IGF1 and hyperinsulinism: The increase of sex steroids might stimulate premature adrenarche [50] and induce the insulin-like growth factor/growth hormone (IGF/GH) axis [51], which is associated with many metabolic disorders including dyslipidemia, hyperinsulinism, metabolic syndrome, and polycystic ovary syndrome [52, 53], and this change was related to amino acid metabolism.