In addition, it was shown that obese prepubertal girls had significantly higher BMI-SDS, leptin, insulin, and HOMA-IR values than the control group, and that girls with obesity in early puberty presented higher BMI-SDS, leptin, IGF-1, IGFBP3, insulin, HOMA-IR, LH, LH/FSH ratio, ACTH, DHEA-S, androstenedione, testosterone, and free testosterone values than the control group [82]. Here, INS is linked to obesity due to melanocortin 4 receptor deficiency.