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Background Physiological expansion of subcutaneous adipose tissue (SAT) protects against harmful lipid deposition and metabolic disease and is generally greater in women than men. We hypothesised that sex differences in fibrillar collagen composition and remodelling contribute to differences in SAT expansion and function. Methods SAT from age- and BMI-matched men and women, SAT from male and female mice exposed to a high-fat diet to induce adipose tissue expansion and obesity, and publicly available human SAT and VAT RNA sequencing data sets were analysed. SAT was assessed by proteomics, histology, Western blot, qRT-PCR and flow cytometry. The 3T3-L1 preadipocyte cell line was used to test the effect of altered collagen type 1-to-3 ratio. Results Men showed greater SAT fibrosis than women. Fibrillar collagen levels correlated negatively with BMI in women but positively with cholesterol and liver enzyme levels in men. Despite similar adiposity, HFD-induced obese female mice had healthier metabolic profiles and fewer fibroinflammatory SAT changes than males. HFD preferentially induced Col1a1 in males and Col3a1 in females. Unchallenged male mice had a higher collagen type 1-to-3 ratio than females, and a similar sex difference was observed in humans. A lower, female-like collagen type 1-to-3 ratio increased preadipocyte proliferation. Consistently, acute HFD increased proliferation of SAT PDGFRβ + adipogenic stem cells in females only. Conclusions Sex differences in fibrillar collagen composition and remodelling may promote greater SAT expansion in females by facilitating adipogenic precursor proliferation and limiting fibroinflammatory changes during obesity.
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Vujičić et al. (2026) studied this question.
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