Thus, specifically leptin, adiponectin, and inflammatory cytokines produced by WAT could be permissive key players during an early onset of puberty in girls with obesity.9, 36, 62, 68 As an exception, HMW adiponectin seems to have a stimulatory effect on peripheral reproductive function as HMW is not able to cross the blood brain barrier.63 Here, LEP is linked to obesity due to melanocortin 4 receptor deficiency.