Influence of Large-Volume Liposuction on Metabolic and Cardiovascular Health: A Systematic Review.
Level 2 - randomized trial
Systematic review consisting predominantly of non-randomized prospective cohort/case series with only 2 randomized trials.
PubMed 28737560 · doi:10.1097/SAP.0000000000001195
What was done
Authors systematically reviewed PubMed for prospective studies assessing the impact of large-volume liposuction (LVL, defined as >3.5 L of lipoaspirate) on preoperative versus postoperative cardiovascular risk factors, inflammatory cytokines, and insulin resistance or sensitivity.
What was found
Twelve prospective studies (364 total pooled patients; 2 randomized controlled trials, 3 with control groups, 1 continuation study) met inclusion criteria. Mean lipoaspirate volume was 7440 ± 1934.9 mL. Mean baseline BMI decreased from 30.7 to 28.4 post-procedure. Seven studies reported a trend toward reduced total cholesterol, with an overall mean reduction of 0.21 ± 0.05 mmol/L (from 4.6 ± 0.79 to 4.4 ± 0.74 mmol/L). Significant decreases were reported for leptin (4 studies), TNF-α (2 studies), and IL-6 (2 studies), while adiponectin significantly increased in 2 studies. Out of 10 studies assessing insulin sensitivity, 6 reported improvement; 2 studies included patients with type 2 diabetes mellitus. Six studies were rated Level II and 6 were rated Level IV evidence.
Why it matters
This review synthesizes clinical data on whether removing large amounts of metabolically active subcutaneous fat provides systemic cardiometabolic benefits, suggesting potential modest improvements in lipid and insulin metrics.
Limits
The literature base is small (364 total patients across 12 studies) and dominated by uncontrolled prospective series (only 2 randomized trials). Search was restricted to PubMed. Findings for inflammatory markers and insulin sensitivity were heterogeneous and conflicting across studies, and hard cardiovascular clinical endpoints were not assessed.
Cited by
- context Studies show that removing substantial body fat via liposuction does not improve any cardiometabolic outcomes.