There is no evidence for a direct angiogenic role of Twist1 in AT in response to hypoxia or for the downstream molecular targets, but it is tempting to propose that high levels of Twist1 expression may promote angiogenesis in a fast growing AT therefore contributing to healthy remodeling of AT in obesity (Figure 2B). The gene discussed is TWIST1; the disease is obesity due to melanocortin 4 receptor deficiency.