Background: The deep layers of abdominal subcutaneous
adipose tissue (SAT) behave functionally like the visceral
adipose tissue (VAT). Both aggravate insulin resistance and
affect the metabolic profile in a similar manner. So, the
removal of Abdominal subcutaneous tissue in abdominal
contouring surgeries as liposuction and lipo-abdominoplasty
can positively affect insulin resistance and the metabolic
profile.
Objective: To assess the effect of abdominal contouring
on metabolic syndrome and insulin resistance.
Patients and Methods: 50 female patients with localized
abdominal obesity i.e. skin pinch ³3cm, Metabolic syndrome
i.e. three or more of the following criteria: (waist circumference
³35 inches, waist-hip ratio above 0.85, blood pressure ³130/85
mmHg, fasting triglyceride (TG) level ³150mg/dl, fasting
high-density lipoprotein (HDL) cholesterol level £50mg/dl
and fasting blood sugar ³100mg/dl) and insulin resistance i.e.
fasting glucose ³l00mg/dL, 2-hour plasma glucose ³140mg/dl,
fasting insulin level ³5mIU/mL and HbA1C between 5.7-
6.4%. Patients were divided into two groups, Group I (n=25);
the lipo-abdominoplasty group and Group II (n=25); the
liposuction only group. The change in the metabolic profile
and insulin resistance was followed 3- and 6-months post
operatively by measuring waist circumference, waist-hip ratio,
blood pressure, fasting triglyceride, fasting high-density
lipoprotein (HDL) cholesterol level, fasting blood sugar,
fasting insulin, and fasting glucose level using specific laboratory
equation called Homeostasis Model Assessment (HOMA-
IR).
Results: For both groups, there is a significant improvement
in glycaemic and lipid profile for all studied patients
together with weight loss and BMI. but there was no difference
in glycemic or lipid profile between both groups. Waist/hip < br />ratio was significantly improved in lipo-abdominoplasty group < br />more than liposuction only group. There was no relation
between amount of resected fat and the improvement in
glycemic and lipid profile for all patients.
Conclusion: As a part of body contouring surgeries,
liposuction and lipo-abdominoplasty could play a role in
improvement of insulin resistance and metabolic syndrome in  patients with localized abdominal obesity. So, one time, it may not only be considered as an aesthetic procedure to
improve the individual body image, but also it can be approved
by the authorities and insurance companies as it affects the
wellbeing.