Italian network for obesity and cardiovascular disease surveillance: A pilot project

<p>Abstract</p> <p>Background</p> <p>Also in Mediterranean countries, which are considered a low risk population for cardiovascular disease (CVD), the increase in body mass index (BMI) has become a public health priority. To evaluate the feasibility of a CVD and obesity surveillance network, forty General Practitioners (GPs) were engaged to perform a screening to assess obesity, cardiovascular risk, lifestyle habits and medication use.</p> <p>Methods</p> <p>A total of 1,046 women and 1,044 men aged 35–74 years were randomly selected from GPs' lists stratifying by age decade and gender. Anthropometric and blood pressure measurements were performed by GPs using standardized methodologies. BMI was computed and categorized in normal weight (BMI 18.5–24.9 kg/m²), overweight (BMI 25.0–29.9 kg/m²) and obese (BMI ≥ 30 kg/m²). Food frequency (per day: fruits and vegetables; per week: meat, cheese, fish, pulses, chocolate, fried food, sweet, wholemeal food, rotisserie food and sugar drink) and physical activity (at work and during leisure time) were investigated through a questionnaire. CVD risk was assessed using the Italian CUORE Project risk function.</p> <p>Results</p> <p>The percentage of missing values was very low. Prevalence of overweight was 34% in women and 50% in men; prevalence of obesity was 23% in both men and women. Level of physical activity was mostly low or very low. BMI was inversely associated with consumption of pulses, rotisserie food, chocolate, sweets and physical activity during leisure time and directly associated with consumption of meat. Mean value of total cardiovascular risk was 4% in women and 11% in men. One percent of women and 16% of men were at high cardiovascular risk (≥ 20% in 10 years). Normal weight persons were four times more likely to be at low risk than obese persons.</p> <p>Conclusion</p> <p>This study demonstrated the feasibility of a surveillance network of GPs in Italy focusing on obesity and other CVD risk factors. It also provided information on lifestyle habits, such as diet and physical activity.</p

Identification of the molecular events underlying liver stem cell choices at the branch of epithelial/mesenchymal differentiation

Beside the many promises and expectation, as yet current therapeutic applications of tissue engineering and regenerative medicine are restricted to a limited number of epithelial tissues (i.e. skin, cornea and heart valve) [1] where both 3D structure and instructive signals arising from cellular interplay show a low level of complexity. Regarding the liver, the challenge of the use of tissue engineering for the treatment of acute and chronic hepatic failure is still far from won; the organ, in fact, is composed by several histotypes that guarantee liver functions only when they correctly set up cell-cell interactions in the complex anatomical architecture of the hepatic lobule. Moreover, local micro-environmental elements, such as growth factors and both stiffness and composition of the extracellular matrix (ECM), provide important cues to determine cell fate. Particularly, mechanical properties of the ECM play a pivotal role in the regulation of many important cell processes that, eventually, decide cell fate and function. Here, we present experimental data obtained with the use of a new cellular tool constituted by resident liver stem cells (RLSCs), derived from murine livers and established in lines [2]. These cells display a metastable phenotype, as underlined by i) the co-expression of epithelial and mesenchymal markers and ii) the ability to differentiate toward two mutually exclusive epithelial or mesenchymal derivatives: hepatocytes and hepatic stellate cells (HSCs). These progenitor cells, indeed, when transplanted in healthy growing livers (i.e. in murine newborns 1-2 days old) were found to contribute to the liver tissue with both hepatocytes and HSCs properly integrated in the hepatic architecture. Heterotopic transplantations, while confirm the dual differentiation potentiality of RLSCs, indicate as tissue local cues are necessary to drive a full hepatic differentiation [3]. One of the local elements mainly influencing the liver cell function is the elasticity/stiffness of the ECM. Liver tissue in physiological condition displays a liver stiffness (LS) lower than 6 KPa. LS increases during progression of liver fibrosis, a pathological state shared by several liver diseases and characterized by proliferation of collagen producing cells [4]. Our results showed that mechanical stimuli drive RLSCs differentiation choices within 24 hours: soft matrix (0,4 KPa) selectively induces epithelial differentiation while stiff matrix (80 KPa) induces mesenchymal differentiation. We are currently characterizing, in this dynamic cellular model, the epigenetic events that anticipate liver-specific gene expression, focusing in particular on the promoter region of HNF4alpha, a transcriptional master regulator of hepatic differentiation. Our data would disclose new insight into the early events driving pivotal cellular choices at the branch of epithelial/mesenchymal differentiation