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

描述（由申请人提供）：美国美容整形外科学会认为，唇部切除术是当今美国最常见的美容手术，并且被认为是永久性的，但没有长期的随访研究来证实这一说法。事实上，动物研究表明，脂肪组织（AT）在脂肪切除术后快速再积累是常见的，甚至可能伴随着疾病风险的不利变化。最近的人类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手段。然而，这些研究都没有评估AT再积累或报告代谢结果的长期（bbb6个月）变化，也没有评估去除股骨AT的效果，尽管股骨AT是女性脂肪切除术的常见部位，尽管下体脂肪具有明显的心脏保护作用。此外，这些研究都没有纳入绝经后腹部at积累风险增加的妇女。我们的总体工作假设是，通过脂肪切除术去除股骨AT会加重雌激素缺乏患者的代谢性疾病风险（以餐后脂血症衡量）

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.