Objective:The study aims to investigate the different proportions of immune cells in visceral adipose tissue(VAT)among lean group,metabolically healthy obesity(MHO)group and metabolically unhealthy obesity(MUO)group. Methods:Samples of VAT came from 48 obese patients who received metabolic surgeries and 11 other patients who had non-inflammatory disease(such as hernia, cholecystolithiasis and renal cyst)and received laparoscopic surgery at the First Affiliated Hospital of Nanjing Medical University. After extracting RNA from VAT,we applied RNA-seq technology to count and analyze proportions of immune cells and differentially expressed genes in VAT among three groups. One - way ANOVA and Pearson correlation analysis were used for statistical analysis. Results:The proportion of regulatory T cells,natural killer cells,M0 macrophages,and M2 macrophages varied among three groups(P= 0.031;P=0.002;P=0.004;P=0.024). In MUO group,the proportion of M2 macrophages decreased compared with other two groups(P= 0.014). SPP1,CHIT1,ITGAX,CD300LB,IL1RN,DCSTAMP and some other genes had positive correlation with the proportion of M0 and M1 macrophages in two obese groups,but had negative correlation with the proportion of M2 macrophages. C5AR1 and GPR183 had positive correlation with the proportion of M0 and M1 macrophages in MHO group and had negative correlations with the proportion of M2 macrophages. However,the correlation between these two genes and macrophages is opposite in MUO group compared with MHO group. Conclusion:Compared with lean group,the infiltration status of immune cells in VAT is more severe in MHO and MUO group. Comparing between MHO and MUO group,the proportion of M1 macrophages in VAT lifted,indicating that higher level of inflammation in vivo connects with impaired metabolic ability. The differently expressed gene C5AR1 and GPR183 between two obese groups may play a role in predicting alterations in metabolic ability.