Abstract
Although obesity is an important determinant of metabolic disease, specific accumulation of visceral fat is strongly and independently associated with important metabolic alterations such as insulin resistance, hypertension and dyslipidemia. Excess accumulation of visceral fat is a strong predictor of cardiometabolic risk in both sexes, but a marked dimorphism and large interindividual variations are observed in body fat distribution. Women are more likely to store lipids in lower-body fat compartments through adipocyte hyperplasia, while visceral adipose tissue depots of men are more prone to manage incoming lipids through adipocyte hypertrophy. Adipocyte hypertrophy appears as a critical determinant of sex-related and depot-related differences in lipid metabolism and may contribute to the chronic, low-grade inflammation observed in abdominally obese individuals. Regarding the hormonal etiology of abdominal obesity, active androgens are known to inhibit adipogenesis and lipogenesis in adipose tissue. Estrogens have important central effects on energy balance, but may also directly modulate central fat accumulation through direct effects on adipose tissue metabolism. Moreover, a relatively high adipose tissue glucocorticoid reactivation by 11β-hydroxysteroid dehydrogenase type 1 appears to promote specific accumulation of visceral fat and to alter adipocyte function in humans. Interventions targeting visceral fat accumulation such as moderate weight loss are known to exert beneficial effects on cardiometabolic disease risk.
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Mansour, M.F., Chan, CW.J., Laforest, S., Veilleux, A., Tchernof, A. (2017). Sex Differences in Body Fat Distribution. In: Symonds, M. (eds) Adipose Tissue Biology. Springer, Cham. https://doi.org/10.1007/978-3-319-52031-5_8
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