ANPEP and hyperinsulinism: The authors believe that the main reason is that the secretion of estrogen and androgen in girls with CPP increases significantly, and the accumulation of fat will cause compensatory hyperinsulinemia in girls, reduce the synthesis of SHBG, and affect the secretion of APN; at the same time, exogenous adipokine changes the release of GnRH pulse in the hypothalamus by binding with the leptin receptor, leading to the increase in LH and FSH levels [28, 29].