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Insulin sensitivity

Fat cell volume associated with improved insulin sensitivity

A strong correlation was seen for reduced subcutaneous fat cell size and improved insulin sensitivity

A reduction in fat cell volume following bariatric surgery is strongly associated with improvement in insulin sensitivity, with the peak incidence seen among older women, according to a study published in Diabetes Care.

It is known that large subcutaneous fat cells associate with insulin resistance and high risk of developing type 2 diabetes. As a result the researchers from the Karolinska Institutet in Stockholm, Sweden, investigated if changes in fat cell volume and fat mass correlate with improvements in the metabolic risk profile after bariatric surgery in obese patients.

They measured fat cell volume and number abdominal subcutaneous adipose tissue before and after Roux-en-Y gastric bypass (RYGB), in a cohort of 62 obese women.

The researchers observed a 33 percent decrease in body weight with RYGB, which was accompanied by a decrease in the volume, but not number, of adipocytes.

After RYGB, there was a decrease in fat mass in the measured regions and improvement in all metabolic parameters (p< 0.0001). A strong correlation was seen for reduced subcutaneous fat cell size and improved insulin sensitivity (p=0.0057), but this correlation was not seen for regional changes in fat mass, except for weak associations between changes in visceral fat mass, insulin sensitivity, and triglycerides.

After weight loss, there was an alteration in the curve-linear relationship between fat cell size and fat mass (p=0.03).

“After bariatric surgery in obese women, a reduction in subcutaneous fat cell volume associates more strongly with improvement of insulin sensitivity than fat mass reduction per se,” the authors write. An altered relationship between adipocyte size and fat mass may be important for improving insulin sensitivity after weight loss. Fat cell size reduction could constitute a target to improve insulin sensitivity.”

The study was partially funded by the Novo Nordisk Foundation and the European Association for the Study of Diabetes/Lilly.

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