IGF1 and Hyperinsulinemia: Interestingly, analyzing the GH-IGF-I axis, Reinhert et al.’s group did not find any differences in the IGF-I levels between pGm and pseudo-Gm groups; however, locally produced IGF-1 might be more relevant than circulating IGF-1 for the development of gynecomastia, and hyperinsulinemia in obese adolescents might also potentially influence its occurrence [74,86].