Adipokines as Possible New Predictors of Cardiovascular Diseases: A Case Control Study

Background and Aims. The secretion of several adipocytokines, such as adiponectin, retinol-binding protein 4 (RBP4), adipocyte fatty acid binding protein (aFABP), and visfatin, is altered in subjects with abdominal adiposity; these endocrine alterations could contribute to increased cardiovascular risk. The aim of the study was to assess the relationship among adiponectin, RBP4, aFABP, and visfatin, and incident cardiovascular disease. Methods and Results. A case-control study, nested within a prospective cohort, on 2945 subjects enrolled for a diabetes screening program was performed. We studied 18 patients with incident fatal or nonfatal IHD (Ischemic Heart Disease) or CVD (Cerebrovascular Disease), compared with 18 matched control subjects. Circulating adiponectin levels were significantly lower in cases of IHD with respect to controls. Circulating RBP4 levels were significantly increased in CVD and decreased in IHD with respect to controls. Circulating aFABP4 levels were significantly increased in CVD, while no difference was associated with IHD. Circulating visfatin levels were significantly lower in cases of both CVD and IHD with respect to controls, while no difference was associated with CVD. Conclusions. The present study confirms that low adiponectin is associated with increased incidents of IHD, but not CVD, and suggests, for the first time, a major effect of visfatin, aFABP, and RBP4 in the development of cardiovascular disease

The GALEX Arecibo SDSS survey: III. Evidence for the Inside-Out Formation of Galactic Disks

We analyze a sample of galaxies with stellar masses greater than $10^{10} M_{\odot}$ and with redshifts in the range $0.025<z<0.05$ for which HI mass measurements are available from the GALEX Arecibo SDSS Survey (GASS) or from the Arecibo Legacy Fast ALFA survey (ALFALFA). At a given value of $M_*$, our sample consists primarily of galaxies that are more HI-rich than average. We constructed a series of three control samples for comparison with these HI-rich galaxies. As expected, HI-rich galaxies differ strongly from galaxies of same stellar mass that are selected without regard to HI content. The majority of these differences are attributable to the fact that galaxies with more gas are bluer and more actively star-forming. In order to identify those galaxy properties that are causally connected with HI content, we compare results derived for the HI sample with those derived for galaxies matched in stellar mass, size and NUV-$r$ colour. The only photometric property that is clearly attributable to increasing HI content, is the colour gradient of the galaxy. Galaxies with larger HI fractions have bluer, more actively star-forming outer disks compared to the inner part of the galaxy. HI-rich galaxies also have larger $g$-band radii compared to $i$-band radii. Our results are consistent with the "inside-out" picture of disk galaxy formation, which has commonly served as a basis for semi-analytic models of the formation of disks in the context of Cold Dark Matter cosmologies. The lack of any intrinsic connection between HI fraction and galaxy asymmetry suggests that gas is accreted smoothly onto the outer disk.Comment: 18 pages, 20 figures. Accepted for publication in MNRAS. GASS publications and released data can be found at http://www.mpa-garching.mpg.de/GASS/index.ph

Bubbles and outflows: the novel JWST/NIRSpec view of the z=1.59 obscured quasar XID2028

Quasar feedback in the form of powerful outflows is invoked as a key mechanism to quench star formation in galaxies, although direct observational evidence is still scarce and debated. Here we present Early Release Science JWST NIRSpec IFU observations of the z=1.59 prototypical obscured quasar XID2028: this target represents a unique test case to study QSO feedback at the peak epoch of AGN-galaxy co-evolution thanks to its existing extensive multi-wavelength coverage and massive and extended outflow detected both in the ionised and molecular components. With the unprecedented sensitivity and spatial resolution of JWST, the NIRSpec dataset reveals a wealth of structures in the ionised gas kinematics and morphology previously hidden in the seeing-limited ground-based data. In particular, we find evidence of interaction between the interstellar medium of the galaxy and the QSO-driven outflow and radio jet, which is producing an expanding bubble from which the fast and extended wind detected in previous observations is emerging. The new observations confirm the complex interplay between the AGN jet/wind and the ISM of the host galaxy, highlighting the role of low luminosity radio jets in AGN feedback, and showcase the new window opened by NIRSpec on the detailed study of feedback at high redshift.Comment: 12 pages, 11 figures, submitted to A&A. Comments welcom

SIO management algorithm for patients with overweight or obesity: consensus statement of the Italian Society for Obesity (SIO)

In approaching the treatment of obesity, three major caveats, specific to this complex disease, need to be taken into consideration in order to avoid over-simplification. Firstly, obesity definition is currently based on the body mass index (BMI). However, BMI has two major limitations: it is not a measure of fat mass, and it does not convey any information on fat distribution and regional fat depots. These limitations are well known by the scientific community that is struggling to find ways to move beyond BMI in obesity classification. Secondly, for the reasons specified above, the development of comorbidities or complications, which occur in the vast majority of obese patients during the course of the disease, is not always linearly correlated with BMI. Many variables contribute to their manifestation beyond the degree of obesity: duration of disease, age, sex, fat distribution, genetic background, the degree of mechanical disability, etc. Thirdly, treatment options are now quite few. Their indications should take into account the severity of obesity together with the presence and severity of complications and age, in order to grade interventions; these varying from therapeutic lifestyle changes to bariatric surgery. In order to provide a staging system able to help clinicians in phenotyping obese patients, beyond BMI, Sharma and Kushner [1] developed the so-called EOSS (Edmonton Obesity Staging System) composed of the following five stages: 0.No apparent obesity-related risk factors (e.g., blood pressure, serum lipids, fasting glucose, etc., within normal range), no physical symptoms, no psychopathology, no functional limitations and/or impairment of well-being. 1. Presence of obesity-related subclinical risk factors (e.g., borderline hypertension, impaired fasting glucose, elevated liver enzymes, etc.), mild physical symptoms (e.g., dyspnea on moderate exertion, occasional aches and pains, fatigue, etc.), mild psychopathology, mild functional limitations, and/or mild impairment of well-being. 2.Presence of established obesity-related chronic disease (e.g., hypertension, type 2 diabetes, sleep apnea, osteoarthritis, reflux disease, polycystic ovary syndrome, anxiety disorder, etc.), moderate limitations in activities of daily living and/or well-being. 3. Established end-organ damage such as myocardial infarction, heart failure, diabetic complications, incapacitating osteoarthritis, significant psychopathology, significant functional limitations, and/or impairment of well-being. 4.Severe (potentially end-stage) disabilities from obesity-related chronic diseases, severe disabling psychopathology, severe functional limitations, and/or severe impairment of well-being. The EOSS has been validated as a system able to identify patients at increased mortality risk who therefore deserve more clinical and therapeutic attention [2]. We have taken advantage of this now well-established staging system to develop a therapeutic algorithmic chart (Fig. 1) that includes BMI, age and EOSS stages. At each intersection, a color code identifies the proposed preferred treatment option. Obviously, treatment options are not mutually exclusive, but have to be understood as additive (e.g., a patient eligible for bariatric surgery should continue to follow therapeutic lifestyle changes and, if needed, pharmacotherapy). Treatment algorithm chart that takes advantage of the EOSS (Edmonton Obesity Staging System, see text and Ref. [1]). At each intersection a color code identifies the proposed preferred treatment option. Obviously, treatment options are not mutually exclusive ... Strengths and limitations The strength of the EOSS system relies on its ability to better identify patients who are at increased risk of mortality [2]. The limitations of the EOSS system have been clearly highlighted by Sharma and Kushner in their review paper [1]. They recognize that definitions of some risk factors are subject to change. Furthermore, the EOSS system includes subjective parameters, such as psychological impact or functional performance, the assessment of which may vary among clinicians. In this regard, attention should be drawn to the vagueness of certain definitions such as mild psychopathology, anxiety disorder, significant psychopathology, and severe disabling psychopathology. In addition, the lack of any reference to eating disorders, in particular binge eating disorder, should be pointed out which since 2013 has been considered an autonomous diagnostic category by DSM-5. By integrating the EOSS system, our therapeutic algorithmic chart includes its pros and cons. In addition, a specific limitation of our chart is the lack of evidence-based data

Fit and Motivated: Outcome Predictors in Patients Starting a Program for Lifestyle Change

Background: In previous pilot studies we have demonstrated that the Treatment Motivation and Readiness Test (TRE-MORE) is capable of predicting the outcome of obesity therapy and that a higher muscle mass (MM) is associated with a greater weight loss. Purposes of the present study were: to confirm the predictive value of TRE-MORE scores and MM, using a standardized non-pharmacologic intervention for weight loss; to explore the relationship between TRE-MORE and MM; to discriminate predictors of attendance from predictors of final therapeutic success. Methods: A consecutive series of 331 patients was enrolled and addressed to a standardized treatment protocol. Results: Mean weight loss at 6 months was -5.03%. Among participants, 48.7% lost at least 5% initial body weight after 6 months and had significantly higher TRE-MORE total scores and MM. Weight loss was significantly associated with baseline MM, TRE-MORE-3, and a lower number of previous diets. Significantly lower TRE-MORE-3 scores were associated with drop-out. Conclusion: The present study confirms that therapeutic success is predicted by TRE-MORE scores and, independently from these, by estimated MM (after adjustment for BMI). TRE-MORE total score is a predictor of failure, but not of attendance, whereas drop-out patients showed a lower score only in TREMORE-3 subscale which investigates lifestyle habits