Key result
Visceral fat is linked to higher cardiometabolic risk while gluteal-femoral fat is independently protective.
Understanding depot-specific differences in adipose tissue biology may help explain the relationship between body shape and cardio-metabolic disease risk.
May refine cardio-metabolic risk assessment beyond BMI; hypothesis-generating for depot-specific interventions.
Body shape influences risk of cardio-metabolic diseases, independent of obesity. An apple shape, defined by larger waist circumference, is associated with higher risk. Higher amounts of visceral and/or subcutaneous adipose tissues contribute to whole-body metabolic risk. In contrast, a pear shape, with higher fat storage in gluteal-femoral depots, exerts protective effects on metabolic health, independent of sex and total adiposity. Differences in growth, remodeling, metabolism, and endocrine functions of adipose depots contribute to these associations. Innervation, blood supply, and sensitivity to endocrine signals and local secreted factors contribute to depot variations in function. At the systemic level, adipose tissues influence metabolic health by secreting adipokines and other factors packaged in extracellular vesicles. Depot differences in the production of secreted factors and their contributions to risk for developing obesity-related metabolic diseases hold promise for understanding the role of body shape in metabolic health.
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Divoux et al. (2026) conducted a review in Cardio-metabolic diseases. Adipose tissue distribution (body shape) was evaluated. Body shape and adipose tissue distribution influence cardio-metabolic risk independent of total adiposity, with visceral fat increasing risk and gluteal-femoral fat exerting protective effects.
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