Abstract
Obesity increases the risks of developing cardiovascular and metabolic diseases and degrades quality of life, ultimately increasing the risk of death. However, not all forms of obesity are equally dangerous: some individuals, despite higher percentages of body fat, are at less risk for certain chronic obesity-related complications. Many open questions remain about why this occurs. Data suggest that the physical location of fat and the overall health of fat dramatically influence disease risk; for example, higher concentrations of visceral relative to subcutaneous adipose tissue are associated with greater metabolic risks. As such, understanding the determinants of the location and health of adipose tissue can provide insight about the pathological consequences of obesity and can begin to outline targets for novel therapeutic approaches to combat the obesity epidemic. Although age and sex hormones clearly play roles in fat distribution and location, much remains unknown about gene regulation at the level of adipose tissue or how genetic variants regulate fat distribution. In this review, we discuss what is known about the determinants of body fat distribution, and we highlight the important roles of sex hormones, aging, and genetic variation in the determination of body fat distribution and its contribution to obesity-related comorbidities.
Highlights
SEX HORMONES REGULATE BODY FAT DISTRIBUTIONBody fat distribution in humans is sexually dimorphic, with men and women having differential distribution of adipose tissue
Obesity increases the risks of developing cardiovascular and metabolic diseases and degrades quality of life, increasing the risk of death
There are data to suggest that factors such as adipokines are differentially released from different adipose tissue depots and this too is with metabolic syndrome (MetS) risk [6]
Summary
Body fat distribution in humans is sexually dimorphic, with men and women having differential distribution of adipose tissue. Premenopausal women accumulate more SCAT fat in the gluteofemoral depot [32,33,34,35], whereas men have more abdominal VAT [36]. There is a switch in fat deposition in postmenopausal women, who, similar to men, tend to accumulate more abdominal VAT, even after adjustment for total body fat, age, or both [37]. There is evidence to suggest that sex and sex hormones are key determinants of body fat distribution. We will describe how the sex hormones, estrogen and testosterone, are implicated in body fat distribution
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