Biology of upper-body and lower-body adipose tissue—link to whole-body phenotypes.
Abstract
The distribution of adipose tissue in the body has wide-ranging and reproducible associations with health and disease. Accumulation of adipose tissue in the upper body (abdominal obesity) is associated with the development of cardiovascular disease, insulin resistance, type 2 diabetes mellitus and even all-cause mortality. Conversely, accumulation of fat in the lower body (gluteofemoral obesity) shows opposite associations with cardiovascular disease and type 2 diabetes mellitus when adjusted for overall fat mass. The abdominal depots are characterized by rapid uptake of predominantly diet-derived fat and a high lipid turnover that is easily stimulated by adrenergic receptor activation. The lower-body fat stores have a reduced lipid turnover with a capacity to accommodate fat undergoing redistribution. Lower-body adipose tissue also seems to retain the capacity to recruit additional adipocytes as a result of weight gain and demonstrates fewer signs of inflammatory insult. New data suggest that the profound functional differences between the upper-body and lower-body tissues are controlled by site-specific sets of developmental genes, such as HOXA6, HOXA5, HOXA3, IRX2 and TBX5 in subcutaneous abdominal adipose tissue and HOTAIR, SHOX2 and HOXC11 in gluteofemoral adipose tissue, which are under epigenetic control. This Review discusses the developmental and functional differences between upper-body and lower-body fat depots and provides mechanistic insight into the disease-prot…
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Abdominal obesity, especially increased visceral fat, is associated with an increased risk of type 2 diabetes mellitus, non-alcoholic fatty liver disease, and cardiovascular disease.
“Abdominal obesity, especially increased visceral fat, is associated with an increased risk of the above-mentioned diseases (Karpe and Pinnick, 2015), rendering it an important target in attempts to improve metabolic health.”
From Effect of Exercise Training on Fat Loss—Energetic Perspectives and the Role of Improved Adipose Tissue Function and Body Fat Distribution (2021) · cites this paper as Karpe and Pinnick, 2015
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- Authors
- Karpe, F., & Pinnick, K. E.
- Affiliations
- Churchill Hospital (GB)
- Corresponding author
- Karpe, Fredrik
- Pinnick, Katherine E.
- Venue
- Nature Reviews Endocrinology
- Published
- 2014-11-04
- Volume
- 11
- Issue
- 2
- Pages
- 90-100
- ISSN
- 1759-5029 (ISSN-L)
- 1759-5037
- OpenAlex
- W1980719167
- Cited by
- 543
- References
- 16
- Citations by year
- 2026: 33 · 2025: 55 · 2024: 40 · 2023: 69 · 2022: 48 · 2021: 50 · 2020: 76 · 2019: 50 · 2018: 40 · 2017: 35 · 2016: 27 · 2015: 19
- FWCI
- 3.17
- Type
- journal article
- Language
- en
- Open access
- closed
- Licence
- www.springer.com/tdm (tdm)
- Locations
- Nature Reviews Endocrinology (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Wellcome Trust
- British Heart Foundation (PG/12/78/29862)
- Topics
- Health Sciences › Medicine › Physiology › Adipose Tissue and Metabolism
- Health Sciences › Medicine › Epidemiology › Adipokines, Inflammation, and Metabolic Diseases
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiovascular Disease and Adiposity
- Keywords
- body fat distribution, abdominal obesity, upper body fat, adipose tissue development, adipose tissue inflammation, epigenetic regulation, cardiovascular disease, insulin resistance, type 2 diabetes, all-cause mortality
- MeSH terms
- Adipose Tissue, Cardiovascular Diseases, Diabetes Mellitus, Type 2, Humans, Obesity
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