title: Emerging pathomechanisms involved in obesity.
abstract: OBJECTIVE
  Overweight/obesity prevalence has increased dramatically worldwide. Recent evidence suggests sleep deprivation/fragmentation, fructose-exceedingly rich diets, and exposure to endocrine disruptors (eg, 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 relation between obesogenic factors and childhood obesity. BPA was measured by gas chromatography/tandem mass spectrometry on early morning urine samples. Correlations between the continuous variables were analysed using Spearman rank correlation.
  
  
  RESULTS
  Sleep deprivation/fragmentation, nocturnal breathing problems, and daytime sleepiness increased with increasing body mass index, correlating with the presence of clinical markers of metabolic syndrome (eg, 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 body mass index 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 relation between certain factors and paediatric obesity, underscoring their role as emerging targets for prevention and therapy.
authors.affiliation: *Department of Medicine and Surgery, Pediatrics Section, University of Salerno, Baronissi †Pediatrics Section, Local Health Service-ASL Salerno, Salerno, Italy.
authors.forename: Roberta
authors.initials: R
authors.lastname: D'Aniello
authors.forename: Jacopo
authors.initials: J
authors.lastname: Troisi
authors.forename: Osvaldo
authors.initials: O
authors.lastname: D'Amico
authors.forename: Maria
authors.initials: M
authors.lastname: Sangermano
authors.forename: Grazia
authors.initials: G
authors.lastname: Massa
authors.forename: Anna
authors.initials: A
authors.lastname: Moccaldo
authors.forename: Luca
authors.initials: L
authors.lastname: Pierri
authors.forename: Marco
authors.initials: M
authors.lastname: Poeta
authors.forename: Pietro
authors.initials: P
authors.lastname: Vajro
mesh_terms: D000293:Adolescent; D017195:Adolescent Nutritional Physiological Phenomena; D001559:Benzhydryl Compounds / Q000633:toxicity / Q000652:urine; D015415:Biomarkers / Q000652:urine; D015992:Body Mass Index; D016022:Case-Control Studies; D002648:Child; D002664:Child Nutritional Physiological Phenomena; D002675:Child, Preschool; D004032:Diet / Q000009:adverse effects*; D052244:Endocrine Disruptors / Q000633:toxicity / Q000652:urine; D005260:Female; D005632:Fructose / Q000009:adverse effects; D019456:Health Transition; D006801:Humans; D007558:Italy / Q000453:epidemiology; D008297:Male; D009765:Obesity / Q000139:chemically induced / Q000453:epidemiology / Q000209:etiology* / Q000652:urine; D050177:Overweight / Q000139:chemically induced / Q000453:epidemiology / Q000209:etiology* / Q000652:urine; D010636:Phenols / Q000633:toxicity / Q000652:urine; D010865:Pilot Projects; D012307:Risk Factors; D012892:Sleep Deprivation / Q000503:physiopathology; D000098826:Bisphenol A Compounds
chemical_list: D001559:Benzhydryl Compounds; D015415:Biomarkers; D052244:Endocrine Disruptors; D005632:Fructose; D010636:Phenols; C006780:bisphenol A; D000098826:Bisphenol A Compounds