Abdominoplasty in Mildly Obese Patients (BMI 30-35 kg/m2): Metabolic, Biochemical and Complication Analysis at One Year

Abstract

Background/aim: Dermolipectomy dramatically improves the quality of life of previously obese patients. Fat removal in patients undergoing liposuction and reduction mammoplasty has positive effects, but no data regarding sequelae of abdominal dermolipectomy on metabolism have been reported. Thus, the aim of the present study was to assess metabolic and biochemical modifications occurring after abdominoplasty. A correlation between the results and the rate of complications was also evaluated.

Patients and methods: One hundred and twenty-eight patients with body mass index (BMI) between 30 and 35 kg/m(2) were enrolled. Clinical assessment, anthropometric measurements, blood biochemical analysis (fasting plasma glucose, total cholesterol, free fatty acids, plasma insulin), plasma adipocytokines (leptin, adiponectin,resistin), levels of inflammatory markers [tumor necrosis factor-alpha (TNFα), interleukin-6 (IL6), C-reactive protein (CRP)] and insulin sensitivity by Homeostasis Model Assessment were performed three times.

Results: The average age was 37.6 years. At baseline, the mean (±SD) BMI of patients overall was 33.44 (±2.3) kg/m(2) and the amount of fat surgically removed was 1,578.33 (±1,013.02) g. A significant decrease in BMI at 1 year was found. Adiponectin levels were found to have significantly increased (p<0.05) in long-term evaluation. We noted significant increases in the mean TNFα (p<0.05), IL6 (p<0.01) and CRP (p<0.05), with a return to baseline values of all variables. The majority of patients were satisfied with the surgical procedure after 12 months. We noted a lower rate (10%) of complications in patients whose blood analysis showed an increase of adiponectin.

Conclusion: Abdominal dermolipectomy is a safe surgical procedure that improves the quality of life of previously obese patients from an aesthetic functional view. A statistically significant increase of adiponectin after the procedure was found. A low level of adiponectin after surgery indicates a higher probability of complications.

Keywords: Obesity; adipokines; adiponectin; complications; dermolipectomy; systemic inflammation.