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March 5, 2012Nutrition and DiabetesOpen Access

In severely obese participants, the presence of macrophage crown-like structures in subcutaneous adipose tissue was associated with increased systemic insulin resistance (P=0.01).

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Population

92 severely obese adults undergoing planned bariatric surgery at a single US center. Key exclusions…

Design

Cross-sectional, All samples were evaluated by a single pathologist blinded to…

Key result

In severely obese participants, the presence of macrophage crown-like structures in subcutaneous adipose tissue was associated with increased systemic insulin resistance (P=0.01).

Authors

SBSherman BigorniaMFMelissa G. FarbMMMelanie M. Mott

Discussion

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Overview

Suggests adipose inflammation links to insulin resistance in severe obesity; hypothesis-generating and should not yet change practice.

Study Design

Type

Cross-Sectional (n=92)

Multicenter

No

Structured PICO

P
Population
92 severely obese adults (mean age 42±11 years, 86% female, BMI ≥30 kg/m²) undergoing planned bariatric surgery at a single US center. Key exclusions: unstable medical conditions (active coronary syndromes, congestive heart failure, systemic infection, malignancy, pregnancy) and type 1 diabetes.
O
Outcome
Inflammatory status of subcutaneous and visceral fat depots (assessed by presence of macrophage crown-like structures [CLS]) and its relation to systemic insulin resistance (HOMA, insulin, glucose, HbA1c).surrogate

Main Result

p-value: p=0.01

Limitations

  • Relied on a single biopsy site from each depot, which may have increased false negatives
  • Low number of individuals exhibited abundant tissue CLS based on the classification scheme
  • HOMA represents an approximation of systemic insulin resistance rather than a direct measure like euglycemic clamp
  • Unable to quantify degree of visceral fat burden using imaging due to size constraints of standard machines
  • Small number of male participants prevented sex-specific analyses
  • Single biopsy site from each depot
  • Low number of individuals with abundant tissue CLS
  • HOMA is an approximation of systemic insulin resistance (no euglycemic clamp)
  • Unable to quantify degree of visceral fat burden using imaging due to size constraints
  • Small number of male participants preventing sex-specific analyses

Cite This Study

Bigornia et al. (2012) conducted a cross-sectional in Severe obesity (n=92). Presence of macrophage crown-like structures (CLS+) in adipose tissue vs. Absence of CLS (CLS-) was evaluated on Homeostasis model assessment (HOMA) for insulin resistance (p=0.01). In severely obese participants, the presence of macrophage crown-like structures in subcutaneous adipose tissue was associated with increased systemic insulin resistance (P=0.01).

synapsesocial.com/papers/6a0f71f0d13714ec96fe2ab6https://doi.org/10.1038/nutd.2012.3
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1Reduced Adipose Tissue Inflammation Represents an Intermediate Cardiometabolic Phenotype in Obesity2011 · 85 citations
  2. 2Adipose Macrophage Infiltration Is Associated With Insulin Resistance and Vascular Endothelial Dysfunction in Obese Subjects2008 · 384 citations
  3. 3Tissue-specific inflammation and insulin sensitivity in subjects with obesity2024 · 19 citations
  4. 4Insulin-sensitive obesity2010 · 862 citations
  5. 5Adipose tissue inflammation and metabolic dysfunction: a clinical perspective2013 · 18 citations