Abstract：
In this review, we delve into the intricate relationship between white adipose tissue (WAT) remodeling and metabolic aspects in obesity, with a specific focus on individuals with metabolically healthy obesity (MHO) and metabolically unhealthy obesity (MUO). WAT is a highly heterogeneous, plastic, and dynamically secreting endocrine and immune organ. WAT remodeling plays a crucial role in metabolic health, involving expansion mode, microenvironment, phenotype, and distribution. In individuals with MHO, WAT remodeling is beneficial, reducing ectopic fat deposition and insulin resistance (IR) through mechanisms like increased adipocyte hyperplasia, anti-inflammatory microenvironment, appropriate extracellular matrix (ECM) remodeling, appropriate vascularization, enhanced WAT browning, and subcutaneous adipose tissue (SWAT) deposition. Conversely, for those with MUO, WAT remodeling leads to ectopic fat deposition and IR, causing metabolic dysregulation. This process involves adipocyte hypertrophy, disrupted vascularization, heightened pro-inflammatory microenvironment, enhanced brown adipose tissue (BAT) whitening, and accumulation of visceral adipose tissue (VWAT) deposition. The review underscores the pivotal importance of intervening in WAT remodeling to hinder the transition from MHO to MUO. This insight is valuable for tailoring personalized and effective management strategies for patients with obesity in clinical practice.
摘要：
在这次审查中,我们深入研究了肥胖中白色脂肪组织（WAT）重塑和代谢方面之间的复杂关系，特别关注代谢健康肥胖(MHO)和代谢不健康肥胖(MUO)的个体。WAT是一个高度异质的，塑料,动态分泌内分泌和免疫器官。WAT重塑在代谢健康中起着至关重要的作用，涉及扩展模式，微环境,表型,和分配。在拥有MHO的个人中，WAT重塑是有益的，通过增加脂肪细胞增生等机制减少异位脂肪沉积和胰岛素抵抗（IR），抗炎微环境，适当的细胞外基质（ECM）重塑，适当的血管化，增强WAT褐变，和皮下脂肪组织（SWAT）沉积。相反，对于那些有MUO的人来说，WAT重塑导致异位脂肪沉积和IR，导致代谢失调.这个过程涉及脂肪细胞肥大，血管化中断,促炎微环境增强，增强棕色脂肪组织（BAT）美白，和内脏脂肪组织（VWAT）沉积的积累。审查强调了干预WAT改造以阻碍从MHO向MUO过渡的重要性。这种见解对于在临床实践中为肥胖患者量身定制个性化和有效的管理策略很有价值。
