[Fat distribution and metabolism]

It is well known that adipose tissue distribution is an important factor involved in the etiology of type 2 diabetes and cardiovascular diseases. Adipose tissue distribution is obviously different between men and women, men being prone to accumulate their excess of energy in the abdominal region, more specifically in the intra-abdominal depot (visceral) whereas women show a selective deposition of adipose tissue in the gluteo-femoral region. Several studies have demonstrated an association between age and adipose tissue distribution and a selective deposition of visceral adipose tissue has been reported with age, in both men and women. In this regard, the menopause transition also appears to be a factor associated with an accelerated accumulation of abdominal adipose tissue. This increase in visceral adipose tissue has been suggested to play a significant role in the etiology of metabolic complications increasing the risk of type 2 diabetes and cardiovascular diseases. However, a selective mobilization of visceral adipose tissue in response to a weight loss program has been noted among viscerally obese patients, this reduction in visceral adipose tissue being associated with improvements in the lipoprotein-lipid profile and insulin sensitivity. Thus, the distribution of adipose tissue is an important factor to take into account in the evaluation of the patient. Furthermore, the amount of abdominal adipose tissue should also be considered as an important therapeutic target for the optimal management of cardiovascular disease risk.