© 1997 American Heart Association, Inc.
Articles |
Sex Differences in Visceral Fat Lipolysis and Metabolic Complications of Obesity
From the Departments of Medicine (F.L., V.L., P.A.) and Surgery (A.T.), Huddinge University Hospital, and the Research Center, Karolinska Institute, Stockholm (F.L., A.T., V.L., P.A.), Sweden.
Abstract Cardiovascular complications of
obesity are more common in men than women. Sex differences in visceral
fat lipolysis may be of importance in this respect, since increased
release of free fatty acids (FFAs) from visceral fat to the liver by
the portal venous system has been thought to cause several
metabolic complications due to obesity, such as
hypertension, hyperlipidemia, and glucose intolerance.
The aim of this study was to investigate sex differences in clinical
characteristics and visceral fat mobilization in obesity. Obese
subjects (22 male and 23 female) undergoing elective surgery were
matched for body mass index and age. The males had both higher
waist-to-hip ratio (WHR), sagittal diameter, blood pressure, fat-cell
volume, plasma insulin, glucose, and triglyceride and lower
HDL cholesterol levels than the females. The rate of
norepinephrine-induced FFA and glycerol release was twofold
higher in men (P=.02). No significant reutilization of FFA
was observed. The difference in maximum
norepinephrine-induced rate of lipolysis between men and
women was independent of both WHR and sagittal diameter and was an
independent regressor for levels of plasma glucose and plasma HDL
cholesterol. Fat-cell volume was an independent regressor
for plasma triglycerides and blood pressure. No sex
differences in the lipolytic sensitivity to ß1- or
ß2-adrenoceptor–specific agonists or in the
antilipolytic effect of insulin were observed. However, the lipolytic
ß3-adrenoceptor sensitivity was 12 times higher
(P=.004) and the antilipolytic 
2-adrenoceptor
sensitivity 17 times lower (P=.003) in men. Furthermore,
lipolysis induced by agents acting at the adenylate cyclase
and protein kinase A levels were almost twofold enhanced in men.
However, no sex difference in maximum hormone-sensitive lipase activity
was observed. In conclusion, in obesity,
catecholamine-induced rate of FFA mobilization from
visceral fat to the portal venous system is higher in men than women.
This phenomenon is partly due to a larger fat-cell volume but also to a
decrease in the function of 2-adrenoceptors, an increase
in the function of ß3-adrenoceptors, and an increased
ability of cyclic AMP to activate hormone-sensitive lipase.
These factors may contribute to gender-specific differences in
metabolic and cardiovascular
disturbances accompanied by obesity.
Key Words: adipocytes • free fatty acids • gender • adrenoceptors • ß3-adrenoceptor • insulin • obesity
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