IGF1 and obesity due to melanocortin 4 receptor deficiency: To our knowledge, only a few studies have evaluated the association of IGF-1 and IGFBP3 with metabolic abnormalities in children and adolescents, finding an association of lower IGF-1 and IGFBP-3 with metabolic abnormalities (36) and that improving the status of obesity and insulin resistance in children and adolescents may further augment the functionality of the IGF-1 axis (37).