Women and men have similar amounts of liver and intra-abdominal fat, despite more subcutaneous fat in women: implications for sex differences in markers of cardiovascular risk

• Published in: Diabetologia Vol. 47; no. 8; pp. 1360 - 1369
• Main Authors: WESTERBACKA, J, CORNER, A, TIIKKAINEN, M, TAMMINEN, M, VEHKAVAARA, S, HÄKKINEN, A.-M, FREDRIKSSON, J, YKI-JÄRVINEN, H
• Format: Journal Article
• Language: English
• Published: Berlin Springer 01-08-2004; Springer Nature B.V
• Subjects: Abdomen; Adiponectin; Adipose Tissue - anatomy & histology; Adolescent; Adult; Atherosclerosis (general aspects, experimental research); Biological and medical sciences; Biomarkers; Blood and lymphatic vessels; Cardiology. Vascular system; Cardiovascular Diseases - epidemiology; Clinical Medicine; Diabetes. Impaired glucose tolerance; Endocrine pancreas. Apud cells (diseases); Endocrinology and Diabetes; Endocrinopathies; Endokrinologi och diabetes; European Continental Ancestry Group; Female; glucose; Humans; Insulin Resistance; Intercellular Signaling Peptides and Proteins - blood; Klinisk medicin; Male; Medical and Health Sciences; Medical sciences; Medicin och hälsovetenskap; Middle Aged; NEFA; non-alcoholic fatty liver disease; Risk Factors; Sex Characteristics; Skin; Sweden; visceral fat; Sweden; Endocrinopathy; Human; Visceral fat; Digestive system; Subcutaneous; Diabetes mellitus; Hepatic disease; Cardiovascular disease; Glucose; Vascular disease; Non alcoholic steatohepatitis; NEFA; Atherosclerosis; Digestive diseases; Female; Sexual dimorphism; Non-alcoholic fatty liver disease
• ISSN: 0012-186X; 1432-0428; 1432-0428
• DOI: 10.1007/s00125-004-1460-1

Fat accumulation in the liver has been shown to be closely correlated with hepatic insulin resistance and features of insulin resistance, also independently of body weight. It remains to be established how fat in the liver correlates with that in other depots, and whether any association differs between men and women.
Liver fat (assessed using proton spectroscopy), intra-abdominal and subcutaneous fat (measured using magnetic resonance imaging) and markers of insulin resistance, including serum adiponectin, were determined in 132 non-diabetic subjects: 66 men (age 41+/-1 years) and 66 women (age 42+/-1 years).
Although the women had almost twice as much subcutaneous fat as the men (5045+/-207 vs 2610+/-144 cm3, p<0.0001), amounts of intra-abdominal fat (1305+/-80 vs 1552+/-111 cm3, NS) and liver fat (6.7+/-0.8 vs 8.9+/-1.2%, NS) were similar. In this study, no sex differences were observed with respect to serum insulin, adiponectin, triglyceride and HDL cholesterol concentrations. Of all measures of body composition, liver fat was best correlated with serum insulin (r=0.58, p<0.001), with no difference observed between men and women. Serum adiponectin was inversely correlated with liver fat content (r=-0.21, p<0.05). Multiple linear regression analysis revealed that intra-abdominal fat was significantly associated with liver fat, independently of serum adiponectin and subcutaneous fat. Liver fat, but not intra-abdominal fat, significantly explained the variation in serum insulin concentrations.
Intra-abdominal fat is independently associated with liver fat, whereas subcutaneous fat is not. Liver fat, but not intra-abdominal fat, is independently associated with serum insulin. Men and women with similar amounts of intra-abdominal and liver fat do not exhibit sex differences in markers of insulin resistance (serum insulin, triglycerides, HDL cholesterol and adiponectin).