Sex‐Specific Differences in Visceral and Subcutaneous Adiposity Accumulation and Their Association With Metabolic Abnormalities

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Some studies suggest that body fat distribution differs between sexes; there remains a gap regarding the exact mechanisms that regulate these differences and their cardiometabolic consequences. This study investigated sex‐specific differences influencing the concentration and metabolic risk associated with visceral abdominal adipose tissue (VAT) and subcutaneous adipose tissue (SAT). This cross‐sectional study includes outpatients from a university‐affiliated public hospital. Consecutive patients aged ≥ 20 years were included in our sample. VAT and SAT were measured using ultrasound (the mean of three attempts). Intra‐ and interevaluator reproducibility was tested, demonstrating high reliability (> 0.90) for both VAT and SAT. Demographic (age, sex, and self‐reported race), anthropometric, behavioral, and biochemical variables were assessed. A total of 253 patients were included. They had a mean age of 46.3 ± 11.6 years (64.4% females and 68.7% non‐white). Although the mean total abdominal adipose tissue was similar between sexes ( p = 0.125), males exhibited a higher mean VAT (7.3 ± 3.0 vs. 6.0 ± 2.1 cm; p < 0.001), while women presented with a higher mean SAT (3.4 ± 1.2 vs. 2.7 ± 1.4 cm; p < 0.001). Among females, VAT was directly associated with serum triglycerides (TG), TG/HDL ratio, blood glucose, and glycated hemoglobin (HbA1c), and inversely associated with HDL. VAT/SAT ratio predicted higher levels of total cholesterol (TC), LDL, TG, TG/HDL ratio, glucose, and HbA1c ( p < 0.05). Among males, VAT did not significantly affect metabolic alterations. In conclusion, within the same mean BMI, males had higher VAT concentrations, whereas in females, despite lower VAT, a worse adverse metabolic profile was observed.

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