School of Physical Education and Sport, University of Sao Paulo, Sao Paulo, Brazil;
Diabetes Metab Syndr Obes. 2011;4:141-54. doi: 10.2147/DMSO.S12143. Epub 2011 Apr 20.
Liposuction is the most popular aesthetic surgery performed in Brazil and worldwide. Evidence showing that adipose tissue is a metabolically active tissue has led to the suggestion that liposuction could be a viable method for improving metabolic profile through the immediate loss of adipose tissue. However, the immediate liposuction-induced increase in the proportion of visceral to subcutaneous adipose tissue could be detrimental to metabolism, because a high proportion of visceral to subcutaneous adipose tissue is associated with risk factors for cardiovascular disease. The results of studies investigating the effects of liposuction on the metabolic profile are inconsistent, however, with most studies reporting either no change or improvements in one or more cardiovascular risk factors. In addition, animal studies have demonstrated a compensatory growth of intact adipose tissue in response to lipectomy, although studies with humans have reported inconsistent results. Exercise training improves insulin sensitivity, inflammatory balance, lipid oxidation, and adipose tissue distribution; increases or preserves the fat-free mass; and increases total energy expenditure. Thus, liposuction and exercise appear to directly affect metabolism in similar ways, which suggests a possible interaction between these two strategies. To our knowledge, no studies have reported the associated effects of liposuction and exercise in humans. Nonetheless, one could suggest that exercise training associated with liposuction could attenuate or even block the possible compensatory fat deposition in intact depots or regrowth of the fat mass and exert an additive or even a synergistic effect to liposuction on improving insulin sensitivity and the inflammatory balance, resulting in an improvement of cardiovascular risk factors. Consequently, one could suggest that liposuction and exercise appear to be safe and effective strategies for either the treatment of metabolic disorders or aesthetic purposes.
吸脂术是巴西乃至全球最流行的美容手术。有证据表明脂肪组织是一种代谢活跃的组织，这提示我们吸脂术可能是一种可行的方法，通过立即减少脂肪组织来改善代谢状况。然而，吸脂术即刻引起的内脏脂肪与皮下脂肪比例增加可能对代谢不利，因为内脏脂肪与皮下脂肪比例高与心血管疾病的危险因素有关。然而，关于吸脂术对代谢状况影响的研究结果并不一致，大多数研究报告称，一种或多种心血管危险因素要么没有变化，要么有所改善。此外，动物研究表明，完整脂肪组织在脂肪切除术时会发生代偿性生长，尽管人体研究报告的结果并不一致。运动训练可改善胰岛素敏感性、炎症平衡、脂质氧化和脂肪组织分布；增加或保持去脂体重；并增加总能量消耗。因此，吸脂术和运动似乎以相似的方式直接影响代谢，这表明这两种策略之间可能存在相互作用。据我们所知，目前尚无研究报告人类吸脂术和运动联合的相关影响。尽管如此，我们可以推测，与吸脂术相关的运动训练可以减轻甚至阻断完整脂肪组织中可能发生的代偿性脂肪沉积，或阻止脂肪质量的再生，并对改善胰岛素敏感性和炎症平衡产生附加甚至协同作用，从而改善心血管危险因素。因此，我们可以推测，吸脂术和运动似乎是治疗代谢紊乱或美容目的的安全有效策略。
