Regional fat-re-accumulation following lipectomy in pre- and postmenopausal women

描述(申请人提供)：脂肪切除是当今美国最常见的美容手术，美国美容整形外科学会认为它是永久性的，但没有进行长期的后续研究来证实这一说法。事实上，动物研究表明，脂肪切除后脂肪组织(AT)迅速重新积聚是很常见的，甚至可能伴随着疾病风险的不利变化。最近在人类身上的研究集中在腹部脂肪切除术作为降低肥胖绝经前妇女代谢性疾病风险的一种手段。然而，这些研究中没有一项评估AT再积聚或报告代谢结果的长期(&gt；6个月)变化，也没有一项评估去除股骨AT的效果，尽管这是女性常见的脂肪切除部位，尽管下半身肥胖症明显有利于心脏保护。此外，这些研究中没有一项包括绝经后妇女，她们腹部AT积聚的风险增加。我们的总体工作假设是，通过脂肪切除去除股骨AT将恶化雌激素缺乏患者的代谢性疾病风险(以餐后血脂来衡量)。 绝经后妇女，与绝经前妇女不同，在腹部而不是在股骨区域积聚AT。这项研究的全球目标是确定：1)脂肪切除后局部(腹部和股骨)AT重新积聚是否存在与绝经相关的差异；以及2)餐后甘油三酯清除和膳食衍生脂肪酸储存后股骨AT质量的变化(移除和恢复)。此外，我们假设绝经相关的餐后血脂和饮食脂肪酸处理的差异将决定股骨脂肪切除术使这些参数恶化的程度。绝经前和绝经后妇女(n=80)将被随机分配到股骨脂肪切除组或对照组(不做手术)。所有符合条件的志愿者将在研究开始时以及脂肪切除后2、8和14个月接受测试。测量将包括身体成分评估、膳食测试和AT活检，以评估与脂肪切除相关的变化：1)腹部和股骨脂肪质量；2)系统性餐后甘油三酯漂移；以及3)AT中饮食脂肪酸的储存。这些研究旨在评估股骨脂肪切除术对绝经前和绝经后妇女局部AT再积聚和代谢性疾病风险的影响。

DESCRIPTION (provided by applicant): 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 our overall working hypothesis that removal of femoral AT by lipectomy will worsen metabolic disease risk (as measured by postprandial lipemia) in estrogendeficient 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, we 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.