Metabolically Healthy Obesity (MHO) is generally recognized as the absence of any metabolic disorders and cardiovascular diseases, including type 2 diabetes, dyslipidemia, and hypertension, in obese individuals; however, it is not clearly defined. Therefore, the present study investigated differences in metabolic characteristics between individuals with MHO and Metabolically Unhealthy Obesity (MUO) during weight reduction therapy. The key factors defining MHO and the importance of weight reduction therapy for MHO were also examined. Cohort data from the Japan Obesity and Metabolic Syndrome (JOMS) study were analyzed. Subjects were divided into the MHO (n = 25) and MUO (n = 120) groups. Prior to weight reduction therapy, serum adiponectin levels were significantly higher in the MHO group than in the MUO group. Serum adiponectin levels also negatively correlated with the area of subcutaneous adipose tissue (SAT) and Homeostasis model assessment (HOMA)-R in the MHO group, but not in the MUO group. Collectively, the present results suggest the importance of adiponectin for maintaining metabolic homeostasis in the MHO group. On the other hand, no significant differences were observed in inflammatory markers between the MHO and MUO groups, suggesting the presence of chronic inflammation in both groups. Furthermore, a positive correlation was noted between changes in serum cystatin C levels and waist circumference in the MHO group, which indicated that despite the absence of metabolic disorders, the MHO group exhibited anti-inflammatory responses during weight reduction therapy. These results underscore the significance of weight reduction even for individuals with MHO.

代谢健康肥胖（MHO）通常被认为是肥胖个体不存在任何代谢紊乱和心血管疾病，包括 2 型糖尿病、血脂异常和高血压；然而，它并没有明确的定义。因此，本研究调查了 MHO 和代谢不健康肥胖 (MUO) 个体在减肥治疗期间代谢特征的差异。还研究了定义 MHO 的关键因素以及减肥治疗对 MHO 的重要性。对日本肥胖和代谢综合症 (JOMS) 研究的队列数据进行了分析。受试者被分为 MHO ( n = 25) 组和 MUO ( n = 120) 组。减重治疗前，MHO 组的血清脂联素水平显着高于 MUO 组。在 MHO 组中，血清脂联素水平还与皮下脂肪组织 (SAT) 面积和稳态模型评估 (HOMA)-R 呈负相关，但在 MUO 组中则不然。总的来说，目前的结果表明脂联素对于维持 MHO 组代谢稳态的重要性。另一方面，MHO 组和 MUO 组之间的炎症标志物没有观察到显着差异，表明两组都存在慢性炎症。此外，MHO组血清胱抑素C水平的变化与腰围呈正相关，这表明尽管没有代谢紊乱，MHO组在减肥治疗期间表现出抗炎反应。这些结果强调了减肥的重要性，即使对于 MHO 患者也是如此。