Objectives: Regional fat accumulation may play an important role in the pathogenesis of metabolic syndrome
(MetS) and cardiovascular diseases, yet the results are controversial. The aim of this study was to determine
the relationship between regional fat accumulation and MetS as well as the underlying mechanism in
Methods: We conducted a cross-sectional study of 428 Chinese adults (166 men and 262 women). Android
and gynoid fat percentage (AFP and GFP) were measured by dual energy x-ray absorptiometry. Fasting lipid
parameters were analyzed by chemistry analyzer COBAS.
Results: Forty-six (28%) men and 34 (13%) women had MetS according to the modified National Cholesterol
Education Panel Adult Treatment Panel III definition for South Asia. AFP was strongly correlated with more
metabolic risk factors than GFP in men. In women, AFP and GFP showed significant opposite effects on triacylglycerol, high-density lipoprotein cholesterol, and waist circumference. On multivariate regression, AFP
was an independent determinant of MetS in men after adjustment for confounding factors. For women, both
AFP and the homeostatic model assessment for insulin resistance were predictors for MetS.
Conclusions: Increased android fat may play a direct role in the development of MetS in Chinese adults. However, the associations between android fat, insulin resistance, and MetS are sex-dependent. This is probably due to different effects of sex hormones on adipose tissue or by genetic factors between sexes. Knowing the sex differences in developing MetS may help design sex-specific preventive strategies that will benefit the overall population health.