AT abundance of selected transcripts related to adipogenesis or lipid metabolism did not differ between women with or without secretory adiposopathy, except for lower GLUT4 mRNA levels in OME fat.<h4>Conclusions</h4>Secretory adiposopathy assessed as the plasma A/L ratio, more so than adiponectin or leptin levels alone, discriminates low and elevated lipolysis in OME and SCABD adipocytes despite similar AT expression of selected genes involved in lipid metabolism. This evidence concerns the gene SLC2A4 and otitis media with effusion.