Reduced adipose tissue lymphatic drainage of macromolecules in obese subjects: a possible link between obesity and local tissue inflammation?

The aim of this study was to investigate subcutaneous adipose tissue lymphatic drainage (ATLD) of macromolecules in lean and obese subjects and, furthermore, to evaluate whether ATLD may change in parallel with adipose tissue blood flow. Lean and obese male subjects were studied before and after an oral glucose load. Adipose-tissue blood flow was measured in the anterior subcutaneous abdominal adipose tissue by the Xe-133-washout technique. ATLD was measured as the disappearance rate of Tc-99m-labelled nanoaggregated human albumin, during fasting and after an oral glucose load. A significant increase in ATLD was seen after the glucose load in the lean subjects. In the obese subjects, ATLD remained constant throughout the study and was significantly lower compared to the lean subjects. These results indicate a reduced ability to remove macromolecules from the interstitial space through the lymphatic system in obese subjects. Furthermore, they suggest that postprandial changes in ATLD taking place in lean subjects are not observed in obese subjects. This may have a role in the development of obesity-related inflammation in hypertrophic adipose tissue.