Human Subcutaneous Adipose Tissue Sampling Using a Mini-Liposuction Technique

Summary

The manuscript and associated video demonstrate a percutaneous biopsy technique to obtain samples of subcutaneous adipose tissue from areas surrounding the umbilicus. This method is a low-risk and efficient way to investigate a range of parameters (e.g., gene or protein expression, enzyme activity, lipid content) within adipose tissue.

Abstract

Studies on adipose tissue are useful in understanding metabolic and other conditions. Human subcutaneous adipose tissue is accessible. With appropriate training and strict adherence to aseptic technique, subcutaneous adipose samples can be safely and efficiently obtained in a non-clinical setting by researchers. Following the administration of local anesthetic lateral to the umbilicus, a 14 G needle attached to a 5 or 10 mL syringe is inserted through the skin into the subcutaneous tissue. Under suction, the syringe is moved in a reciprocating, slicing motion to isolate fragments of adipose tissue. Withdrawing the plunger is enough to ensure that adipose tissue fragments are aspirated through the needle into the syringe. A single biopsy can collect about 200 mg of tissue. This biopsy technique is very safe for both participants and research staff. Following the biopsy, participants can resume most everyday activities, although they should avoid swimming and overly strenuous activities for 48 h to avoid excessive bleeding. Participants can safely undergo 2 biopsies within a single day, meaning that the technique can be applied in before-after acute intervention studies.

Introduction

Adipose tissue can provide useful information on the metabolic function of humans. Human subcutaneous adipose tissue is readily accessible. A technique for subcutaneous adipose tissue extraction was first described in the mid-80s¹; since then, the initial protocol has been improved to increase the yield and improve study participant tolerability. Subcutaneous adipose tissue can be obtained from numerous sites, most commonly from the glutei¹ and abdominal area². Samples from the latter may be more desirable as they provide more valuable information in metabolic disease-related contexts

Protocol

NOTE: The University of Stirling NHS, Invasive, or Clinical Research Committee approved the biopsy procedure described below. All research studies using this procedure must be approved by the appropriate independent ethics committee. The biopsy taker must have completed formal training in the described technique in accordance with their institution's requirements. Typically, this involves observing a demonstration of the described adipose tissue biopsy technique by a board-certified physician, followed by supervised practice. Once the trainee has performed 10 practice adipose tissue biopsies on volunteer subjects under supervision, they will be examined by a board....

Results

The described adipose tissue biopsy procedure is an efficient and low-risk technique for researchers to obtain subcutaneous adipose tissue samples from human volunteers. We performed 39 subcutaneous adipose tissue biopsies using the described procedure in 11 healthy, normal weight females (age, 27.4 ± 3.3 years; body mass index (BMI), 22.6 ± 1.5 kg.m²). All participants attended the laboratory between 07:00 and 10:00 following an 8-12 h fasting period. Sample yield using this adipose tissue biopsy procedure wa.......

Discussion

The described protocol and associated video provide a step-by-step overview of a mini-liposuction technique to obtain subcutaneous adipose tissue samples from the abdominal area. This research group has performed a total of 124 biopsies over the course of 19 months with no adverse effects in participants. The procedure is safe and associated with minimum risk to participants or the biopsy team, provided that the described safety measures are followed. Aseptic technique (including opening and dispensing of sterile equipme.......

Materials

List of materials used in this article

Name	Company	Catalog Number	Comments
Item: 14 G needle 14 G x 3 1/8" 210 mm x 80 mm	B Braun	4665473	Per biopsy: 1
Item: 21 G needle 21 G x 1 1/2" 0.8 mm x 38 mm	Terumo	AN*2138R1	Per biopsy: 2
Item: 26 G  needle 26 G x 1/2" microlance needle 0.45 mm x 13 mm	BD	303800	Per biopsy: 2
Item: 5 mL syringe 5 mL luer	DB plastipak	302187	Per biopsy: 2
Item: Adhesive wound dressing Opsite Post-Op Dressing 9.5 x 8.5	Smith & Nephew	6600709	Per biopsy: 1
Item: Disposable sterile scalpel Disposable Scalpel Sterile Blade no. 10	Swann Morton	/0501	Per biopsy: 1
Item: Icepack BlueDot Reusable Hot/Cold Pack 26.5 cm x 13.0 cm	NuCare	F711	Per biopsy: 1
Item: Iodine based antiseptic Videne antiseptic solution	Ecolab Videne	3030440	Per biopsy: q.s
Item: Lidocaine 2% w/o epinephrine Lidocaine 2% injection 5 mL	B Braun	3558553	Per biopsy: 5 mL
Item: Non-sterile gloves Starguard sensitive powder free nitrile gloves	Starguard	SG-N-S	Per biopsy: pair
Item: Sodium chloride 0.9% Sodium chlride 0.9% w/v intravenous infusion BP	BBraun	S8004-5384	Per biopsy: q.s.
Item: Stabilization solution* RNAlater Stabilization Solution	ThermoFisher Scientific	AM7020	Per biopsy: q.s
Item: Sterile forceps Sterile forceps	Rocialle	RML109-006	Per biopsy: 1
Item: Sterile gauze swabs Non woven swabs sterile 7.5 x 7.5 cm	Prestige	1860	Per biopsy: 5
Item: Sterile gloves Prestige soft vinyl sterile powder free medical gloves	Prestige	S: P4301 M:P3302 L:P3301	Per biopsy: pair
Item: Sterile Microcentrifuge tubes 1.5 mL Sterile Microcentrifuge Tubes	StarLab	I1415-5510	Per biopsy: q.s
Item: Sterile sheet Paper plain white 90 x 90 cm	Rocialle	RML 126-216	Per biopsy: 1
Item: Weighing boat Diamond shape weigh boats	Heathrow Scientific	HS1427C	Per biopsy: 1
* denotes optional materials