The Concept of CMR

A question of gender: apples and pears…

It is well known that intra-abdominal adipose tissue increases with age, regardless of gender (1). It is also known that adipose tissue distribution differs markedly between men and women. Men are more likely to accumulate adipose tissue in the upper body (trunk, abdomen), whereas women usually accumulate adipose tissue in the lower body (hips, thighs) (2-4). 

In the 1940s, professor Jean Vague of the University of Marseille was the first to highlight the importance of regional adipose tissue distribution as a correlate of obesity complications (4). He used the term “android obesity” to refer to adipose tissue accumulation in the trunk area and the term “gynoid obesity” to refer to adipose tissue accumulation in the hips and thighs, typically in pre-menopausal women. This adipose tissue distribution is also associated to the apple and pear shapes (Figure). Vague also emphasized the health hazards associated with the android pattern of adipose tissue distribution usually observed in men as compared to the lower-risk gynoid pattern mostly observed in women. In fact, even in the absence of sophisticated laboratory methods, Vague was the first to propose that android obesity was more frequently associated with type 2 diabetes and coronary heart disease than gynoid obesity.