Adipocyte size in morbidly obese women and its relation to type 2 diabetes

Aim of the study: The aim was to perform a morphometric analysis of subcutaneous and visceral adipose tissue of morbidly obese women and to determine the relationship between adipocyte size and the development of type 2 diabetes (T2D).

Materials and methods: White adipose tissue of morbidly obese women was obtained from subcutaneous and omental adipose tissue during bariatric surgery. The same tissues were obtained at judicial autopsy in non-obese (lean) non-diabetic patients. The harvested tissue was embedded in paraffin and 5 μm thick hematoxylin-eosin stained sections were analyzed by the Olympus cellSens system. Statistical evaluation was performed by GraphPad Prism 6.1 software.

Results: We found a relationship between adipocyte size and the presence of T2D. The most pronounced changes were seen in visceral adipocytes (cell diameter increased from 61.9 μm in controls to 79.5 μm in patients with T2D). Also, the size of the subcutaneous adipocytes increased against the control. A statistically significant difference between diabetic and non-diabetic patients was not proven in subcutaneous adipocytes. We also observed differences in the distribution of adipocyte mean diameters. Whilst in the control group there was a normal (Gaussian) distribution, in the morbidly obese we found an asymmetric distribution with a positive skewness to the right.

Conclusion: We have demonstrated that in morbidly obese women a significant increase in visceral adipocyte size is associated with the development of both insulin resistance and T2D.