{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,27]],"date-time":"2026-10-27T07:57:23Z","timestamp":1793087843120,"version":"4.5.0"},"reference-count":33,"publisher":"Oxford University Press (OUP)","issue":"2","license":[{"start":{"date-parts":[[2026,1,19]],"date-time":"2026-01-19T00:00:00Z","timestamp":1768780800000},"content-version":"vor","delay-in-days":2539,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2019,2,6]],"date-time":"2019-02-06T00:00:00Z","timestamp":1549411200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2019,4,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>Left ventricular diastolic dysfunction (LVDD) is common in obese subjects, and a relationship between epicardial adipose tissue (EAT), increased adipocytokines, and cardiovascular diseases has been reported. This study sought to examine as to whether the adipo-fibrokine activin A is a link between increased EAT, the metabolic syndrome (MetS), and LVDD in severely obese subjects.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods and results<\/jats:title>\n                    <jats:p>In 236 obese subjects (\u00f8 body mass index 39.8 \u00b1 7.9 kg\/m2) with a variable degree of the MetS and in 60 healthy non-obese controls (\u00f8 body mass index 24.8 \u00b1 3.4 kg\/m2), serum activin A levels were measured and correlated with parameters of the MetS, epicardial fat thickness (EFT), and echocardiographic parameters of LVDD. Activin A levels were higher in obese than in non-obese subjects (362 \u00b1 124 vs. 301 \u00b1 94 pg\/mL, P = 0.0004), increased with the number of MetS components (from 285 \u00b1 82 with no MetS component, 323 \u00b1 94 with one or two MetS components, to 403 \u00b1 131 pg\/mL with \u22653 MetS components, P &amp;lt; 0.0001) and correlated with EFT (r = 0.41, P &amp;lt; 0.001). Furthermore, activin A levels were related to several parameters of LVDD [e.g. left atrial size (382 \u00b1 117 vs. 352 125 pg\/mL, P = 0.024), E\/e\u2032 (394 \u00b1 108 vs. 356 \u00b1 127 pg\/mL, P = 0.005)]. LVDD was highest in MetS obese subjects with high EFT (44.3%) compared with MetS obese subjects with low EFT (27.0%), non-MetS obese subjects with high EFT (24.2%), and non-MetS obese subjects with low EFT (10.6%, P &amp;lt; 0.0001).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>In severe obesity, activin A was significantly related to EFT, MetS, and LVDD, implicating MetS-related alterations in the secretory profile of EAT in the pathogenesis of obesity-related heart disease.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/ehf2.12409","type":"journal-article","created":{"date-parts":[[2019,2,7]],"date-time":"2019-02-07T00:11:11Z","timestamp":1549498271000},"page":"362-370","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":26,"title":["The Adipo-Fibrokine Activin A is Associated with Metabolic 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