On the other hand, the findings of Joham et al. [20] indicate that PEDF does not play a causal role in the development of insulin resistance, strengthening the notion that women with PCOS have an intrinsic insulin-related dysfunction that might be exacerbated by, but not attributed to, obesity, as previously thought [40]. This evidence concerns the gene SERPINF1 and obesity due to melanocortin 4 receptor deficiency.