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Petersson M, Höybye C. Is Oxytocin a Contributor to Behavioral and Metabolic Features in Prader-Willi Syndrome? Curr Issues Mol Biol 2024; 46:8767-8779. [PMID: 39194735 DOI: 10.3390/cimb46080518] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2024] [Revised: 08/05/2024] [Accepted: 08/10/2024] [Indexed: 08/29/2024] Open
Abstract
Prader-Willi Syndrome (PWS) is a rare genetic disorder typically characterized by decreased social interaction, hyperphagia, poor behavioral control and temper tantrums, together with a high risk of morbid obesity unless food intake is controlled. The genetic defects that cause PWS include paternal 15q deletion (estimated in 60% of cases), chromosome 15 maternal uniparental disomy (UPD) (estimated in 35% of cases) and imprinting defects and translocations. Several studies indicate an oxytocin deficiency in PWS. Oxytocin is a hypothalamic nonapeptide with receptors located in the brain and in various other tissues in the body. It acts as a neuropeptide in several brain areas of great importance for behavioral and metabolic effects, as well as a neurohypophyseal hormone released into the circulation. Oxytocin in both rats and humans has strong and long-lasting behavioral and metabolic effects. Thus, an oxytocin deficiency might be involved in several of the behavioral and metabolic symptoms characterizing PWS. Treatment with oxytocin has, in some studies, shown improvement in psycho-social behavior and hyperphagia in individuals with PWS. This review focus on the behavioral and metabolic effects of oxytocin, the symptoms of a potential oxytocin deficiency in PWS and the effects of oxytocin treatment.
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Affiliation(s)
- Maria Petersson
- Department of Endocrinology, Karolinska University Hospital, 171 76 Stockholm, Sweden
- Department of Molecular Medicine and Surgery, Karolinska Institutet, 171 76 Stockholm, Sweden
| | - Charlotte Höybye
- Department of Endocrinology, Karolinska University Hospital, 171 76 Stockholm, Sweden
- Department of Molecular Medicine and Surgery, Karolinska Institutet, 171 76 Stockholm, Sweden
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Andrews SM, Panjwani AA, Potter SN, Hamrick LR, Wheeler AC, Kelleher BL. Specificity of Early Childhood Hyperphagia Profiles in Neurogenetic Conditions. AMERICAN JOURNAL ON INTELLECTUAL AND DEVELOPMENTAL DISABILITIES 2024; 129:175-190. [PMID: 38657964 DOI: 10.1352/1944-7558-129.3.175] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/03/2023] [Accepted: 10/10/2023] [Indexed: 04/26/2024]
Abstract
Hyperphagia is highly penetrant in Prader-Willi syndrome (PWS) and has increasingly been reported in other neurogenetic conditions (NGC). The Hyperphagia Questionnaire (HQ) was completed by caregivers of 4-8-year-olds with PWS (n = 17), Angelman syndrome (AS; n = 22), Williams syndrome (WS; n = 25), or low-risk controls (LRC; n = 35). All NGC groups were significantly elevated in HQ Total and Behavior scores compared to LRC. Only AS and WS were significantly elevated in the Drive domain, and only PWS in the Severity domain. After controlling for externalizing behavior, HQ Total scores were higher for PWS relative to other groups. Hyperphagic symptoms may not differentiate PWS from other NGCs in early childhood. However, hyperphagic phenotypes may be most severe in PWS. Further investigation of these profiles may inform etiology and syndrome-specific treatments.
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Dykens EM, Roof E, Hunt-Hawkins H. The Prader-Willi syndrome Profile: validation of a new measure of behavioral and emotional problems in Prader-Willi syndrome. Orphanet J Rare Dis 2024; 19:83. [PMID: 38395848 PMCID: PMC10885615 DOI: 10.1186/s13023-024-03045-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2023] [Accepted: 01/19/2024] [Indexed: 02/25/2024] Open
Abstract
BACKGROUND Prader-Willi syndrome (PWS) is a rare, neurodevelopmental disorder caused by the lack of expression of paternally imprinted genes on chromosome 15q11-13. PWS features a complex behavioral phenotype, including hyperphagia, anxiety, compulsivity, rigidity, repetitive speech, temper outbursts, aggressivity, and skin-picking. Questionnaires exist for measuring hyperphagia, but not for the aggregation of other problems that are distinctive to PWS. A PWS-specific tool is needed for phenotypic research, and to help evaluate treatment efficacy in future clinical trials aimed at attenuating PWS's hyperphagia and related problems. In this 4-phase study, we leveraged our expertise in PWS with feedback from families and specialists to validate the PWS Profile, a novel, informant-based measure of behavioral and emotional problems in this syndrome. RESULTS The authors developed a bank of 73 items that tapped both common and less frequent but clinically significant problems in PWS (Phase 1). An iterative feedback process with families and stakeholders was used to ensure content and construct validity (Phase 2). After adding, omitting, or revising items, in Phase 3, we pilot tested the measure in 112 participants. Results were reviewed by an international team of PWS specialists and revised again (Phase 3). The final, 57-item Profile was then administered to 761 participants (Phase 4). Principal component factor analyses (n = 873) revealed eight conceptually meaningful factors, accounting for 60.52% of test variance, and were readily interpretated as: Rigidity, Insistence; Aggressive Behaviors; Repetitive Questioning, Speech; Compulsive Behaviors; Depression, Anxiety; Hoarding; Negative Distorted Thinking; and Magical Distorted Thinking. Factors were internally consistent and showed good test-retest reliability and convergent validity with existent measures of behavioral problems. Profile factors were not related to IQ, BMI, or parental SES. Three Profile factors differed across PWS genetic subtypes. Age and gender differences were found in only one Profile factor, Hoarding. CONCLUSIONS The PWS Profile is a valid, psychometrically-sound questionnaire that already has shown responsivity to treatment in a previous clinical trial. The Profile can extend the reach of future clinical trials by evaluating the impact of novel agents not only on hyperphagia, but also on the emotional and behavioral problems that characterize PWS.
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Affiliation(s)
- Elisabeth M Dykens
- Department of Psychology and Human Development, Vanderbilt University, Vanderbilt Kennedy Center, 1 Magnolia Circle, 37203, Nashville, TN, USA.
| | - Elizabeth Roof
- Department of Psychology and Human Development, Vanderbilt University, Vanderbilt Kennedy Center, 1 Magnolia Circle, 37203, Nashville, TN, USA
| | - Hailee Hunt-Hawkins
- Department of Psychology and Human Development, Vanderbilt University, Vanderbilt Kennedy Center, 1 Magnolia Circle, 37203, Nashville, TN, USA
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Kalinderi K, Goula V, Sapountzi E, Tsinopoulou VR, Fidani L. Syndromic and Monogenic Obesity: New Opportunities Due to Genetic-Based Pharmacological Treatment. CHILDREN (BASEL, SWITZERLAND) 2024; 11:153. [PMID: 38397265 PMCID: PMC10886848 DOI: 10.3390/children11020153] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/28/2023] [Revised: 01/21/2024] [Accepted: 01/23/2024] [Indexed: 02/25/2024]
Abstract
Obesity is a significant health problem with a continuously increasing prevalence among children and adolescents that has become a modern pandemic during the last decades. Nowadays, the genetic contribution to obesity is well-established. For this narrative review article, we searched PubMed and Scopus databases for peer-reviewed research, review articles, and meta-analyses regarding the genetics of obesity and current pharmacological treatment, published in the English language with no time restrictions. We also screened the references of the selected articles for possible additional articles in order to include most of the key recent evidence. Our research was conducted between December 2022 and December 2023. We used the terms "obesity", "genetics", "monogenic", "syndromic", "drugs", "autosomal dominant", "autosomal recessive", "leptin-melanocortin pathway", and "children" in different combinations. Recognizing the genetic background in obesity can enhance the effectiveness of treatment. During the last years, intense research in the field of obesity treatment has increased the number of available drugs. This review analyzes the main categories of syndromic and monogenic obesity discussing current data on genetic-based pharmacological treatment of genetic obesity and highlighting the necessity that cases of genetic obesity should follow specific, pharmacological treatment based on their genetic background.
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Affiliation(s)
- Kallirhoe Kalinderi
- Laboratory of Medical Biology-Genetics, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece;
| | - Vasiliki Goula
- School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece;
| | - Evdoxia Sapountzi
- Second Department of Pediatrics, School of Medicine, Faculty of Health Sciences, AHEPA University Hospital, Aristotle University of Thessaloniki, 54636 Thessaloniki, Greece; (E.S.); (V.R.T.)
| | - Vasiliki Rengina Tsinopoulou
- Second Department of Pediatrics, School of Medicine, Faculty of Health Sciences, AHEPA University Hospital, Aristotle University of Thessaloniki, 54636 Thessaloniki, Greece; (E.S.); (V.R.T.)
| | - Liana Fidani
- Laboratory of Medical Biology-Genetics, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece;
- Second Department of Pediatrics, School of Medicine, Faculty of Health Sciences, AHEPA University Hospital, Aristotle University of Thessaloniki, 54636 Thessaloniki, Greece; (E.S.); (V.R.T.)
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Han JC, Rasmussen MC, Forte AR, Schrage SB, Zafar SK, Haqq AM. Management of Monogenic and Syndromic Obesity. Gastroenterol Clin North Am 2023; 52:733-750. [PMID: 37919024 DOI: 10.1016/j.gtc.2023.08.005] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2023]
Abstract
Similar to the general population, lifestyle interventions focused on nutrition and physical activity form the foundation for treating obesity caused by rare genetic disorders. Additional therapies, including metreleptin and setmelanotide, that target defects within the leptin signaling pathway can effectively synergize with lifestyle efforts to treat monogenic disorders of leptin, leptin receptor, proopiomelanocortin (POMC), and proprotein convertase subtilisin/kexin type 1 (PCSK1) and syndromic conditions, such as the ciliopathies Bardet-Biedl and Alström syndromes, whose pathophysiological mechanisms also converge on the leptin pathway. Investigational treatments for Prader-Willi syndrome target specific defects caused by reduced expression of paternally derived genes within the chromosome 15q region.
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Affiliation(s)
- Joan C Han
- Division of Pediatric Endocrinology and Diabetes, Department of Pediatrics, Icahn School of Medicine at Mount Sinai, New York, NY, USA; Diabetes, Obesity, and Metabolism Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA; The Mindich Child Health and Development Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
| | - Marcus C Rasmussen
- Division of Pediatric Endocrinology and Diabetes, Department of Pediatrics, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Alison R Forte
- Division of Pediatric Endocrinology and Diabetes, Department of Pediatrics, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Stephanie B Schrage
- Division of Pediatric Endocrinology and Diabetes, Department of Pediatrics, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Sarah K Zafar
- Division of Pediatric Endocrinology and Diabetes, Department of Pediatrics, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Andrea M Haqq
- Department of Pediatrics, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, Canada; Department of Agricultural, Food and Nutritional Science, University of Alberta, Edmonton, Alberta, Canada
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Matesevac L, Vrana-Diaz CJ, Bohonowych JE, Schwartz L, Strong TV. Analysis of Hyperphagia Questionnaire for Clinical Trials (HQ-CT) scores in typically developing individuals and those with Prader-Willi syndrome. Sci Rep 2023; 13:20573. [PMID: 37996659 PMCID: PMC10667498 DOI: 10.1038/s41598-023-48024-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2023] [Accepted: 11/21/2023] [Indexed: 11/25/2023] Open
Abstract
The Hyperphagia Questionnaire for Clinical Trials (HQ-CT) is an observer-reported outcome measure that has been widely used in interventional studies to assess changes in hyperphagic behaviors in individuals with Prader-Willi syndrome (PWS). However, HQ-CT scores in the wider PWS population and the general population have not been reported. Here we report HQ-CT scores from more than 400 individuals with PWS and 600 typical individuals, aged 5-26. Overall, HQ-CT scores were significantly higher in those with PWS compared to typically developing individuals at all ages evaluated. In addition, while HQ-CT scores in the typically developing population decreased with age, scores increased with age in PWS. To further understand the variability of HQ-CT scores in the PWS population, semi-structured interviews were conducted with caregivers of a small subset of adults with PWS who had unexpectedly low HQ-CT scores. These caregivers reported that strict adherence to a food routine, food security measures and supervised food preparation reduced the frequency and intensity of hyperphagic behaviors measured by HQ-CT. Thus, hyperphagic behaviors are captured by the HQ-CT for most individuals with PWS, but for some individuals residing in settings with highly structured food routines, HQ-CT scores may not fully reflect the extent of PWS-associated hyperphagia.
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Affiliation(s)
| | | | | | - Lauren Schwartz
- Foundation for Prader-Willi Research, Covina, CA, USA
- Department of Rehabilitation Medicine, University of Washington, Seattle, WA, USA
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Castellano JM, Ariza-Jimenez AB, Tena-Sempere M. New Avenues for Pharmacological Management of Hyperphagia and Associated Behavioral Disorders in Prader-Willi Syndrome. J Clin Endocrinol Metab 2023; 108:e895-e896. [PMID: 36896885 DOI: 10.1210/clinem/dgad131] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/01/2023] [Accepted: 03/03/2023] [Indexed: 03/11/2023]
Affiliation(s)
- Juan M Castellano
- Instituto Maimónides de Investigación Biomédica de Córdoba (IMIBIC), 14004 Cordoba, Spain
- Department of Cell Biology, Physiology and Immunology, University of Córdoba, 14004 Cordoba, Spain
- Pediatric Endocrinology Section, Hospital Universitario Reina Sofía, 14004 Cordoba, Spain
| | - Ana B Ariza-Jimenez
- Instituto Maimónides de Investigación Biomédica de Córdoba (IMIBIC), 14004 Cordoba, Spain
- CIBER Fisiopatología de la Obesidad y Nutrición, Instituto de Salud Carlos III, 14004 Cordoba, Spain
| | - Manuel Tena-Sempere
- Instituto Maimónides de Investigación Biomédica de Córdoba (IMIBIC), 14004 Cordoba, Spain
- Department of Cell Biology, Physiology and Immunology, University of Córdoba, 14004 Cordoba, Spain
- Pediatric Endocrinology Section, Hospital Universitario Reina Sofía, 14004 Cordoba, Spain
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Aulinas A, Muhammed M, Becker KR, Asanza E, Hauser K, Stern C, Gydus J, Holmes T, Murray HB, Breithaupt L, Micali N, Misra M, Eddy KT, Thomas JJ, Lawson EA. Oxytocin response to food intake in avoidant/restrictive food intake disorder. Eur J Endocrinol 2023; 189:149-155. [PMID: 37474111 PMCID: PMC10396082 DOI: 10.1093/ejendo/lvad087] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/22/2023] [Revised: 05/16/2023] [Accepted: 06/07/2023] [Indexed: 07/22/2023]
Abstract
OBJECTIVE To investigate the response of anorexigenic oxytocin to food intake among adolescents and young adults with avoidant/restrictive food intake disorder (ARFID), a restrictive eating disorder characterized by lack of interest in food or eating, sensory sensitivity to food, and/or fear of aversive consequences of eating, compared with healthy controls (HC). DESIGN Cross-sectional. METHODS A total of 109 participants (54 with ARFID spectrum and 55 HC) were instructed to eat a ∼400-kcal standardized mixed meal. We sampled serum oxytocin at fasting and at 30-, 60-, and 120-min postmeal. We tested the hypothesis that ARFID would show higher mean oxytocin levels across time points compared with HC using a mixed model ANOVA. We then used multivariate regression analysis to identify the impact of clinical characteristics (sex, age, and body mass index [BMI] percentile) on oxytocin levels in individuals with ARFID. RESULTS Participants with ARFID exhibited greater mean oxytocin levels at all time points compared with HC, and these differences remained significant even after controlling for sex and BMI percentile (P = .004). Clinical variables (sex, age, and BMI percentile) did not show any impact on fasting and postprandial oxytocin levels among individuals with ARFID. CONCLUSIONS Consistently high oxytocin levels might be involved in low appetite and sensory aversions to food, contributing to food avoidance in individuals with ARFID.
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Affiliation(s)
- Anna Aulinas
- Department of Endocrinology and Nutrition, Hospital de la Santa Creu i Sant Pau, IIB-Sant Pau, 08041 Barcelona, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER Unidad 747), ISCIII, 08025 Barcelona, Spain
- Department of Medicine, University of Vic—Central University of Catalonia, 08500 Vic, Barcelona, Spain
| | - Maged Muhammed
- Neuroendocrine Unit, Division of Endocrinology, Department of Medicine, Massachusetts General Hospital, 02114 Boston, MA, United States
| | - Kendra R Becker
- Department of Medicine, Harvard Medical School, 02115 Boston, MA, United States
- Eating Disorders Clinical and Research Program, Department of Psychiatry, Massachusetts General Hospital, 02114 Boston, MA, United States
| | - Elisa Asanza
- Neuroendocrine Unit, Division of Endocrinology, Department of Medicine, Massachusetts General Hospital, 02114 Boston, MA, United States
| | - Kristine Hauser
- Neuroendocrine Unit, Division of Endocrinology, Department of Medicine, Massachusetts General Hospital, 02114 Boston, MA, United States
| | - Casey Stern
- Neuroendocrine Unit, Division of Endocrinology, Department of Medicine, Massachusetts General Hospital, 02114 Boston, MA, United States
- Eating Disorders Clinical and Research Program, Department of Psychiatry, Massachusetts General Hospital, 02114 Boston, MA, United States
| | - Julia Gydus
- Neuroendocrine Unit, Division of Endocrinology, Department of Medicine, Massachusetts General Hospital, 02114 Boston, MA, United States
- Eating Disorders Clinical and Research Program, Department of Psychiatry, Massachusetts General Hospital, 02114 Boston, MA, United States
| | - Tara Holmes
- Translational and Clinical Research Center, Massachusetts General Hospital, 02114 Boston, MA, United States
| | - Helen Burton Murray
- Department of Medicine, Harvard Medical School, 02115 Boston, MA, United States
- Center for Neurointestinal Health, Division of Gastroenterology, Massachusetts General Hospital, 02114 Boston, MA, United States
| | - Lauren Breithaupt
- Department of Medicine, Harvard Medical School, 02115 Boston, MA, United States
- Eating Disorders Clinical and Research Program, Department of Psychiatry, Massachusetts General Hospital, 02114 Boston, MA, United States
| | - Nadia Micali
- Eating Disorders Research Unit, Mental Health Services of the Capital Region of Denmark, Psychiatric Centre Ballerup, 2750 Ballerup, Denmark
- Population, Policy and Practice, Great Ormond Street Institute of Child Health, University College London, WC1N 1EH, London, United Kingdom
| | - Madhusmita Misra
- Neuroendocrine Unit, Division of Endocrinology, Department of Medicine, Massachusetts General Hospital, 02114 Boston, MA, United States
- Department of Medicine, Harvard Medical School, 02115 Boston, MA, United States
- Division of Pediatric Endocrinology, Massachusetts General Hospital, 02114 Boston, MA, United States
| | - Kamryn T Eddy
- Department of Medicine, Harvard Medical School, 02115 Boston, MA, United States
- Eating Disorders Clinical and Research Program, Department of Psychiatry, Massachusetts General Hospital, 02114 Boston, MA, United States
| | - Jennifer J Thomas
- Department of Medicine, Harvard Medical School, 02115 Boston, MA, United States
- Eating Disorders Clinical and Research Program, Department of Psychiatry, Massachusetts General Hospital, 02114 Boston, MA, United States
| | - Elizabeth A Lawson
- Neuroendocrine Unit, Division of Endocrinology, Department of Medicine, Massachusetts General Hospital, 02114 Boston, MA, United States
- Department of Medicine, Harvard Medical School, 02115 Boston, MA, United States
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Singh D, Miller JL, Wassman ER, Butler MG, Foley Shenk A, Converse M, Picone M. The Arduous Path to Drug Approval for the Management of Prader-Willi Syndrome: A Historical Perspective and Call to Action. Int J Mol Sci 2023; 24:11574. [PMID: 37511333 PMCID: PMC10381011 DOI: 10.3390/ijms241411574] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2023] [Accepted: 06/19/2023] [Indexed: 07/30/2023] Open
Abstract
Prader-Willi syndrome (PWS) is a neuroendocrine genetic disorder resulting from the loss of paternally expressed imprinted genes in chromosome 15q11-q13 [...].
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Affiliation(s)
- Deepan Singh
- Department of Psychiatry, Maimonides Medical Center, Brooklyn, New York, NY 11219, USA
| | - Jennifer L Miller
- Department of Pediatrics, Division of Pediatric Endocrinology, University of Florida, Gainesville, FL 32611, USA
| | | | - Merlin G Butler
- Departments of Psychiatry & Behavioral Sciences and Pediatrics, University of Kansas Medical Center, Kansas City, KS 66160, USA
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Dubern B, Faccioli N, Poitou C, Clément K. Novel therapeutics in rare genetic obesities: A narrative review. Pharmacol Res 2023; 191:106763. [PMID: 37037398 DOI: 10.1016/j.phrs.2023.106763] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/08/2023] [Revised: 04/04/2023] [Accepted: 04/07/2023] [Indexed: 04/12/2023]
Abstract
The better understanding of the molecular causes of rare genetic obesities and its associated phenotype involving the hypothalamus allows today to consider innovative therapeutics focused on hunger control. Several new pharmacological molecules benefit patients with monogenic or syndromic obesity. They are likely to be among the treatment options for these patients in the coming years, helping clinicians and patients prevent rapid weight progression and eventually limit bariatric surgery procedures, which is less effective in these patients. Their positioning in the management of such patients will be needed to be well defined to develop precision medicine in genetic forms of obesity.
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Affiliation(s)
- Beatrice Dubern
- Assistance Publique Hôpitaux de Paris, Trousseau Hospital, Pediatric Nutrition and Gastroenterology Department, French Reference Center for Prader-Willi Syndrome and other rare obesities (PRADORT), Paris, France; Sorbonne Université, INSERM, Nutrition and obesities; systemic approaches, NutriOmics research group, 75013, Paris, France.
| | - Nathan Faccioli
- Assistance Publique Hôpitaux de Paris, Trousseau Hospital, Pediatric Nutrition and Gastroenterology Department, French Reference Center for Prader-Willi Syndrome and other rare obesities (PRADORT), Paris, France; Sorbonne Université, INSERM, Nutrition and obesities; systemic approaches, NutriOmics research group, 75013, Paris, France
| | - Christine Poitou
- Assistance Publique Hôpitaux de Paris, Pitié-Salpêtrière Hospital, Nutrition Department, Paris, France; Sorbonne Université, INSERM, Nutrition and obesities; systemic approaches, NutriOmics research group, 75013, Paris, France
| | - Karine Clément
- Assistance Publique Hôpitaux de Paris, Pitié-Salpêtrière Hospital, Nutrition Department, Paris, France; Sorbonne Université, INSERM, Nutrition and obesities; systemic approaches, NutriOmics research group, 75013, Paris, France
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