• Antti P M Viljanen, Riikka Lautamäki, Mikko Järvisalo, Riitta Parkkola, Risto Huupponen, Terho Lehtimäki, Tapani Rönnemaa, Olli T Raitakari, Patricia Iozzo, and Pirjo Nuutila.
• Turku PET Centre, University of Turku, Turku University Hospital, Finland.
• Ann. Med. 2009 Jan 1;41(2):152-60.

ObjectiveRapid weight loss with very-low-calorie diet (VLCD) is known to improve insulin sensitivity and decrease adipose tissue masses. The aim was to investigate the effects of VLCD on adipose tissue regional glucose uptake (rGU) and perfusion and their association with adipokines.Research Design And MethodsSixteen healthy obese (body mass index 33+/-1.1 kg/m(2)) subjects underwent VLCD for 6 weeks. RGU and perfusion were measured using [(18)F]-fluoro-deoxy-glucose, [(15)O]H(2)O and positron emission tomography.ResultsBlood-flow and rGU expressed per gram of adipose tissue were higher in visceral fat compared to abdominal subcutaneous fat (P<0.01 for both). Dieting decreased weight by 11+/-0.9 kg (P<0.0001). Visceral adipose fat decreased by 25% (P<0.001) and abdominal subcutaneous fat by 16% (P<0.001). Whole body insulin sensitivity increased by 33% (P<0.01). Perfusion of both fat depots decreased (P<0.001), while rGU remained unchanged. Among the adipokines, leptin and interleukin-6 levels seemed to be associated with abdominal subcutaneous and intra-abdominal adipose tissue insulin resistance but not with adipose tissue perfusion.ConclusionsAbdominal adipose tissue perfusion and rGU are not related in obesity. Rapid weight loss decreases perfusion through adipose tissue depots but has no influence on rGU demonstrating the 'sink' role of adipose tissue.

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