Surgical removal of omental fat does not improve insulin sensitivity and cardiovascular risk factors in obese adults.
Surgical removal of omental fat does not improve insulin sensitivity and cardiovascular risk factors in obese adults.
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DOI：
10.1053/j.gastro.2010.04.056
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发表时间：
2010-08
期刊：
影响因子：
29.4
通讯作者：
Abumrad NN
中科院分区：
文献类型：
--
作者：
Fabbrini E;Tamboli RA;Magkos F;Marks-Shulman PA;Eckhauser AW;Richards WO;Klein S;Abumrad NN
内脏脂肪组织（VAT）是肥胖相关代谢并发症的重要危险因素。因此，降低VAT被认为是肥胖治疗的重要目标。因此，我们评估了通过手术切除网膜来减少VAT质量是否能改善肥胖患者的胰岛素敏感性和代谢功能。我们进行了：1）一项为期12个月的随机对照试验，以确定在22名肥胖受试者中通过网膜切除术减少VAT是否增强Roux-en-Y胃旁路术（RYGB）手术诱导的肝脏和骨骼肌胰岛素敏感性的改善，通过使用高胰岛素-正葡萄糖钳夹技术进行评估，和2）一项为期3个月的纵向单组研究，以确定7名患有2型糖尿病（T2 DM）的肥胖受试者单独进行腹腔镜网膜切除术是否改善了胰岛素敏感性，通过使用频繁采样静脉内葡萄糖耐量试验进行评估。在两项研究中，从接受网膜切除术的受试者中切除了重0.82 kg（95% CI：0.67-0.97）的大网膜。在研究1中，与基线相比，单独RYGB和RYGB加网膜切除术后12个月，肌肉胰岛素敏感性（胰岛素输注期间葡萄糖处置的相对增加）约增加一倍，肝脏胰岛素敏感性增加约4倍（P<0.001）。组间差异无统计学意义（P>0.87），组×时间交互作用差异无统计学意义（P>0.36）。在研究2中，手术对胰岛素敏感性（P=0.844）和糖尿病药物的使用没有影响。这些结果表明，通过网膜切除术降低VAT，无论是单独进行还是与RYGB手术联合进行，都不能改善肥胖患者的代谢功能。
Visceral adipose tissue (VAT) is an important risk factor for the metabolic complications associated with obesity. Therefore, a reduction in VAT is considered an important target of obesity therapy. Therefore, we evaluated whether reducing VAT mass by surgical removal of the omentum, improves insulin sensitivity and metabolic function in obese patients. We conducted: 1) a 12-month randomized controlled trial to determine whether reduction in VAT by omentectomy in 22 obese subjects enhances Roux-en-Y gastric bypass (RYGB) surgery-induced improvement in hepatic and skeletal muscle insulin sensitivity, assessed by using the hyperinsulinemic-euglycemic clamp technique, and 2) a 3-month longitudinal single-arm study to determine whether laparoscopic omentectomy alone in 7 obese subjects with type 2 diabetes mellitus (T2DM) improves insulin sensitivity, assessed by using the Frequently Sampled Intravenous Glucose Tolerance Test. The greater omentum, weighing 0.82 kg (95% CI: 0.67–0.97) was removed from subjects who had omentectomy in both studies. In study 1, muscle insulin sensitivity (relative increase in glucose disposal during insulin infusion) approximately doubled and hepatic insulin sensitivity increased by ~4-fold at 12 months after RYGB alone and RYGB plus omentectomy compared with baseline (P<0.001). There were no significant differences between groups (P>0.87) or group×time interactions (P>0.36). In study 2, surgery had no effect on insulin sensitivity (P=0.844) and use of diabetes medications. These results demonstrate that decreasing VAT through omentectomy, whether performed alone or in combination with RYGB surgery, does not improve metabolic function in obese patients.
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影响因子：
5.4
作者：
Boston, Ray C;Stefanovski, Darko;Bergman, Richard N
通讯作者：
Bergman, Richard N
影响因子：
8.2
作者：
Coletta DK;Sriwijitkamol A;Wajcberg E;Tantiwong P;Li M;Prentki M;Madiraju M;Jenkinson CP;Cersosimo E;Musi N;Defronzo RA
通讯作者：
Defronzo RA
影响因子：
6.9
作者：
Bergman, Richard N.;Kim, Stella P.;Ader, Marilyn
通讯作者：
Ader, Marilyn
影响因子：
5.5
作者：
Jakobsen, M. U.;Berentzen, T.;Overvad, K.
通讯作者：
Overvad, K.
DOI：
10.1152/ajpendo.00312.2006
发表时间：
2007-05-01
影响因子：
5.1
作者：
Li, Weijie;Tonelli, Julia;Hawkins, Meredith
通讯作者：
Hawkins, Meredith