Phenotypic clusters of obesity: gender, clinical, laboratory and genetic characteristics

Aim. To identify phenotypic clusters of patients with various types of obesity and to study their gender, clinical, laboratory and genetic characteristics. Materials and methods. 100 patients (47 men and 53 women, median age 58.5 [50; 69] years) were included in the cross-sectional study. All patients underwent chest and retroperitoneal space computed tomography with the calculation of pericardial, perivascular adipose tissue volumes and the thickness of perirenal fat. Alleles and genotypes of the peroxisome proliferator activated receptor gamma (PPARG) rs1801282 polymorphism, angiotensin II receptor type 1 (AGTR1) rs5186 polymorphism, and vascular endothelial growth factor A (VEGF-A) rs699947 polymorphism were identified in all patients. Cluster analysis was performed with python version 3.11. using the k-means algorithm. Silhouette value 0.2. Results. Cluster 1 (n=36) consisted of middle-aged patients (men – 38.9%) with hypertension (HTN) – 100%, combined obesity [general obesity (GO) – 61%, abdominal obesity (AO) – 100%, ectopic obesity – 80.5%] and dyslipidaemia (77.8%). Cluster 2 included 14 patients: elderly (77.8%) men (71.4%) with HTN (100%), combined obesity (GO – 92.8%, AO – 85.7%, ectopic obesity – 100%), high incidence of dyslipidaemia (92.8%) and target organ damage. Cluster 3 consisted of 21 patients, mostly elderly (87.5%) women (76.2%) with HTN (90.1%), AO (80.9%), without GO (0%) and perirenal obesity (0%). Cluster 4 consisted of 29 patients, mostly young men without HTN (0%) with isolated AO (72.4%). The highest prevalence of risky alleles of the studied polymorphisms was found in cluster 2 (25, 32.1, 64.3%). The frequency of risky alleles was low 10.3, 20.7 and 43.1% in the most metabolically favourable cluster 4 compared to cluster 2. Conclusion. We identified 4 clusters of obese patients in our study. Among them, the most unfavorable from a metabolic and genetic point of view was cluster 2, and the most favourable was cluster 4.