Original articleMesenteric visceral lipectomy using tissue liquefaction technology reverses insulin resistance and causes weight loss in baboons☆
Section snippets
Animals
For optimization studies performed in Phase I, a total of 3 male baboons with obesity (weight>37 kg, %fat>21) were carefully selected [28]. For the Phase II efficacy study, a total of 9 nondiabetic obese animals (mean age = 12.0 ± 1.2 yr; mean glycated hemoglobin [HbA1C] 4.8 ± .4%) with the highest HbA1C levels (Table 1) were then enrolled into the study from the colony housed at the Southwest National Primate Research Center, Texas Biomedical Research Institute (San Antonio, TX). Baseline
Optimization
For Phase I, we performed an initial safety trial in obese male baboons (n = 3). For each procedure, approximately 125 to 150 g of MF was surgically removed using TLT (Fig. 1A). In all surgeries, the majority of the operating time was spent starting and stopping the fat removal activity in an effort to determine the optimal parameters and settings for removing VF using the TLT system. As these studies were intended for optimization, the effect on MF removal efficiency was tested with numerous
Discussion
Here, we have demonstrated that safe and effective removal of MF can be achieved in obese insulin-resistant baboons using TLT. We were able to remove up to 75% to 80% of all visible adipose tissue in the mesentery without complications, which we estimate to be approximately 40% of total VF stores, based upon prior estimates of abdominal fat mass in baboons [36]. To our knowledge, this is the first report of significant adipose tissue removal from the mesentery in any mammalian species.
Conclusion
We have demonstrated here that significant quantities of mesenteric visceral fat can be safely and effectively surgically excised, using TLT, in adult male baboons, thereby providing the first important proof-of-concept that such a surgical intervention may be feasible in humans. Importantly, this procedure produced marked metabolic benefits in previously insulin-resistant, male, obese baboons, reversing insulin resistance and promoting significant weight loss. This suggests that meaningful
Disclosures
The authors have no commercial associations that might be a conflict of interest in relation to this article.
Mark Andrew, MD is the Founder and Chief Scientific Officer of Andrew Technologies, and he does have a financial interest in Andrew Technologies.
References (43)
- et al.
Abdominal adiposity and insulin resistance in early pregnancy
J Obstet Gynaecol Can
(2014) - et al.
Role of visceral adipose tissue in aging
Biochim Biophys Acta
(2009) - et al.
The origins and drivers of insulin resistance
Cell
(2013) - et al.
Omentectomy added to Roux-en-Y gastric bypass surgery: a randomized, controlled trial
Surg Obes Relat Dis
(2013) - et al.
Surgical removal of omental fat does not improve insulin sensitivity and cardiovascular risk factors in obese adults
Gastroenterology
(2010) - et al.
Prospective randomized controlled trial to compare the effect on the macula of AquaLase liquefaction and ultrasound phacoemulsification cataract surgery
J Cataract Refract Surg
(2008) - et al.
Protocol for the measurement of fatty acid and glycerol turnover in vivo in baboons
J Lipid Res
(2011) - et al.
Weight and mortality in Finnish men
J Clin Epidemiol
(1989) Abdominal obesity: a marker of ectopic fat accumulation
J Clin Invest
(2015)- et al.
Visceral adipose tissue modulates mammalian longevity
Aging Cell
(2008)
Removal of visceral fat prevents insulin resistance and glucose intolerance of aging: an adipokine-mediated process?
Diabetes
Surgical removal of visceral fat reverses hepatic insulin resistance
Diabetes
Hospitalization and 1-year all-cause mortality in type 2 diabetic patients with chronic kidney disease at Stages 1 and 2: effect of mild anemia
J Diabetes
Time trends in ischemic stroke among type 2 diabetic and non-diabetic patients: analysis of the Spanish national hospital discharge data (2003-2012)
PLoS One
Metabolic changes following a 1-year diet and exercise intervention in patients with type 2 diabetes
Diabetes
Effect of 6-month calorie restriction and exercise on serum and liver lipids and markers of liver function
Obesity (Silver Spring)
Dietary adherence during weight loss predicts weight regain
Obesity (Silver Spring)
Absence of an effect of liposuction on insulin action and risk factors for coronary heart disease
N Engl J Med
Behavior of insulin sensitivity and its relation to leptin and tumor necrosis factor-alpha in obese women undergoing liposuction: 6-month follow-up
Obes Surg
The effects of liposuction removal of subcutaneous abdominal fat on lipid metabolism are independent of insulin sensitivity in normal-overweight individuals
Obes Surg
A pilot study of long-term effects of a novel obesity treatment: omentectomy in connection with adjustable gastric banding
Int J Obes Relat Metab Disord
Cited by (0)
M. S. A. and D. M. H equally contributed to this work.
- ☆
Supported by National Institutes of Health Grant R43 DK112428.