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

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 (<i>p</i>=0.125), males exhibited a higher mean VAT (7.3 ± 3.0 vs. 6.0 ± 2.1 cm; <i>p</i> < 0.001), while women presented with a higher mean SAT (3.4 ± 1.2 vs. 2.7 ± 1.4 cm; <i>p</i> < 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 (<i>p</i> < 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.