CONTEXT: Modulation of adipose tissue exposure to active glucocorticoids by type 1 11-hydroxysteroid dehydrogenase (11-HSD1) is involved in abdominal obesity of rodent models, but only a few studies have related 11-HSD1 oxoreductase activity to fat distribution in humans.

OBJECTIVE: To examine the link between 11-HSD1 oxoreductase activity, fat distribution patterns and the metabolic profile in women.

METHODS: Omental (OM) and subcutaneous (SC) adipose tissue samples were obtained from 36 lean to obese women (age: 47.2±5.3 years; BMI: 29.1±5.2 kg/m²) undergoing gynaecological surgery. Measures of body composition, fat distribution, blood lipids and insulin sensitivity were obtained. 11-HSD1 oxoreductase activity was measured over a 24h period by the reduction of [¹⁴C]cortisone in adipose tissue homogenates. RESULTS: 11-HSD1 oxoreductase activity was higher in OM compared to SC adipose tissue (9.6±4.9 vs. 7.9±4.2 pmol/mg/h, p<0.01). OM 11-HSD1 oxoreductase activity was positively associated with OM adipocyte size (r=0.67, p<0.0001) and visceral adipose tissue area (r=0.57, p<0.0003). A positive correlation was also observed between the OM/SC 11-HSD1 oxoreductase activity ratio and the OM/SC adipocyte size ratio (r=0.37, p<0.05) as well as the visceral/subcutaneous adipose tissue area ratio (r=0.36, p<0.05). Women in the highest tertile of OM 11-HSD1 oxoreductase activity had larger OM adipocytes, increased OM lipolysis, increased lipoprotein lipase activity, decreased HDL cholesterol, decreased adiponectin levels and an increased HOMA-IR index compared to women in the lower tertile (p<0.05).

CONCLUSIONS: These results suggest that a relatively higher 11-HSD1 activity in OM vs. SC adipose tissue is associated with preferential visceral fat accumulation and concomitant metabolic alterations.