Department of Plastic and Reconstructive Surgery, Soonchunhyang University Bucheon Hospital, Soonchunhyang University College of Medicine, 170 Jomaru-ro, Bucheon-si, Gyeonggi-do, Korea.
Department of Integrated of Biomedical Science, Soonchunhyang University, Cheonan, Korea.
Aesthetic Plast Surg. 2022 Jun;46(3):1439-1449. doi: 10.1007/s00266-021-02630-8. Epub 2021 Oct 21.
Most preconditioning techniques before fat grafting require external manipulation. Since nutrition is the main factor maintaining the balance of lipogenesis and lipolysis, we hypothesized that fasting before undergoing autologous fat grafting may increase lipolysis and reduce adipocyte size, thereby improving the fat graft survival rate.
C57BL/6 mice were divided into 24 h starved or fed groups. Adipose tissue lipolysis, adipogenesis, and angiogenesis-related gene expression, in fat from both groups, were analyzed. The volume and weight of the grafted fat at 4-8 weeks postoperatively were measured using micro-computed tomography. Immunohistochemistry staining and mRNA expression analysis were also performed to evaluate the effect of fasting on fat graft survival.
Fasting decreased adipocyte size by inducing adipose tissue lipolysis. Adipogenesis-related genes were remarkably downregulated while lipolysis-related genes and angiogenesis inducer genes were significantly upregulated in the starved adipose tissue. The mice grafted with the fat from the 24 h starved group had approximately 20% larger volumes and considerably heavier weights than those from the fed group. Increased viable adipocytes and vessels, and reduced macrophages in the fat grafts obtained from the 24 h starved group were also observed.
Fasting for 24 h before harvesting fat increased the retention volume of fat graft by increasing angiogenesis via VEGF induction. Therefore, fasting would be a novel and reliable preconditioning strategy to improve graft survival in autologous fat grafting.
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大多数脂肪移植前的预处理技术都需要外部操作。由于营养是维持脂肪生成和脂肪分解平衡的主要因素，我们假设在进行自体脂肪移植前禁食可能会增加脂肪分解并减小脂肪细胞的体积，从而提高脂肪移植的成活率。
将 C57BL/6 小鼠分为禁食 24 小时组和正常进食组。分析两组脂肪组织的脂肪分解、脂肪生成和血管生成相关基因的表达。术后 4-8 周，通过 micro-CT 测量移植脂肪的体积和重量。还进行了免疫组织化学染色和 mRNA 表达分析，以评估禁食对脂肪移植存活的影响。
禁食通过诱导脂肪组织脂肪分解来减小脂肪细胞的体积。禁食脂肪组织中脂肪生成相关基因显著下调，而脂肪分解相关基因和血管生成诱导剂基因显著上调。与正常进食组相比，来自禁食 24 小时组的脂肪移植小鼠的体积增加了约 20%，重量也明显增加。还观察到来自禁食 24 小时组的脂肪移植中存活的脂肪细胞和血管增加，而巨噬细胞减少。
在收获脂肪前禁食 24 小时通过诱导 VEGF 增加血管生成来增加脂肪移植的保留体积。因此，禁食可能是一种提高自体脂肪移植中移植成活率的新型可靠预处理策略。
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