Abdominal Adipose Tissue Fibrosis as an Obesity Biomarker in Clinical Practice.

Objective: To describe a biopsy procedure to obtain subcutaneous adipose tissue (SAT) samples for fibrosis assessment in patients with adipose-based chronic disease (ABCD) and to explore potential associations between SAT fibrosis and comorbidities. Methods: Single-center, cross-sectional study conducted at the Arnau de Vilanova University Hospital (Lleida, Spain) between January and December 2024. We included patients aged 18-65 years attending their first appointment in the Obesity Unit. Between-group comparisons were performed using Student’s t-test for continuous variables and chi-square tests for categorical variables, and correlations were assessed using Spearman’s rank correlation coefficient. Results: 58 patients were recruited and 50 were included in the final analysis. Most were female (76.0%), with a mean age of 47.1 years (SD: 10.8), and a mean BMI of 46.3 kg/m2 (SD: 5.0). The biopsy technique evolved over time, reducing the procedure duration from 55 minutes to under 10 minutes without any adverse events. SAT fibrosis was observed in 10 patients (20.0%), who showed a higher prevalence of type 2 diabetes (50.0% vs. 15.0%, P=0.017), significantly higher aspartate transaminase and gamma-glutamyl transferase, and elevated signs of liver fibrosis. Conclusions: SAT fibrosis was associated with ABCD comorbidities and could serve as a tool for risk stratification beyond traditional indicators.