The "ON-OFF" Switching Response of Reactive Oxygen Species in Acute Normobaric Hypoxia: Preliminary Outcome.

Exposure to acute normobaric hypoxia (NH) elicits reactive oxygen species (ROS) accumulation, whose production kinetics and oxidative damage were here investigated. Nine subjects were monitored while breathing an NH mixture (0.125 FIO2 in air, about 4100 m) and during recovery with room air. ROS production was assessed by Electron Paramagnetic Resonance in capillary blood. Total antioxidant capacity, lipid peroxidation (TBARS and 8-iso-PFG2α), protein oxidation (PC) and DNA oxidation (8-OH-dG) were measured in plasma and/or urine. The ROS production rate (µmol·min-1) was monitored (5, 15, 30, 60, 120, 240 and 300 min). A production peak (+50%) was reached at 4 h. The on-transient kinetics, exponentially fitted (t1/2 = 30 min r2 = 0.995), were ascribable to the low O2 tension transition and the mirror-like related SpO2 decrease: 15 min: -12%; 60 min: -18%. The exposure did not seem to affect the prooxidant/antioxidant balance. Significant increases in PC (+88%) and 8-OH-dG (+67%) at 4 h in TBARS (+33%) one hour after hypoxia offset were also observed. General malaise was described by most of the subjects. Under acute NH, ROS production and oxidative damage resulted in time and SpO2-dependent reversible phenomena. The experimental model could be suitable for evaluating the acclimatation level, a key element in the context of mountain rescues in relation to technical/medical workers who have not had enough time for acclimatization-as, for example, during helicopter flights.

Variation of skeletal muscle ultrasound imaging intensity in horses after treadmill exercise: a proof of concept for glycogen content estimation.

BACKGROUND: Glycogen in skeletal muscle is a major source of energy during exercise and an important determinant of endurance capacity, so that its measurement may provide a meaningful marker of athletes' preparation and a possible predictor of performance, both in humans and in equines. Gold standard of glycogen concentration measurement is the histochemical and biochemical analysis of biopsy-derived muscle tissue, an invasive and potentially injuring procedure. Recently, high-frequency ultrasound (US) technology is being exploited in human sports medicine to estimate muscle glycogen content. Therefore, aim of the present study is to evaluate the feasibility of US assessment of muscle glycogen in equines. RESULTS: US images of gluteus medius (GL) and semitendinosus (ST) muscles were obtained on eight healthy horses (3-10 years) before and after a steady-state exercise on treadmill (velocity: 4.0-12.5 m/s; duration: 2-20 min; heart rate: 137-218 b/min). Average image greyscale intensity was significantly different between GL and ST, both before and after exercise (p < 0.001). Comparing baseline and post-exercise US images, significant increase in greyscale intensity has been observed in ST (p < 0.001), but not in GL (p = 0.129). The volume of the exercise was significantly correlated with exercise-dependent change in image intensity (R2 = 0.891), consistent with a reduction of glycogen muscle stores resulting from aerobic activity. CONCLUSIONS: US technique evidences also in horses muscle changes possibly associated to glycogen utilisation during exercise. Present results on a small sample need to be further confirmed and provide preliminary data warranting future validation by direct glycogen measurement through biopsy technique.

Sedentary Behaviors and Physical Activity Habits Independently Affect Fat Oxidation in Fasting Conditions and Capillary Glucose Levels After Standardized Glucose-Rich Meal in Healthy Females.

PURPOSE: Sedentary behaviors and muscle inactivity are being growingly recognized as important risk factors for health, adjunctively and independently from a scarce physical activity (PA), although the metabolic mechanism underneath is barely clear. To explore the relation between sedentary behaviors (SBs) and metabolism, we measured the metabolic profile in fasting condition and after oral glucose overload in a group of women, along with objective monitoring of their PA/sedentary lifestyle habits. SUBJECTS AND METHODS: Thirteen women (age: 32.5 ± 16.1 years; BMI: 24.0 ± 3.3 kg/m2), recruited among university students and research staff, underwent indirect calorimetry to assess fat and carbohydrate contribution to energy metabolism, in fasting conditions and after a glucose-rich standard meal (about 45 g of glucose). Glucose concentration in capillary blood was determined in fasting state and 15 and 30 min after meal. Habitual PA and SBs in the previous week were continuously monitored with Actigraph accelerometers. RESULTS: After adjustment for age, the contribution of fat oxidation to metabolic energy sources, normalized for fat-free mass, in fasting conditions was significantly correlated with time spent in sitting/lying position during wake hours (p < 0.001), independent from PA habits, whereas capillary blood peak and change of glucose concentration after the meal were significantly and inversely correlated with average daily moderate to vigorous PA (p = 0.025 and p = 0.019, respectively), independent from average daily sitting/lying time. CONCLUSIONS: Here, we report for the first time a direct effect of muscle inactivity on increased fat oxidation in fasting conditions, which can be hypothesized as a preliminary condition for the development of insulin resistance. We also report the direct independent effect of PA on the capacity to respond to a glycemic load, so that SBs and reduced PA appear to concur, although independently, to the increased health risk, as elsewhere observed on an epidemiological ground.

A Mobile Phone Intervention to Improve Obesity-Related Health Behaviors of Adolescents Across Europe: Iterative Co-Design and Feasibility Study.

BACKGROUND: Promotion of physical activity, healthy eating, adequate sleep, and reduced sedentary behavior in adolescents is a major priority globally given the current increase in population health challenges of noncommunicable diseases and risk factors such as obesity. Adolescents are highly engaged with mobile technology, but the challenge is to engage them with mobile health (mHealth) technology. Recent innovations in mobile technology provide opportunities to promote a healthy lifestyle in adolescents. An increasingly utilized approach to facilitate increased engagement with mHealth technology is to involve potential users in the creation of the technology. OBJECTIVE: This study aimed to describe the process of and findings from co-designing and prototyping components of the PEGASO Fit for Future (F4F) mHealth intervention for adolescents from different cultural backgrounds. METHODS: A total of 74 adolescents aged 13 to 16 years from Spain, Italy, and the United Kingdom participated in the co-design of the PEGASO F4F technology. In 3 iterative cycles over 12 months, participants were involved in the co-design, refinement, and feasibility testing of a system consisting of diverse mobile apps with a variety of functions and facilities to encourage healthy weight-promoting behaviors. In the first iteration, participants attended a single workshop session and were presented with mock-ups or early-version prototypes of different apps for user requirements assessment and review. During the second iteration, prototypes of all apps were tested by participants for 1 week at home or school. In the third iteration, further developed prototypes were tested for 2 weeks. Participants' user experience feedback and development ideas were collected through focus groups and completion of questionnaires. RESULTS: For the PEGASO F4F technology to be motivating and engaging, participants suggested that it should (1) allow personalization of the interface, (2) have age-appropriate and easy-to-understand language (of icons, labels, instructions, and notifications), (3) provide easily accessible tutorials on how to use the app or navigate through a game, (4) present a clear purpose and end goal, (5) have an appealing and self-explanatory reward system, (6) offer variation in gamified activities within apps and the serious game, and (7) allow to seek peer support and connect with peers for competitive activities within the technology. CONCLUSIONS: Incorporating adolescents' preferences, the PEGASO F4F technology combines the functions of a self-monitoring, entertainment, advisory, and social support tool. This was the first study demonstrating that it is possible to develop a complex mobile phone-based technological system applying the principles of co-design to mHealth technology with adolescents across 3 countries. The findings from this study informed the development of an mHealth system for healthy weight promotion to be tested in a controlled multinational pilot trial.

Promoting healthy teenage behaviour across three European countries through the use of a novel smartphone technology platform, PEGASO fit for future: study protocol of a quasi-experimental, controlled, multi-Centre trial.

BACKGROUND: Behaviour change interventions targeting physical activity, diet, sleep and sedentary behaviour of teenagers show promise when delivered through smartphones. However, to date there is no evidence of effectiveness of multicomponent smartphone-based interventions. Utilising a user-centred design approach, we developed a theory-based, multi-dimensional system, PEGASO Fit For Future (PEGASO F4F), which exploits sophisticated game mechanics involving smartphone applications, a smartphone game and activity sensors to motivate teenagers to take an active role in adopting and maintaining a healthy lifestyle. This paper describes the study protocol to assess the feasibility, usability and effectiveness (knowledge/awareness and behavioural change in lifestyle) of the PEGASO system. METHODS: We are conducting a quasi-experimental controlled cluster trial in 4 sites in Spain, Italy, and UK (England, Scotland) over 6 months. We plan to recruit 525, in a 2:1 basis, teenagers aged 13-16 years from secondary schools. The intervention group is provided with the PEGASO system whereas the comparison group continues their usual educational routine. Outcomes include feasibility, acceptance, and usability of the PEGASO system as well as between and within group changes in motivation, self-reported diet, physical activity, sedentary and sleeping behaviour, anthropometric measures and knowledge about a healthy lifestyle. DISCUSSION: PEGASO F4F will provide evidence into the cross-cultural similarities and differences in the feasibility, acceptability and usability of a multi-dimensional smartphone based behaviour change intervention for teenagers. The study will explore facilitating factors, challenges and barriers of engaging teenagers to adapt and maintain a healthy lifestyle when using smartphone technology. Positive results from this ICT based multi component intervention may have significant implications both at clinical level, improving teenagers health and at public health level since it can present an influential tool against the development of chronic disease during adulthood. TRIAL REGISTRATION: https://clinicaltrials.gov Registration number: NCT02930148, registered 4 October 2016.

Influence of the Size of the Field of View on Visual Perception While Running in a Treadmill-Mediated Virtual Environment.

We investigated how the size of the horizontal field of view (FoV) affects visual speed perception with individuals running on a treadmill. Twelve moderately trained to trained participants ran on a treadmill at two different speeds (8 and 12 km/h) in front of a moving virtual scene. Different masks were used to manipulate the visible visual field, masking either the central or the peripheral area of the virtual scene or showing the full visual field. We asked participants to match the visual speed of the scene to their actual running speed. For each trial, participants indicated whether the scene was moving faster or slower than they were running. Visual speed was adjusted according to the responses using a staircase method until the Point of Subjective Equality was reached, that is until visual and running speed were perceived as matching. For both speeds and all FoV conditions, participants underestimated visual speed relative to the actual running speed. However, this underestimation was significant only when the peripheral FoV was masked. These results confirm that the size of the FoV should absolutely be taken into account for the design of treadmill-mediated virtual environments (VEs).

Regular physical activity modulates perceived visual speed when running in treadmill-mediated virtual environments.

In virtual reality, visual speed is usually underestimated relative to locomotor speed. Here we investigated how physical activity and fitness affect perceived visual speed when running in a treadmill-mediated virtual environment. Thirty healthy participants (ten sedentary individuals, ten team sport players and ten expert runners) ran on a treadmill at two different speeds (8, 12km/h) in front of a moving virtual scene. Participants were asked to match the speed of the visual scene to their running speed (i.e. treadmill speed), indicating for each trial whether the scene was moving slower or faster than the treadmill. The speed of the visual scene was adjusted according to the participant's response using a staircase until visual and running speeds were perceived as equivalent. More sedentary participants underestimated visual speed relative to their actual running speed. Specifically, visual speed had to exceed running speed to be perceived as equivalent. The underestimation of visual speed was speed-dependent, and it was significantly larger for sedentary participants than for team sports players and expert runners. The volume of physical activity per week was found to be the best predictor of visual speed perception for both running speeds, while the perceived effort constituted a good predictor only at 8km/h. Physical fitness, on the other hand turned out to be a poor predictor of visual speed perception. Therefore, in order to enhance users' engagement and their adherence to physical activity programs, the development of "personalized" treadmill-mediated virtual environments should take into account users' personal characteristics to provide the most natural and engaging feedback possible.

Evaluation of the Tinetti score and fall risk assessment via accelerometry-based movement analysis.

Gait and balance disorders are among the main predisposing factors of falls in elderly. Clinical scales are widely employed to assess the risk of falling, but they require trained personnel. We investigate the use of objective measures obtained from a wearable accelerometer to evaluate the fall risk, determined by the Tinetti clinical scale. Seventy-nine patients and eleven volunteers were enrolled in two rehabilitation centers and underwent a full Tinetti test, while wearing a triaxial accelerometer at the chest. Tinetti scores were assessed by expert physicians and those subjects with a score ≤18 were considered at high risk. First, we analyzed 21 accelerometer features by means of statistical tests and correlation analysis. Second, one regression and one classification problem were designed and solved using a linear model (LM) and an artificial neural network (ANN) to predict the Tinetti outcome. Pearson's correlation between the Tinetti score and a subset of 9 features (mainly related with standing and walking) was 0.71. The misclassification error of high risk patient was 0.21 and 0.11, for LM and ANN, respectively. The work might foster the development of a new generation of applications meant to monitor the time evolution of the fall risk using low cost devices at home.

Matching optical flow to motor speed in virtual reality while running on a treadmill.

We investigated how visual and kinaesthetic/efferent information is integrated for speed perception in running. Twelve moderately trained to trained subjects ran on a treadmill at three different speeds (8, 10, 12 km/h) in front of a moving virtual scene. They were asked to match the visual speed of the scene to their running speed-i.e., treadmill's speed. For each trial, participants indicated whether the scene was moving slower or faster than they were running. Visual speed was adjusted according to their response using a staircase until the Point of Subjective Equality (PSE) was reached, i.e., until visual and running speed were perceived as equivalent. For all three running speeds, participants systematically underestimated the visual speed relative to their actual running speed. Indeed, the speed of the visual scene had to exceed the actual running speed in order to be perceived as equivalent to the treadmill speed. The underestimation of visual speed was speed-dependent, and percentage of underestimation relative to running speed ranged from 15% at 8km/h to 31% at 12km/h. We suggest that this fact should be taken into consideration to improve the design of attractive treadmill-mediated virtual environments enhancing engagement into physical activity for healthier lifestyles and disease prevention and care.

Development and validation of new predictive equation for resting energy expenditure in adults with overweight and obesity.

BACKGROUND & AIMS: Accurate predictive equations of resting energy expenditure (REE) are crucial in devising nutritional strategies to manage overweight/obesity, especially in countries where these are highly prevalent. REE is the most common measurement used to estimate energy requirements in the nutritional context; the most accurate method of measuring REE is indirect calorimetry (IC). However, this method is costly and often rarely feasible in many clinical settings. The objective of the present study was to develop and validate a new equation for predicting REE in adults with overweight and obesity. METHODS: This was a cross-sectional study including 410 men and women with overweight and obesity (20-60 y). Participants were randomly assigned; the development group included 200 subjects and the validation group 210 subjects. The new predictive equation was derived using stepwise multiple linear regression analysis. The accuracy of the new equation was compared to several existing predictive equations (PEs). The accuracy rate was calculated as the percentage of subjects whose REE-PE was within ±10% of the REE-IC. REE was measured by IC and anthropometric measurements. RESULTS: One predictive equation was developed (NEQ) in which weight was the strongest predictor of REE. Compared with others predicted equations already using, the new designed equation showed the less mean bias (Kj/day): NEQ: 25.7, Valencia:129, WHO/FAO/United Nations University: 270, Mifflin-St Jeor: 308, Owen: -808, Carrasco: -1097, Korth: -36.4, Johnstone: -375, Livingstone: -315, De Lorenzo: -28.3, Lazzer: -123, Muller: -145, Huang: -399 and Bernstein: -1335. CONCLUSIONS: The present equation had the highest predictive accuracy in subjects with overweight or obesity compared with the previous equations derived from different populations. Thus, these new equation can be used to assist the nutritional management of these subjects.

Clinical, functional, behavioural and epigenomic biomarkers of obesity.

Overweight and obesity are highly prevalent conditions worldwide, linked to an increased risk for death, disability and disease due to metabolic and biochemical abnormalities affecting the biological human system throughout different domains. Biomarkers, defined as indicators of biological processes in health and disease, relevant for body mass excess management have been identified according to different criteria, including anthropometric and molecular indexes, as well as physiological and behavioural aspects. Analysing these different biomarkers, we identified their potential role in diagnosis, prognosis and treatment. Epigenetic biomarkers, cellular mediators of inflammation and factors related to microbiota-host interactions may be considered to have a theranostic value. Though, the molecular processes responsible for the biological phenomenology detected by the other analysed markers, is not clear yet. Nevertheless, these biomarkers possess valuable diagnostic and prognostic power. A new frontier for theranostic biomarkers can be foreseen in the exploitation of parameters defining behaviours and lifestyles linked to the risk of obesity, capable to describe the effects of interventions for obesity prevention and treatment which include also behaviour change strategies.

Automatic muscle and fat segmentation in the thigh from T1-Weighted MRI.

PURPOSE: To introduce and validate an automatic segmentation method for the discrimination of skeletal muscle (SM), and adipose tissue (AT) components (subcutaneous adipose tissue [SAT] and intermuscular adipose tissue [IMAT]) from T1-weighted (T1 -W) magnetic resonance imaging (MRI) images of the thigh. MATERIALS AND METHODS: Eighteen subjects underwent an MRI examination on a 1.5T Philips Achieva scanner. Acquisition was performed using a T1 -W sequence (TR = 550 msec, TE = 15 msec), pixel size between 0.81-1.28 mm, slice thickness of 6 mm. Bone, AT, and SM were discriminated using a fuzzy c-mean algorithm and morphologic operators. The muscle fascia that separates SAT from IMAT was detected by integrating a morphological-based segmentation with an active contour Snake. The method was validated on five young normal weight, five older normal weight, and five older obese females, comparing automatic with manual segmentations. RESULTS: We reported good performance in the extraction of SM, AT, and bone in each subject typology (mean sensitivity above 96%, mean relative area difference of 1.8%, 2.7%, and 2.5%, respectively). A mean distance between contours pairs of 0.81 mm and a mean percentage of contour points with distance smaller than 2 pixels of 86.2% were obtained in the muscle fascia identification. Significant correlation was also found between manual and automatic IMAT and SAT cross-sectional areas in all subject typologies (p < 0.001). CONCLUSION: The proposed automatic segmentation approach provides adequate thigh tissue segmentation and may be helpful in studies of regional composition.

Automatic vs. clinical assessment of fall risk in older individuals: A proof of concept.

Falling in elderly is a worldwide major problem because it can lead to severe injuries, and even sudden death. Fall risk prediction would provide rapid intervention, as well as reducing the over burden of healthcare systems. Such prediction is currently performed by means of clinical scales. Among them, the Tinetti Scale is one of the better established and mostly used in clinical practice. In this work, we proposed an automatic method to assess the Tinetti scores using a wearable accelerometer. The balance and gait characteristics of 13 elderly subjects have been scored by an expert clinician while performing 8 different motor tasks according to the Tinetti Scale protocol. Two statistical analysis were selected. First, a linear regression study was performed between the Tinetti scores and 8 features (one feature for each task). Second, the generalization quality of the regression model was assessed using a Leave-One SubjectOut approach. The multiple linear regression provided a high correlation between the Tinetti scores and the features proposed (adj. R(2) = 0.948; p = 0.003). Moreover, six of the eight features added statistically significantly to the prediction of the scores (p <; 0.05). When testing the generalization capability of the model, a moderate linear correlation was obtained (R(2) = 0.67; p <; 0.05). The results suggested that the automatic method might be a promising tool to assess the falling risk of older individuals.

PEGASO: A Personalised and Motivational ICT System to Empower Adolescents Towards Healthy Lifestyles.

Unhealthy alimentary behaviours and physical inactivity habits are key risk factors for major non communicable diseases. Several researches demonstrate that juvenile obesity can lead to serious medical conditions, pathologies and have important psycho-social consequences. PEGASO is a multidisciplinary project aimed at promoting healthy lifestyles among teenagers through assistive technology. The core of this project is represented by the ICT system, which allows providing tailored interventions to the users through their smartphones in order to motivate them. The novelty of this approach consists of developing a Virtual Individual Model (VIM) for user characterization, which is based on physical, functional and behavioural parameters opportunely selected by experts. These parameters are digitised and updated thanks to the user monitoring through smartphone; data mining algorithms are applied for the detection of activity and nutrition habits and this information is used to provide personalised feedback. The user interface will be developed using gamified approaches and integrating serious games to effectively promote health literacy and facilitate behaviour change.

Skeletal muscle characteristics and motor performance after 2-year growth hormone treatment in adults with prader-willi syndrome.

CONTEXT: In adults with Prader-Willi syndrome (PWS), abnormal body composition with decreased lean body mass and skeletal muscle (SM) volume has been related to altered GH secretion and may possibly contribute to greatly reduced motor capacity. OBJECTIVE: The scope of the study was to test the hypothesis that GH treatment has favorable effects on SM characteristics and motor performance in adults with PWS. DESIGN, SETTING, AND PARTICIPANTS: Fifteen obese PWS subjects (nine males and six females; age range, 19-35 y; body mass index, 37.7-59.9 kg/m(2)) were investigated before and after 12 (GH12) and 24 (GH24) months of GH treatment. MAIN OUTCOME MEASURES: SM cross-sectional area and SM attenuation were determined with computed tomography at the lumbar and midthigh levels. Maximal isometric handgrip strength and isokinetic knee extension peak torque were measured. Motor performance was evaluated with different indoor walking tests, whereas exercise endurance was assessed with a treadmill incremental test to exhaustion. RESULTS: A condition of severe GH deficiency was found in six patients (40%). GH treatment significantly increased lean body mass (GH12, P < .05; GH24, P < .05), reduced percentage of body fat (GH12, P < .05; GH24, P < .05), and augmented SM cross-sectional area and SM attenuation of both lumbar (GH12, P < .01; GH24, P < .001) and thigh muscles (GH24, P < .05). Handgrip strength increased by 7% at GH12 (P < .05) and by 13% at GH24 (P < .001). Peak torque of knee extension extrapolated at zero angular velocity was significantly higher at GH24 (P < .01), and exercise endurance rose by 13% (P < .05) and 17% (P < .05) before exhaustion at GH12 and GH24, respectively, whereas no change was detected with walking tests. No significant difference in the response to GH treatment was detected between patients with and without GH deficiency. CONCLUSION: Long-term GH treatment in adult PWS patients improves body composition and muscle size and quality and increases muscle strength and exercise tolerance independently from the GH secretory status.

Influence of body adiposity on structural characteristics of skeletal muscle in men and women.

The structure of skeletal muscle (SM) can be characterized by quantitative (size) and qualitative (composition) attributes, which are disparately reported to be influenced by body adiposity. This study tests the hypothesis that body adiposity exerts a systematic influence on these muscle characteristics and evaluates the possible functional implications for movements. Lower limb SM volume (VSM) and attenuation (ATTSM), an inverse measure of lipid infiltration in muscle, were determined with computed tomography in 21 men (BMI = 21-36 kg m(-2) ; age = 31-71 years.) and 18 women (BMI = 19-35 kg m(-2) ; age = 32-76 years.). After adjusting for age, a multivariate regression analysis revealed that body adiposity positively correlated (P<0·05-0·001) with absolute VSM and cross-sectional area (CSA) in both genders, while VSM per unit body mass (VSM/BM) decreased with adiposity (P<0·001) in women and was constant in men. ATTSM was higher in men (P<0·05) and decreased (P<0·05) with adiposity in both genders. The product of ATTSM by average muscle CSA (predictor of maximal strength) and by VSM/BM (predictor of maximal dynamic performance) was lower in women (P<0·001) and was reduced by age in both genders (P<0·05-0·01), while obesity had a negative effect (P<0·001) only on the predictor of performance. In conclusion, body adiposity significantly increases SM size and reduces ATTSM. Structural indicators accounting for both quantitative and qualitative characteristics of SM may be useful predictors of the effects of obesity on motor function at different ages. With rising body adiposity and advancing age, women appear mostly affected by the decline of SM features relevant for motor performance.

Ontology-supported clinical profiling for the evaluation of obesity and related comorbidities.

An ontology-supported e-knowledge base aimed to the evaluation of obesity and related co-morbidities is presented. The main goal of such a clinical profiling tool is to help determine the health status of a subject, supporting the knowledge transfer between medical researchers and general practitioners.

Prevalence of the metabolic syndrome and its components among obese men and women in Italy.

OBJECTIVE: Assessment of the prevalence of the metabolic syndrome (MetS) and its components in Italian obese individuals. METHODS: Cross-sectional estimate of MetS prevalence using the IDF definition in 635 obese (BMI ≥ 35 kg/m(2)) individuals (286 men, 349 women) aged 19-78 years hospitalised for mass excess treatment. RESULTS: MetS prevalence was significantly (p < 0.001) higher in males (75.9%) than in females (61.9%), due to the increased prevalence of 4/5 involved abnormalities. A multivariate binary logistic regression analysis disclosed a contributory independent effect of ageing (p < 0.01-0.001), but not of BMI, whereas large waist circumference (p < 0.01) and high waist-to-hip ratio (p < 0.01) contributed to MetS prevalence only in women. Affected individuals were significantly older (males p = 0.022; females p < 0.001), affected men being younger than affected women (p < 0.01). The prevailing clinical picture included all abnormalities (21.2% in men, 22.2% in women); in minimal trait MetS (3/5 abnormalities), the prevailing combination was, beside central obesity, hypertension-hyperglycaemia in men (12.4%), and hypertension-dyslipidemia in women (19.4%). CONCLUSIONS: MetS is a highly prevalent condition among Italian obese individuals. Prevalence and combinations of involved abnormalities differ considerably between genders and suggest a different pathophysiology of the MetS in men and women, with possible relevance for prevention and treatment of the condition.