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Sex Differences in Human Adipose Tissues - The Biology of Pear Shape


Sex Differences in Human Adipose Tissues - The Biology of Pear Shape

Kalypso Karastergiou et al. Biol Sex Differ.


Women have more body fat than men, but in contrast to the deleterious metabolic consequences of the central obesity typical of men, the pear-shaped body fat distribution of many women is associated with lower cardiometabolic risk. To understand the mechanisms regulating adiposity and adipose tissue distribution in men and women, significant research attention has focused on comparing adipocyte morphological and metabolic properties, as well as the capacity of preadipocytes derived from different depots for proliferation and differentiation. Available evidence points to possible intrinsic, cell autonomous differences in preadipocytes and adipocytes, as well as modulatory roles for sex steroids, the microenvironment within each adipose tissue, and developmental factors. Gluteal-femoral adipose tissues of women may simply provide a safe lipid reservoir for excess energy, or they may directly regulate systemic metabolism via release of metabolic products or adipokines. We provide a brief overview of the relationship of fat distribution to metabolic health in men and women, and then focus on mechanisms underlying sex differences in adipose tissue biology.


Figure 1
Figure 1
Simplified overview of adipocyte metabolism. After a meal, triglycerides (TG) packaged into chylomicrons are transported to the adipocytes. The enzyme lipoprotein lipase (LPL) made in the adipocyte is secreted to the capillary endothelium were it cleaves TG to fatty acids (FA) which are in turn taken up by the adipocyte and esterified to a backbone of alpha-glycerophosphate (which is mainly derived from glucose). Insulin stimulates this process, mainly by stimulating glucose uptake. Stored TG can be mobilized after hydrolysis by lipases (adipose tissue triglyceride lipase - ATGL and hormone sensitive lipase - HSL). The process of lipolysis is stimulated by catecholamines and inhibited by insulin. Gluteo-femoral adipocytes of women are more efficient in storing FA via the direct pathway and also show higher LPL activity. See text for details.
Figure 2
Figure 2
Key sex differences in adipose tissue. Compared to men, women are characterized by increased amounts of brown adipose tissue BAT and enlarged peripheral fat depots, whereas intra-abdominal fat depots are preferentially increased in men. Sex differences in the metabolic and endocrine function of these depots are associated with diminished disease risk in women. FFA free fatty acids.

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