Huh? I have heard of liposuction but I have never heard of liposculpture. Is there such a word or procedure? No! I made the word up after reading an article on Yahoo!

Researchers from Georgetown University Medical Center in Washington tried to stress mice to see if this would lead to weight gain (Nat Med 2007; July 1 epub). This is an attempt to simulate what happens in human life as stressed-out people often gain weight. The researchers placed a group of mice standing in cold puddles (to simulate someone riding a bus with wet feet in winter) and another group of mice among aggressive mice to simulate being around an angry human boss. Half of each group of mice were fed a normal mouse diet and the other half were fed a high-fat, high sugar diet. The stressed mice given a normal diet lost weight. However, the stressed mice which fed on a high-fat, high-sugar diet gained weight and gained much more weight than would have been expected given the amount they ate. Interestingly, these weight gaining mice had more neuropeptide Y (NPY) in their blood. (NPY is a natural messenger and is ubiquitous in the body. It is found widely in the central and peripheral nervous systems. In addition NPY is also found in the gastro-intestinal tract, respiratory tract and in fibers innervating the smooth muscle around blood vessels. When NPY attaches itself to the neuropeptide Y2 receptor (Y2R) in fat cells, it activates the fat cells and also some of the cells in the blood vessels found in fat tissue. This activation presumably leads to fat deposition.) When these researchers injected a drug that blocks Y2R, the mice lost 40% of their belly fat. Using thin rhesus monkeys, the researchers inserted NPY slow-release pellet under the skin. These monkeys were found to have grown pockets of fat around the pellets.

Just think of its application if reproducible in humans. Mr Smith with a pot belly, who has a phobia about having an operation, no longer has to agonise over whether to have a liposuction procedure or not. Instead he pops down to his doctor, receives an injection of the drug that blocks Y2R into his belly and within a few weeks the pot belly is gone! (He still has to consider how he is going to get rid of the ugly, wrinkly excess skin on his now thin belly though!) As for Ms Ling who wants a fuller chest, no more silicon breast implants and the fear of future implant leakage leading to a misshapen breast. Just a simple NPY slow release pellet implant and the job is done.

The potential applications are limitless, right? Somehow I am not too sure. Firstly, Mother Nature just has too many tricks up her sleeve. She never relies on a single pathway to control various bodily functions. Secondly, single injection or single pellet implantation is just too imprecise to satisfy the high expectations of most, if not all, aesthetic enthusiasts. As for myself, I will be more interested in knowing how NPY research can help solve the global epidemic of obese people. Perhaps the mice experiment has given us a heads up on this already – mice only gained weight if they ate a high-fat, high-sugar diet.

If one day you see the word liposculpture being used in advertising aesthetic procedures, remember, you saw it here first.

Primary liver cancer or hepatocellular carcinoma (HCC) kills about 1 million people per year worldwide. Although there is a natural incidence of HCC in the general population, its occurrence is more common in individuals with certain conditions, such as chronic infection with hepatitis B (HBV) and C (HCV) virus, excessive iron load within the liver and Wilson’s disease. At present the most common cause of HCC worldwide is chronic HBV and HCV infection. With the increasing number of obese people worldwide, there is the potential fear that this may eventually lead to an increase in HCC burden worldwide. Why? Overweight and obese people can develop fatty deposition in the liver called hepatic steatosis. In some, this is associated with an inflammatory response in the liver called steatohepatitis (SH). Over a prolonged period, patients with SH may develop liver fibrosis, cirrhosis and possible HCC. Does fat in the liver encourage HCC to develop or recur? An interesting question indeed!

A Japanese study involving 88 patients with HCV-associated HCC tried to answer this question (Liver Int 2007; 27: 620 -626). These patients had had liver surgery to remove all evidence of HCC and were considered cured. They were then followed up until they developed recurrent HCC. In patients who had no evidence of fatty liver, the percentage of HCC recurring in the remaining liver at 1, 3 and 5 years after surgery was 12%, 52% and 60%, respectively. In those with evidence of fatty deposits in their remaining liver, the recurrence rate was 19%, 76% and 92% at 1, 3 and 5 years after surgery, respectively. While the chance of having new HCC one year after surgery is similar in both groups of patients, this became much worse for those with fatty liver at 3 and 5 years after surgery. When further analysis of the fatty liver (steatosis) group was performed, the HCC recurrence rate was very different and depended on how severe the fatty deposition was. In patients with grade 1 steatosis, the recurrence rate at 1, 3 and 5 years was 12%, 70% and 89%. The recurrence rate was significantly worse for those with grade 2 steatosis, being 43%, 93% and 100%!! (They did not have patients with grade 3 steatosis.)

Fat in the liver is obviously not a sign of good health. In animal studies, the HCV core protein has been found to promote and induce hepatic steatosis. How do we reverse fatty liver? At present there is no proven, commercially available medicine to make the fat leach out of the liver. The solution lies in a life style change – healthy living! No oily food, lots of vegetables and fruits, no alcohol, regular exercise and a gradual reduction of weight to reach a healthy BMI (body mass index).

Does drinking coffee help? Maybe. A recent Japanese study found that coffee drinkers have a lower chance of developing HCC (Cancer Sci 2007; 98: 214 – 218). Researchers from Karolinska Institue, Sweden, published a meta-analysis of all the studies performed on the relation between coffee consumption and the risk of HCC. They found that coffee drinking was associated with a significant reduction in the risk of HCC (Gastroenterology 2007; 132: 1740 – 1745).

So in your next visit to your local fast food joint, maybe you should stop yourself from ordering that cheese burger or an upsized French fries. Switching that order to just a cup of coffee might not be a bad idea after all.