Peripheral blood leucocyte subclasses as potential biomarkers of adipose tissue inflammation and obesity subphenotypes in humans

While obesity is clearly accepted as a major risk factor for cardio‐metabolic morbidity, it is also apparent that some obese patients largely escape this association, forming a unique obese subphenotype(s). Current approaches to define such subphenotypes include clinical biomarkers that largely reflect already manifested comorbidities, such as markers of dyslipidaemia, hyperglycaemia and impaired regulation of vascular tone, and anthropometric or imaging‐based assessment of adipose tissue distribution. Low‐grade inflammation, evident both systemically and within adipose tissue (particularly intra‐abdominal fat depots), seems to characterize the more cardio‐metabolically morbid forms of obesity. Indeed, several systemic inflammatory markers (C‐reactive protein), adipokines (retinol‐binding protein 4, adiponectin) and cytokines have been shown to correlate in humans with adipose tissue inflammation and with obesity‐associated health risks. Circulating leucocytes constitute a diverse group of cells that form a major arm of the immune system. They are both major sources of cytokines and likely also of infiltrating adipose tissue immune cells in obesity. In the present review, we summarize currently available literature on ‘classical’ blood white cell classes and on more specific leucocyte subclasses present in the circulation in human obesity. We critically raise the possibility that leucocytes may constitute clinically available markers for the more morbidity‐associated obesity subphenotype(s), and when available, for intra‐abdominal adipose tissue inflammation.