion In this study , we found that leptin and insulin were related in weight loss . The data suggest that insulin may act as a strong regulator of leptin secretion during weight loss and that circulating leptin levels can be predicted by insulin level . Using sibutramine in conjunction with hypocaloric diet reduced body weight and decreased fat mass significantly . Visceral and subcutaneous abdominal fat depots were shown to decrease . Whether sibutramine exerts any selective reduction of visceral abdominal fat as opposed to total body fat mass will require further clinical investigation BACKGROUND Caloric restriction ( CR ) increases maximal life span in short-lived organisms , and its effects are being explored in nonhuman primates . The objectives of this study were to determine the feasibility of prolonged CR in nonobese adults and to compare the effects of CR- and exercise-induced weight loss on body composition and abdominal adiposity . METHODS A r and omized , controlled trial was conducted with 48 healthy , nonobese women and men , aged 57 + /- 1 ( mean + /- st and ard error [ SE ] ) years , with body mass index 27.3 + /- 0.3 kg/m2 . Participants were r and omly assigned to a 20 % calorically-restricted diet ( CR , n = 19 ) , exercise design ed to produce a similar energy deficit ( EX , n = 19 ) , or a healthy lifestyle control group ( HL , n = 10 ) for 1 year . Assessment s included weight , body composition by dual-energy x-ray absorptiometry , abdominal adipose tissue by magnetic resonance imaging , and energy intake by doubly labeled water . RESULTS The average level of CR achieved by the CR group was 11.5 + /- 2.1 % , and the EX group completed 59 + /- 6.7 % of their prescribed exercise . Weight changes were greater ( p < or=.0005 ) in the CR ( -8.0 + /- 0.9 kg ) and EX ( -6.4 + /- 0.9 ) groups as compared to the HL group ( -1.3 + /- 0.9 kg ) , corresponding to reductions of 10.7 % , 8.4 % , and 1.7 % of baseline weights , respectively . Whole-body fat mass and visceral and subcutaneous abdominal adipose tissue decreased significantly ( p < .005 ) and comparably in the CR and EX groups , but did not change in the HL group . CONCLUSIONS CR for 1 year was feasible , but the level of CR achieved was less than prescribed . CR and exercise were equally effective in reducing weight and adiposity
These results corroborate the evidence from experimental and clinical studies , which support fat redistribution and compensatory fat growth , as a result of feedback mechanisms , triggered by fat removal .
Adipose tissue is considered as an endocrine organ , which is developed in specific depots , distinguished either as subcutaneous or visceral .
Lipectomy , by means of liposuction or abdominoplasty , is a common plastic surgery procedure , which can remove substantial amounts of subcutaneous fat .
This systematic review aims to evaluate the impact of surgical removal of abdominal subcutaneous adipose tissue on  body weight and fat mass in females in the short- and long-term .