Aim — the objective of the present study was the detection and identification of predictors of fatty degeneration of the liver in the female patients presenting with abdominal-type obesity (AO) considered to be metabolically “healthy” based on the results of the clinical examination, laboratory analyses, and instrumental studies. Material and methods. The study included 108 apparently clinically healthy subjects at the age ranging from 18 to 68 years. Based on the results of laboratory and instrumental studies, they were divided into two groups. Group 1 was comprised of 23 women with metabolically «healthy» obesity, group 2 contained 83 patients presenting with metabolically “unhealthy” abdominal obesity. The patients exhibiting the clinical signs of hepatic pathology, manifestations of hypertensive disease, and/or decompensated atherosclerosis were excluded from the study. Results. The criteria of the National clinical guidelines on diagnostics of metabolic syndrome (Russia, 2013) provide an efficient tool for the pre-nosological diagnostics and evaluation of the functional stress limit in the patients presenting with metabolically «healthy» abdominal obesity (AUC=0,971). Despite the fact that metabolically «healthy» abdominal obesity is characterized by the absence of the well apparent clinical picture and/or the pronounced alteration of the laboratory findings in comparison with the respective reference values, these patients are characterized by the moderately severe picture of fatty degeneration of the liver. The calculated parameters provide a higher accuracy of the evaluation of insulin resistance than the results of measurements of fasting glucose and insulin levels. The use of the waist circumference (WC) for the assessment of the metabolic health has demonstrated the gender-specific differences in the accuracy of the model being used (AUCотmale =0,85, AUCотfemale =0,65) which suggests the necessity of the search for the new markers of the cardiovascular risk. Conclusion. The results obtained in this study give evidence of the advantages of the laboratory investigations for the patients with abdominal obesity over the anthropometric characteristics. It is concluded that the routine examination of the patients presenting with obesity of the abdominal type (even those having the metabolically «healthy» phenotype) should be supplemented by additional studies.