Ostinelli · The Journal of clinical endocrinology and metabolism 2022 · cross-sectional observational study · n=40

Increased Adipose Tissue Indices of Androgen Catabolism and Aromatization in Women With Metabolic Dysfunction.

Cited 27 times in the scientific literature.

Level 4 - case-series / case-control

Cross-sectional observational study using human surgical tissue samples.

PubMed 35511873 · doi:10.1210/clinem/dgac261 · record verified 2026-08-29

What was done

Visceral (VAT) and subcutaneous (SAT) adipose tissue samples were collected from 40 individuals undergoing bariatric surgery (31 women, 9 men). Adipose tissue morphology was evaluated using histological staining and semi-automated quantification. Plasma and intra-adipose steroid levels were quantified with liquid chromatography electrospray ionization tandem mass spectrometry (LC-ESI-MS/MS). Aromatase activity was estimated via product-to-substrate ratios, AKR1C2 activity was measured with a fluorogenic probe, and gene expression was analyzed via quantitative PCR.

What was found

VAT aromatase activity was positively associated with VAT adipocyte hypertrophy (adjusted P < 0.01) and negatively associated with plasma HDL-cholesterol (adjusted P < 0.01). SAT aromatase activity predicted dyslipidemia in women after adjusting for age, waist circumference, and hormonal contraceptive use. Comparing women with high versus low visceral adiposity index, excess VAT was characterized by adipose tissue dysfunction, increased androgen catabolism (higher AKR1C2 activity), and higher aromatase expression and activity indices. Exact numerical values for steroid concentrations and effect sizes were not provided in the abstract.

Why it matters

This study links intra-tissue steroid metabolism, specifically androgen catabolism and aromatization, to adipocyte hypertrophy and systemic dyslipidemia in women with severe obesity, highlighting local endocrine correlates of metabolic dysfunction.

Limits

The study is cross-sectional and cannot establish causal relationships between steroid enzyme activity and adipose dysfunction. The sample size is small (40 participants) with very few men (9 men), limiting sex-specific comparisons. The cohort was restricted to individuals with severe obesity undergoing bariatric surgery. Exact effect sizes, correlation coefficients, and confidence intervals were omitted from the abstract.

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