“Impacto do volume de gordura removido na resposta inflamatória e resistência insulínica em lipoaspiração estética”

Abstract

The sample consisted of 20 patients, female, age 21 to 43 years, with BMI between 19 and 27 kg/m2 submitted to lipectomy alone or combined with silicone breast implant. Lipectomy was performed by wet technique and under general anesthesia. Inflammatory biomarkers were collected at the beginning of the anesthesia, at the end of the surgery and also at the first postoperative day. The indicators of insulin resistance were collected at both the beginning and end of the surgery. The biochemical variables were obtained from plasma dosages and formed in albumin, pre-albumin, C-reactive protein, alfa1globulina acid, glucose and insulin, Prognosis and Nutritional Index (IPIN), C-reactive Protein/Albumin Index (P/A) and Homeostasis Metabolic Assessment (HOMA). The surgical variables were duration of surgery, operated areas and total aspirated fat. Results: The time of liposuction varied from 94 to 278 minutes (mean = 174min), time of breast implant varied from 20 to 140 minutes (mean=65min), total aspirated fat from 680 to 4280 g (mean = 1778 g). Statistical analysis was performed by a cutoff line of 1500 g of aspirated fat and revealed an inflammatory response significantly higher in the group > 1500 g in comparison to the group ≤ 1500 g, with C-reactive protein 238% higher (p = 0.03), IPIN 230% higher (p = 0.02), P/A 174% higher (p=0,06), considering the values from the first postoperative day. The same group also presented insulin resistance significantly higher, with HOMA 187% higher (p = 0.02), calculated from the final operative blood samples. However, the other surgical variables showed no significant correlation. Conclusions: The intensity of inflammatory response and insulin resistance in lipectomy is significantly increased, correlated with the amount of aspirated fat.