The Concept of CMR

Metabolic consequences of gender differences in regional adipose tissue distribution

Page: 5 of 7

Men generally have more intra-abdominal adipose tissue than women, and women have more subcutaneous fat than men. It has been shown that intra-abdominal adipose tissue is a significant correlate of alterations in glucose tolerance and plasma lipoprotein-lipid levels, independent of total adiposity and abdominal subcutaneous adipose tissue (12-16). In this regard, it has been suggested that the gender difference in the cardiovascular disease risk observed between men and pre-menopausal women could be explained, at least in part, by the gender difference in body fat distribution (17-19).

Lemieux et al. (20) have studied gender differences in intra-abdominal adipose tissue and cardiovascular disease risk profile using computed tomography. They found that though pre-menopausal women had more total body fat than men, they also had lower intra-abdominal adipose tissue accumulation and a better metabolic risk profile. After controlling for both total body fat and intra-abdominal adipose tissue as potential confounders of the gender difference in the metabolic risk profile, gender differences in plasma triglyceride and apolipoprotein B levels and the HDL₂ cholesterol/HDL₃ cholesterol ratio were eliminated. However, plasma HDL cholesterol levels remained significantly lower and fasting plasma glucose concentrations significantly higher in men than in women. These results suggest that intra-abdominal adipose tissue accumulation is an important correlate of the gender difference observed in some—but not all—variables predictive of type 2 diabetes and cardiovascular disease risk. 

Reference

close

12. Després JP, Ferland M, Moorjani S, et al. Role of hepatic-triglyceride lipase activity in the association between intra-abdominal fat and plasma HDL cholesterol in obese women. Arteriosclerosis 1989; 9: 485-92.

13. Pouliot MC, Després JP, Nadeau A, et al. Visceral obesity in men. Associations with glucose tolerance, plasma insulin, and lipoprotein levels. Diabetes 1992; 41: 826-34.

14. Ross R, Aru J, Freeman J, et al. Abdominal adiposity and insulin resistance in obese men. Am J Physiol Endocrinol Metab 2002; 282: E657-63.

15. Ross R, Freeman J, Hudson R, et al. Abdominal obesity, muscle composition, and insulin resistance in premenopausal women. J Clin Endocrinol Metab 2002; 87: 5044-51.

16. Lemieux S and Després JP. Metabolic complications of visceral obesity: contribution to the aetiology of type 2 diabetes and implications for prevention and treatment. Diabete Metab 1994; 20: 375-93.

17. Freedman DS, Jacobsen SJ, Barboriak JJ, et al. Body fat distribution and male/female differences in lipids and lipoproteins. Circulation 1990; 81: 1498-506.

18. Larsson B, Bengtsson C, Bjorntorp P, et al. Is abdominal body fat distribution a major explanation for the sex difference in the incidence of myocardial infarction? The study of men born in 1913 and the study of women, Goteborg, Sweden. Am J Epidemiol 1992; 135: 266-73.

19. Seidell JC, Cigolini M, Charzewska J, et al. Fat distribution and gender differences in serum lipids in men and women from four European communities. Atherosclerosis 1991; 87: 203-10.

20. Lemieux S, Després JP, Moorjani S, et al. Are gender differences in cardiovascular disease risk factors explained by the level of visceral adipose tissue? Diabetologia 1994; 37: 757-64.

Page: 5 of 7