Gender difference in the impact of gynoid and android fat masses on the progression of hepatic steatosis in Japanese patients with type 2 diabetes

Abstract

BackgroundIncreased visceral adiposity is strongly associated with non-alcoholic fatty liver disease (NAFLD). However, little attention has been paid to the association between the change in subcutaneous adipose mass and the progression of non-alcoholic fatty liver disease (NAFLD). We aimed to investigate whether increased subcutaneous adipose tissue (gynoid fat mass) could be protective against the progression of NAFLD in Japanese patients with type 2 diabetes.MethodsThis is a retrospective observational study of 294 Japanese patients with type 2 diabetes (65 ± 10 years old, 40% female). Liver attenuation index (LAI) measured by abdominal computed tomography was used for the assessment of hepatic steatosis. Both gynoid (kg) and android (kg) fat masses were measured by the whole body dual-energy X-ray absorptiometry. One-year changes in LAI, gynoid, and android fat masses were evaluated in both male and female patients. Linear regression analysis with a stepwise procedure was used for the statistical analyses to investigate the association of the changes in gynoid and android fat masses with the change in LAI.ResultsLAI levels at baseline were 1.15 ± 0.31 and 1.10 ± 0.34 in female and male patients (p = 0.455). The change in gynoid fat mass was significantly and positively associated with the change in LAI in both univariate (standardized β 0.331, p = 0.049) and multivariate (standardized β 0.360, p = 0.016) models in the female patients. However, no significant association was observed in males. In contrast, the increase in android fat mass was significantly associated with the reduced LAI in both genders in the multivariate models (standardized β −0.651, p < 0.001 in females and standardized β −0.519, p = 0.042 in males).ConclusionsThis study provides evidence that increased gynoid fat mass may be protective against the progression of NAFLD in female Japanese patients with type 2 diabetes.

Novel metabolic indices and incident type 2 diabetes among women and men: the Rotterdam Study

“…Excess gynoid fat mass has been positively correlated with total cholesterol in men and has shown a favourable association with TG and HDL-cholesterol in women [51]. Increased gynoid fat mass has also been shown to be protective against the progression of non-alcoholic fatty liver disease in Japanese women with type 2 diabetes [52]. It therefore seems that regional fat distribution in the android and gynoid regions have varying effects on lipid profiles among women and men.…”

The Omega-3 Index Response to an 8 Week Randomized Intervention Containing Three Fatty Fish Meals Per Week Is Influenced by Adiposity in Overweight to Obese Women

“…Why women with greater adiposity would respond more strongly to the same dose of dietary EPA+DHA is unclear. Regardless, elevations in android fat deposition are reportedly associated with elevated plasma triglycerides, endothelial dysfunction, type 2 diabetes, and fatty liver disease (28)(29)(30)(31), all conditions beneficially affected by high omega-3 fatty acid intake.…”

DEXA Scan Body Fat Mass Distribution in Obese and Non-Obese Individuals and Risk of NAFLD—Analysis of 10,865 Individuals

“…The android fat deposits are in the midsection of the abdomen and contribute to the metabolically active visceral fat [ 26 ]. Gynoid fat, on the other hand, is found around the hips and has been associated with an improved cardiometabolic profile, as well as being protective against NAFLD [ 27 ]. Furthermore, Ciardullo et al [ 28 ] recently found that AGR was significantly associated with liver fibrosis as determined by transient elastography in females, whereas this association was statistically insignificant in males.…”