Question: Does a reduction in visceral fat reverse the deregulation of carbohydrate metabolism and the risk of age-associated disease?

The link between obesity and disease of aging has been confirmed in studies using calorically limited to approximately 65% of their ad labium caloric intake, the mass of tat tissue is markedly decreased and the animals live as much as 50% longer than animals fed ad labium. Furthermore, the onset of neoplastic and cardiovascular disease in these animals is significantly delayed. It has not yet been established whether the benefits of caloric restriction are mediated by the decreased secretion of cyokined by fat cells.

In one of our studies, we looked at the effect of surgical removal of visceral fat on carbohydrate metabolism. We removed visceral fat from one group of rats and performed abdominal surgery without removing visceral fat in another group of sham-operated control rats. Although the visceral fat removed for each rat made up only 10% of their total body fat content, the rats that had visceral fat removed showed decreased insulin resistance and improved insulin action that was not observed in the sham-operated control rats. In addition, we showed that the removal of visceral fat also decreased the expression of TNF-α by subcutaneous fat cells.

These experiments provide powerful evidence that visceral fat tissue has a direct effect on age-associated insulin resistance in rats. Now the challenge is to identify the specific hormonal and/or metabolic signals produced by visceral fat cells that lead to diabetes and cardiovascular diseases. It is likely that the expression of some fat tissue-derived cytokines, such as TNF-α or leptin, mediate these effects, it is tantalizing to speculate that reducing the levels of these cytokines night not only decrease insulin resistance but might also decrease the risk if diabetes and cardiovascular disease.

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