| BODY SHAPING | ARTICLE Figure 1 Subcutaneous fat distribution in males and females


wound healing, and decreased microvascular homeostatic efficiency. Localised adiposities are mostly observed in gynoid


fat distribution and specifically related to oestrogens, which are responsible for the activation of lipogenesis and the inhibition


of lipolysis. In particular,


oestrogen-sensitive fat cells have a peculiar body distribution. They are mostly located within the subcutaneous compartments of the upper and lateral thighs, gluteal regions, medial knees, lower abdominal regions, and hips. Clinically evident modifications of body fat distribution might be observed immediately after puberty. Specific combinations of genetic factors, environmental influence, and personal lifestyle may contribute to progressively consolidate and even worsen this condition. Adipose tissue is extremely dynamic and needs to be supplied by an adequate and efficient vascularÐ lymphatic microcirculation. Lipids stored within adipocytes are derived from plasma very low-density


lipoproteins


Background Modern Western populations are constantly exposed to abundant and unbalanced high-caloric diets. Long working hours and reduced free time have dramatically reduced the performance of physical activities compared with previous generations. Chronic imbalance between food intake and energy expenditure are generating more obesity-prone individuals. Caloric excesses are naturally stored within adipocytes, which progressively increase their size (hypertrophy), while minimally increasing their number (hyperplasia). Accumulation of fat within subcutaneous layers involves white adipose tissue, which provides insulation and serves as a useful energy depot. White adipose tissue plays an important role in maintaining a good endocrine equilibrium and actively contributes to the control of lipids and glucose metabolism. Adipose tissue weighs much less than all other body tissues and this justifies the progressive initial increase of body mass ® not associated with significant modifications of total body weight at the beginning of a high caloric diet ® and without a proportional increase in energy expenditure. Excessive localised adiposities


have been found responsible for a number of side-effects interfering with normal skin function, including skin barrier alterations, sebaceous gland hyperactivity, apocrine and eccrine sweat gland hyperactivity, impaired lymphatic drainage leading to inflammation and fibrosis, altered collagen structure, impaired


(VLDL)-triglycerides. Normally, adipose tissue maintains a highly efficient, physiologically controlled, dynamic equilibrium between fat ÔstorageÕ (lipogenesis) and fat


Ô releaseÕ (lipolysis), in the form of free fatty acids and glycerol2–5


. Stimulation/inhibition of lipogenesis and


lipolysis can be induced by specific active ingredients properly dispersed in a cream.


The tested slimming


formulation was characterised by an innovative association


of actives, dispersed in a topical cream, and combined with an advanced transepidermal delivery system.


Materials and methods The tested slimming formulation was characterised by an innovative association of actives, dispersed in a topical cream, and combined with an advanced transepidermal delivery system. The key actives were selected with the specific purpose of increasing the efficiency of two important adipose tissue functions: localised vascular perfusion by superficial micro- vessels, and lipolysis. A double-blind, randomised, prospective


active versus placebo trial was carried out to assess the safety and efficacy of an innovative


formulation designed to reduce localised adiposities in two groups of female volunteers. The study was performed under strict dermatological control. A group of 110 female volunteers aged 30–55 years


(mean age 48 years), affected by light-to-moderate localised adiposities, mostly evident at waist and hip levels, and a body mass index (BMI) of less than 30, was recruited for this study. Baseline local adiposities were graded according to a visual five-grade severity scale: ■ 0 = smooth skin with normal subcutaneous fat


■ 1 = slight skin dimpling ■ 2 = skin dimpling associated with localised shallow depressions


■ 3 = dimpling, widely distributed depressions, and hypertrophic striae


■ 4 = palpable nodules, widely distributed irregular depressions and atrophic striae.


prime-journal.com | July/August 2012 ❚ 19


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