Hormonal changes during puberty and their relationship to fat distribution

In adults, abdominal visceral adiposity is related to an increased risk of cardiovascular diseases, Type 2 diabetes mellitus, and stroke. The antecede nts of these conditions likely begin with the alterations in body fat distr ibution during childhood and adolescence. The sexually dimorphic alteration s in fat distribution are influenced by sex differences in hormone concentr ations, anatomical differences in the number and density of specific hormon e receptors, capillary blood flow, and the activity of enzymes promoting li pid synthesis or degradation. Hormones influencing the amount and regional distribution of adipose tissue during puberty include cortisol, insulin, gr owth hormone, and the sex steroids. Cortisol and insulin promote fat deposi tion while the sex steroids and GH stimulate lipolysis. An overly sensitive hypothalamic-pituitary-adrenal axis may exist in obesity and disrupt the b alance between the lipogenic effects of cortisol and insulin and the lipoly tic effects of sex steroids and growth hormone. Leptin is released from the adipocytes and may act as a metabolic signal to the hypothalamic areas con trolling satiety, energy expenditure, and the regulation of cortisol, insul in, sex steroid and growth hormone release. The complex issues of the hormo nal control of alterations in body fat distribution during puberty are deve loped and a working model is proposed. (C) 1999 Wiley-Liss, Inc.