The objective of this review was to discuss the evidence and possible mechanisms that suggest a protective role of gluteo-femoral fat. Epidemiological evidence has shown that an elevated gluteo-femoral fat mass was associated with a healthier cardiometabolic risk profile as well as a lower risk of developing diabetes or cardiovascular disease (CVD). Several mechanisms have been proposed to explain the protective role of gluteo-femoral fat. One of them is the distinct properties of gluteo-femoral fat concerning lipolysis and fatty acid uptake which is characterized by long-term fatty acid storage and protection from ectopic fat accumulation. Another possible mechanism is that gluteo-femoral fat is associated with a beneficial adipokine profile represented by a favourable association of leptin and adiponectin levels with gluteo-femoral fat mass. The authors also discuss the fact that pathologies characterized by gluteo-femoral fat loss are associated with a deleterious metabolic profile and an increased metabolic and cardiovascular risk. This evidence supports the protective role of gluteo-femoral fat. In their comment, Janiszewski PM and Kuk JL recognized the contribution of this review to reinforce the important notion that regional distribution of adipose tissue is a critical determinant of metabolic risk. However, they underlined the limitation of this study which neglected the notion that gluteo-femoral fat loss by diet and exercise intervention can result in metabolic improvements among overweight and obese men and women.
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