The objective of this study was to investigate the contribution of mean fat cell size in intra-abdominal (visceral) and subcutaneous adipose tissue on the metabolic and inflammatory profiles of morbidly obese women. The study cohort included 80 women who were scheduled for gastric bypass surgery for morbid obesity. Results showed that there was no relationship between adipose cellularity and inflammatory markers. There was also no significant relationship between fat cell size and mRNA for interleukin-6 and tumour necrosis factor-a. In the intra-abdominal region, enlarged fat cell size was quantitatively associated with elevated plasma levels of total cholesterol, LDL cholesterol, triglycerides and apolipoprotein B. On the other hand, insulin-glucose variables were more strongly related to subcutaneous adipocyte size than intra-abdominal adipocyte size. For instance, obese women with large subcutaneous fat cells had higher HOMA index, plasma insulin and glucose levels and lower insulin-induced glucose disposal than those with small subcutaneous fat cells. All these findings were independent of age, body mass index, total body fat and body fat distribution. Thus, these results suggest that mean fat cell size is associated with metabolic complications but not with circulating or adipose inflammation. Also, enlarged intra-abdominal adipocytes had a stronger impact on the plasma lipid profile whereas large subcutaneous fat cells correlated with impaired glucose metabolism, hyperinsulinemia and insulin resistance.
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