Metabolomics of abdominal adipose tissue samples collected from patients with obesity - a critical review.

Obesity is a multifactorial metabolic disorder characterized by excessive fat accumulation and associated with numerous health risks, including insulin resistance, cardiovascular disease, and metabolic syndrome. Adipose tissue, particularly subcutaneous (SAT) and visceral (VAT) fat, plays a central role in metabolic regulation, yet its biochemical properties and functions differ significantly. While metabolomics offers a promising approach to studying adipose tissue at a molecular level, significant methodological limitations and inconsistencies in study design undermine the reliability of current findings. Although VAT is frequently characterized by a pro-inflammatory and lipolytic metabolic profile, whereas SAT is more involved in lipid storage and insulin, these generalizations overlook important depot-specific variations and fail to address the heterogeneity within adipose tissue. This critical review evaluates existing metabolomic studies, identifying key discrepancies in lipid metabolism, energy homeostasis, and inflammation-related pathways across VAT and SAT. It highlights the need for improved standardization in metabolomic analyses, greater inclusion of diverse populations, and more robust longitudinal studies. By addressing these issues, future research can provide more precise insights into adipose tissue's role in obesity-related metabolic dysfunction and better inform clinical strategies for obesity management.