INS and Prader-Willi syndrome: Although the precise mechanisms underlying this metabolic paradox remain unclear, some authors suggested that orexigenic hormones like ghrelin [40] or insulin-sensitive adipokines like adiponectin could intervene to diminish the consequences of the abnormal body composition of subjects with PWS [34, 39], while others hypothesized a decrease in vagal parasympathetic tone to the pancreas as a potential cause of reduced insulin secretion [8].