Key result
Metabolically unhealthy obesity is linked to altered visceral adipocyte genes driving inflammation and endothelial dysfunction.
Why the study?
Visceral adipose tissue produces several adipokines, but visceral adipose tissue adipocytes' gene expression has not been related to cardio-metabolic components.
Cross-Sectional (n=45)
No
Visceral adipocytes from individuals with metabolically unhealthy obesity exhibit a distinct gene expression profile linked to inflammation, oxidative stress, and endothelial dysfunction compared to those with metabolically healthy obesity.
No immediate clinical implications for obesity phenotyping; leaves open whether these gene differences predict outcomes or guide interventions.
Objective Visceral adipose tissue (VAT) produces several adipokines; however, VAT adipocytes’ gene expression has not been related with cardio-metabolic components. The present study aimed to explore associations between gene expression in human primary VAT adipocytes’ and cardio-metabolic components in subjects who live with Metabolically Unhealthy Obesity (MUO) compared with subjects who live with Metabolically Healthy Obesity (MHO). Methods Cross-sectional study of patients who live with obesity, who underwent bariatric/metabolic surgery. Results Forty-five patients (18 MHO and 27 MUO) aged 44 years, main co-morbidities Diabetes and Hypertension, were analyzed. MUO showed younger age and higher cardio-metabolic risk, as well as larger adipocyte´s sizes. Primary cultured adipocytes were isolated from trans-surgical VAT sample, then cDNA was analyzed for the expression of 92 genes, further distributed as MUO vs. MHO and clustered according to their linkage with cardio-metabolic components. Higher expression of genes like EDN1, IL-6, ADIPOQ, GSTA2, TGFβ, WNT3A, KDR, MAPK3, vWF (p<0.04); as well as reduced NOS2, PDGFA, HAMP and RARRES2 (p<0.01) were observed across clusters of hyperglycemia, hypertension, dyslipidaemia, and central obesity, broadly implicating pathways related to inflammation, oxidative stress, endothelial dysfunction, insulin resistance, and vascular regulation. Conclusion Findings from the present exploratory analysis show that cardio-metabolic risk is associated to VAT adipocytes’ gene expression; particularly those genes related to oxidative stress, insulin resistance, inflammation, endothelial dysfunction, athero-thrombosis, and lower vasodilation. Further longitudinal and mechanistic studies are required to clarify the directionality and clinical significance of these associations.
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Suárez‐Cuenca et al. (2026) conducted a cross-sectional in Morbid obesity (Metabolically Healthy vs Unhealthy) (n=45). Metabolically unhealthy obesity (MUO) vs. Metabolically healthy obesity (MHO) was evaluated on Gene expression in human primary visceral adipocytes and associations with cardio-metabolic components.. Metabolically unhealthy obesity was associated with differential expression of visceral adipocyte genes related to oxidative stress, inflammation, and endothelial dysfunction compared to metabolically healthy obesity.
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