Moreover, consistent with the much less marked change with economic development in the sex ratio for diabetes [27] than for IHD, such environmentally driven effects on pubertal sex-steroids would not be expected to affect pubertal pre-cursors of diabetes, which appear to be more strongly related to another hypothalamic-pituitary-endocrine axis, i.e. growth hormone [54-59]. Here, GH1 is linked to myocardial ischemia.