Fig. 4
From: Do patients with Prader–Willi syndrome have favorable glucose metabolism?
The summary figure of possible factors contributing to lower insulin levels and lower IR in PWS patients. “↑” means “increased”; “↓” means “decreased”; “→” means “leads or lead”. Adipose tissue, adiponectin, ghrelin, oxytocin, irisin, growth hormone and the autonomic nervous system all may play a role in the lower insulin levels and lower IR in PWS patients. IR insulin resistance, HMW high molecular weight, AG acyl ghrelin, DAG desacyl ghrelin, GH growth hormone, ANS autonomic nervous system