Insulin resistance, a common consequence of obesity, complicates this process by increasing serum levels of ovarian and adrenal steroid hormones while simultaneously reducing SHBG concentrations, and leading to an elevation of free sex steroids that may disrupt the normal regulation of pubertal timing and progression [13, 14, 29, 30]. This evidence concerns the gene SHBG and obesity due to melanocortin 4 receptor deficiency.