Relevance. Oxidative stress, resulting from an imbalance between ROS production and the antioxidant defense system, is a major disruption of chronic inflammation in OA and obesity. It should be noted that the study and understanding of OS and their relationship with the identification of joint tissues is necessary to develop new therapeutic approaches to the occurrence and expediency of the metabolic phenotype of OA. Aim. To study protein oxidative modification (OMP) and reserve-adaptive potential in patients with the metabolic phenotype of osteoarthritis (OA). Material and methods. Participants were divided into 2 groups: Control group - patients without articular pathology, metabolic syndrome. The exper-imental group consisted of patients with the metabolic phenotype of OA. The subjects were collected complaints and anamnesis, as well as general clinical and orthopedic examination. In the blood serum, indicators of OMP and superoxidedismutase (SOD) were determined. Patients were asked to answer the questions of clinical scales of the functional state of the joints and quality of life. Results. The initial activity of blood serum SOD was somewhat lower in patients with the metabolic phenotype of OA, and the level of OMP showed certain differences in the levels of activity of the processes of spontaneous and metal-catalyzed PMB. The total area under the spontaneous OMP curve was statistically significantly higher (p 0,01), mainly due to the neutral fraction of aldehyde dinitrophenyl hydrozones (ADNFH). The level of reserve-adaptive potential was statistically significantly lower than the control group. An inverse correlation was found between the total area, the area of ADNFH of metal-catalyzed OMP and the level of pain, which indicates higher levels of oxidative stress in patients with severe clinical symptoms. Сonclusion. In patients with pronounced indicators of clinical manifestations of OA, more active processes of redox changes were observed. There was a decrease in the activity of antioxidant activity and the level of reserve-adaptive potential