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Adipose tissue is now considered to be an endocrine organ. Ever since this realization, there has been much debate on the effectiveness of liposuction to improve insulin sensitivity (IS) and the metabolic profile. To examine the ethnic and physiological differences of abdominal and gluteal fat compartments and their relationship to IS. Body composition, fat distribution, IS and serum; lipids, adipokines and inflammatory mediators were measured in fifty-four healthy, premenopausal women. Biopsies were taken from subcutaneous fat depots to measure leptin, adiponectin and IL-18 mRNA levels. Obese black women had more superficial subcutaneous abdominal (SAT) (p<0.01) and gluteal (p=0.043), but less visceral adipose tissue (VAT) (p<0.05) than their white counterparts. Nonetheless, black women were less insulin-sensitive than white women (p<0.01). IS correlated with deep and superficial SAT (p<0.01) in both ethnic groups but gluteal fat was inversely associated with IS only in black women (black p=0.033, white p=0.22). IL-18 mRNA (p<0.001) and leptin mRNA levels (p<0.001) were highest in gluteal fat than abdominal fat depots in both ethnic groups. Obese black women had more SAT than obese white women. SAT area correlated inversely with IS in both races, whereas the gluteal fat mass in black women and VAT in white women were associated with decreasing IS, respectively. Both lean and obese black South African women were more insulin resistant than their white counterparts. We therefore hypothesize that reduction in SAT (in both races) and gluteal fat mass (only in black women) may beneficially improve the IS and metabolic profile.

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Ethnic-Specific Associations between Abdominal and Gluteal Fat Distribution and the Metabolic Complications of Obesity: Implications for the Use of Liposuction