Morphological and functional features of the state of adipose tissue of fascia and muscles in obese people

Annotation. The aim of the study is to conduct a comparative assessment of the structure of adipose tissue and muscles in people with different body weights. The relevance of the issue lies in the comparative characterization of changes in the architectonics of adipose tissue with an increase in body weight and whether these changes are important for understanding the degree of safety of surgical interventions in patients with different degrees of obesity. We studied the structure of the corpus adiposum lumbogluteale, subcutaneous fat tissue of the thigh, m. gluteus maximus, and m. biceps femoris in 30 individuals of both sexes aged 40-60 years who died suddenly from complications of hypertension and had varying degrees of primary obesity, as well as in 10 individuals with normal body weight who died from mechanical injuries. The micro-preparations were divided into five groups. The first group (i.e., the control group) included histological preparations made from material from deceased individuals with normal body weight, the second group included individuals with excess body weight, the third group included specimens from individuals with first-degree obesity, the fourth group included specimens from individuals with second-degree obesity, and the fifth group included specimens from individuals with third-degree obesity. It was noted that as the degree of obesity increased, there was an increase in the size of adipocytes and a decrease in the thickness and number of interlobular septa of the adipose tissue of the gluteal region and thighs. With increasing degrees of obesity, fat cells appear in skeletal muscle, including the replacement of muscle fibers and a decrease in the relative volume of muscle tissue. Based on the nature of histological changes at different degrees of obesity, two types of obesity are simultaneously present: hypertrophic and hyperplastic. The latter predominates in the early stages of obesity. As obesity increases, dystrophic and compensatory-adaptive changes in skeletal muscle tissue progressively increase, reducing its functional capabilities. The morphological features of adipose tissue, fascial sheaths, and layers of the gluteal region and thigh in obesity create the conditions for the massive spread of acute purulent-inflammatory processes in the event of their occurrence, since obesity is a risk factor for the development of surgical infection, including after abdominal surgical interventions.