Race differences in obesity and its relationship to the sex hormone milieu

Abstract

A sexual dimorphism exists in which increased abdominal and visceral adipose tissue (VAT) - found in women and marked by low sex hormone binding globulin (SHBG) and high bioavailable testosterone (BT) - is related to the metabolic risk profile. In men, increased BT is related to decreased abdominal obesity and a decrease in the metabolic risk profile. In women, race differences have been found in androgenic sex steroids including SHBG and BT as well as central fat distribution, creating inherently greater metabolic risk for certain populations. Estrogen and estrogen receptor isoforms play a role in fat deposition and distribution and may influence the changes that occur during the menopausal transition. Androgenic sex steroids serve a mediating role, influencing VAT accumulation and its associated metabolic risk factors while VAT also serves a mediating role influencing the androgenic sex steroid-metabolic risk relationship in women. Furthermore, androgenic sex steroids and VAT may independently contribute to the variance in several metabolic variables associated with cardiovascular disease, type 2 diabetes, and their antecedent conditions such as the metabolic syndrome. Race has been shown to modify the relationship between androgenic sex steroids and metabolic variables associated with risk for diabetes in Black and White women. Further research is warranted to examine the mechanisms involved in race differences. Total adiposity and central fat distribution in accordance with changes in the hormone and metabolic milieu influence breast cancer risk, which varies by race and menopausal status. These findings have broader implications for the study of health promotion/disease prevention in women.

Gender and Sex Differences in Adipose Tissue

“…Women with markedly lower sex hormone-binding globulin (SHBG) and high bioavailable testosterone had increased abdominal and visceral adipose tissue. In men, increased bioavailable testosterone decreased abdominal obesity and metabolic risk profile [110]. The SWAN study showed that Black women had higher SHBG compared to White women, while both Black and Hispanic women had lower free androgen index (FAI) compared to White women, which is consistent with Black and Hispanic women having higher prevalence of obesity.…”

The Association between Metabolically Healthy Obesity, Cardiovascular Disease, and All-Cause Mortality Risk in Asia: A Systematic Review and Meta-Analysis

“…Although a previous meta-analysis revealed sex and age to be significant effect modifiers [7], we found no significant effect, and further studies may be warranted. Sex-related differences in CVD risk could be explained by variations in visceral adipose tissue accumulation, deposition, and distribution which have been associated with insulin resistance and metabolic risks [30,31].…”

The relationship of irisin with metabolic syndrome components and insulin secretion and resistance in schoolchildren

“…Moreover, we speculate that sex and growth hormones in difference races may also contribute sexual contrary relationship between circulating irisin and FPG. The changes of sex hormones show diverse in different ethnic groups, [ 26 , 31 ] which influence the muscle mass and adiposity. On the other hand, 1 study explored 36 girls with Turner syndrome after treating growth hormone.…”