Emerging Pathomechanisms Involved in Obesity: A Paediatric Pilot Study

OBJECTIVE:: Overweight/obesity prevalence has increased dramatically worldwide. Recent evidence suggests sleep deprivation/fragmentation, fructose-exceedingly rich diets and exposure to endocrine disruptors (e.g., bisphenol A, BPA) as emerging additional factors involved in pathomechanisms and in the treatment-resistance of obesity and its complications. Our study focuses on these factors for further preventive/therapeutic approaches in paediatric obesity. METHODS:: Fifty-four Italian children [Cases: n = 31 overweight/obese; Controls: n = 23 normal weight] were clinically/anthropometrically characterised. Parents completed questionnaires on the relationship between obesogenic factors and childhood obesity. BPA was measured by GC/MS-MS on early morning urine samples. Correlations between the continuous variables were analysed using Spearman's Rank Correlation. RESULTS:: Sleep deprivation/fragmentation, nocturnal breathing problems and daytime sleepiness increased with increasing BMI, correlating with the presence of clinical markers of metabolic syndrome (e.g., acanthosis nigricans). Frequency of sugar-enriched drink consumption and the amount of fructose per portion and/or per week increased paralleling the ponderal excess and all the other anthropometric parameters. In the entire sample population, free and total BPA levels increased paralleling the BMI increase (r > 0.8), whereas the conjugate demonstrated the opposite trend. The re-use of disposable plastic showed a positive correlation with urinary BPA levels. CONCLUSIONS:: Despite its exploratory nature, the results of our pilot study confirm the close relationship between certain factors and paediatric obesity, underscoring their role as emerging targets for prevention and therapy.