In any case, these points need to be addressed again in a larger population-based sample, using also MRI abdominal imaging, or by measurement of other cytokines (mainly IL-6) to further support the hypothesis that the impairment of the IGF-I axis in obesity might represent different aspects of the chronic inflammation status more than HS per se. This evidence concerns the gene IL6 and obesity due to melanocortin 4 receptor deficiency.