Sex-specific differences in lipid metabolism play a critical role in the pathophysiology of obesity and its related cardiometabolic risks. Men and women exhibit distinct patterns of fat distribution, lipid handling, and hormonal regulation, contributing to varying susceptibilities to conditions like dyslipidemia, insulin resistance, cardiovascular diseases (CVD), and metabolic syndrome. In women, subcutaneous fat deposition is more prominent, whereas men tend to accumulate visceral fat, which is associated with greater cardiometabolic risk. These differences are influenced by sex hormones, particularly estrogen, which has protective effects on lipid profiles in premenopausal women, but diminishes post-menopause, increasing CVD risk. Furthermore, genetic, epigenetic, and lifestyle factors modulate these sex-specific lipid metabolic processes. Understanding these differences is crucial for developing targeted therapeutic strategies aimed at reducing the burden of obesity-associated cardiometabolic disorders. This review explores the mechanisms underlying sex differences in lipid metabolism, their implications for cardiometabolic risk, and potential interventions to address sex-specific metabolic dysfunction in obesity. Keywords: Sex differences, lipid metabolism, obesity, cardiometabolic risk, estrogen, visceral fat, metabolic syndrome
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