Notably, research suggests that phthalates may induce central precocious puberty by upregulating kisspeptin levels, subsequently activating gonadotropin-releasing hormone (GnRH) neurons in the hypothalamus, as evidenced by higher urinary phthalate metabolite levels and elevated serum kisspeptin concentrations in girls with precocious puberty compared to control, age-matched girls [54]. This evidence concerns the gene KISS1 and central precocious puberty.