Hyperinsulinemia can result from IR, inherent abnormalities in insulin synthesis/secretion, and obesity, whether because of inherent defects in insulin action or by weight gain, activates both adrenal and ovarian cytochrome P450c17a activity and may clarify how early adrenarche during pubertal gonadotropin activation leads to PCOS in girls [15]. This evidence concerns the gene INS and obesity due to melanocortin 4 receptor deficiency.