oa Gender differences in body composition, inflammatory markers and risk of metabolic abnormalities in Arabs

Metabolic syndrome may be a result of both increased and/or inappropriate fat accumulation. As a consequence of the obesity epidemic, which has particularly manifested amongst the populations of the Arabian Gulf, associated with increases in type 2 diabetes mellitus and cardiovascular diseases, metabolic syndrome is becoming an increasing problem. Recent studies from the Gulf region have highlighted that women are more at risk than men. The effect of gender on fat accumulation and distribution, as well as its secretory function, are yet to be studied.

The aim of our study was to investigate gender differences in body composition, aerobic fitness, adipokines and inflammatory markers in a cohort of healthy Qatari adults.

This was a prospective case-control study of healthy Qatari adults (18-50 years of age), comprised of 29 women matched with 29 men for age and body mass index. Detailed investigations included body composition by anthropometric measurements, DXA and CT scans to assess total and regional fat distribution. Subjects were also evaluated for their aerobic fitness and indices of muscular strength. Hematological investigations included fasting glucose, insulin, HOMA-IR, lipid profile analysis, adipokines (s-adiponectin, leptin) and inflammatory markers (IL-6, MCP-1, CRP, S.RANTES).

Waist circumference in males (95.4±17.4 cm) and females (90.1±11.3 cm) was comparable (p=0.192). CT scan results revealed that women accumulate comparatively more fat in the total abdominal (p=0.036), and abdominal sub cutaneous (p=0.066) and total thigh (p<0.001) regions. No differences were detected in HOMA-IR, and despite very high adiposity, the lipid profile was favorable in females (TG=0.8±0.4 vs. 1.2±0.5 mmol/L and LDL=2.8±0.7 vs. 3.2±0.9 mmol/L). Poor aerobic fitness (<50th percentile) was observed in both groups 96% in women compared to 70% in men (p<0.001). S-adiponectin and leptin levels were significantly elevated in females, whereas CRP, IL-6, MCP-1 or S.RANTES were no different.

Elevated leptin concentration in women was attributed to a high percentage of central obesity in the test subjects. The presence of higher levels of s.-adiponectin led to a favorable lipid profile in women. In contrast, deleterious gender differences in aerobic fitness within this population is of critical relevance and must be further investigated.