The Concept of CMR

Intra-abdominal Adipose Tissue: the Culprit?

Gender Differences

A Question of Gender: Apples and Pears…

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Thirty-five years later, Krotkiewski et al. (5) suggested that sex hormones might be involved in regulating the typical gender differences in regional body fat distribution. Their seminal work suggested that these differences were mainly due to the number of local fat cells: men had more fat cells in the abdominal region while women had more fat cells in the gluteal/femoral adipose depots (5). They also observed that this regional adipose tissue distribution was unrelated to the presence or absence of obesity.

Abdominal adipose tissue is composed of intra-abdominal (or visceral) and subcutaneous adipose tissue, both of which can be accurately measured using imaging techniques. Anthropometric measurements such as waist circumference are useful tools in clinical practice to estimate the amount of abdominal fat, but these measurements cannot differentiate between subcutaneous and intra-abdominal adipose tissue compartments. Using computed tomography, it was found that the amount of intra-abdominal adipose tissue is, on average, twice as high in men as in pre-menopausal women (6). In men, intra-abdominal accumulation generally increases with the amount of total body fat whereas in women, the volume of intra-abdominal adipose tissue is less affected by the amount of total body fat compared to men. (6).

In another study (7), even after correcting for total body fat mass, women had a lower ratio of intra-abdominal adipose tissue to total body fat mass as compared to men. Estimated total intra-abdominal adipose tissue volume was 5.23 ± 2.39 L in men and 3.61 ± 1.91 L in women. Women had less intra-abdominal adipose tissue even though they had higher body mass index, total body fat, and abdominal subcutaneous adipose tissue values.


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5. Krotkiewski M, Bjorntorp P, Sjostrom L, et al. Impact of obesity on metabolism in men and women. Importance of regional adipose tissue distribution. J Clin Invest 1983; 72: 1150-62.
6. Kvist H, Chowdhury B, Sjostrom L, et al. Adipose tissue volume determination in males by computed tomography and 40K. Int J Obes 1988; 12: 249-66.
7. Lemieux S, Prud'homme D, Bouchard C, et al. Sex differences in the relation of visceral adipose tissue accumulation to total body fatness. Am J Clin Nutr 1993; 58: 463-7.