The adipocyte volume in human adipose tissue: II. Observations in diabetes mellitus, primary hyperlipoproteinemia and weight reduction.

Body-weight index does not appear suitable as a measure of metabolic risk, since the prevalence of diabetes mellitus, hypertriglyceridemia and hypercholesterolaemia increases only up to a Broca index of 1.2. Attempts were therefore made to demonstrate an abnormal adipocyte enlargement in the subcutaneous adipose tissue of the abdomen in patients suffering from various metabolic disorders. To eliminate the influence of sex and body-weight index, normal curves of the adipocyte volumes in 142 controls were used as basis of comparison. Adipocyte hypertrophy exceeding the degree predicted by the normal curves was observed in patients with subclinical diabetes (n = 20), patients with maturity-onset diabetes (n = 56) and in patients suffering from hyperlipoproteinemia of type IIb (n = 10), type III (n = 8), type IV (n = 42) and type V (n = 24). Excessive hypertrophy could not be detected, however, in juvenile-onset diabetics (n = 11) and in hyperlipoproteinemia type IIa (n = 9). Weight reduction gave further insight into excessive adipocyte hypertrophy. This was effected by reducing caloric intake combined with physical exercise for four to five weeks until 10 per cent of initial weight was lost. Adipocyte shrinking per kg loss of body weight was significantly more pronounced in patients suffering from subclinical diabetes (31 pl/kg,n = 10), from maturity-onset diabetes (26 pl/kg,n = 23) and from hypertriglyceridemia (17 pl/kg, n = 11) in comparison with the controls (7 pl/kg,n = 25).