Genetic and Nongenetic Determinants of Regional Fat Distribution
CLAUDE BOUCHARD,
JEAN-PIERRE DESPRÉS and
PASCALE MAURIÈGE
Physical Activity Sciences Laboratory, Laval University Ste-Foy, Québec, G1K 7P4 Canada
Correspondence: Address requests for reprints to: Claude Bouchard, Ph.D., Physical Activity Sciences Laboratory, PEPS, Laval University, Ste-Foy, Québec G1K 7P4, Canada.
Abstract
THE ROLE of inherited and nongenetic factors in individual differencesobserved in the level of sc fat on the trunk and abdominal areasand in the abdominal visceral deposit is reviewed. First, themetabolic and clinical implications of variation in body fattopography are summarized. Second, the results of genetic epidemiologystudies on the heritability and other evidence for a role ofthe genotype in the amount of truncal-abdominal sc fat and abdominalvisceral fat are reviewed. Third, the impact of total body fat,age, and gender on regional fat distribution is highlighted.Fourth, adipose tissue lipoprotein lipase activity is consideredas a determinant of fat topography, with a discussion of siteand gender differences, the effects of steroid hormones, andevidence from genetic epidemiology. Fifth, the contributionof adipose tissue lipolysis is reviewed with an emphasis onthe various regulatory factors of the lipolytic pathways includingcatecholamines, insulin, adenosine, steroids, and other modulators.The role of lipolytic characteristics on fat topography is furtherassessed by considering changes with age, differences betweenmen and women, effects of excess body fat, and data from heritabilitystudies. Although the study of regional variation of in vitroadipose tissue metabolism has provided valuable information,a better understanding of variation in fat topography and ofthe role played by adipose tissue in the regulation of wholebody carbohydrate and lipid metabolism will likely require extensivein situ and in vivo investigations. Sixth, as enlargement ofa specific fat deposit is associated with increases in fat cellsize and number, these topics are considered with an emphasison the role of adipose cell differentiation. Seventh, the importanceof blood levels of sex steroids and glucocorticoids for regionalfat distribution is discussed. Then, a unifying hypothesis,defined as the hypothalamic arousal and neuroendocrine dysregulationmodel, is briefly described. Finally, the issue of whether bodyfat distribution can be altered by caloric restriction or regularexercise is addressed.
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