Furthermore, the controversial results of previous associations between hyperinsulinemia and DHEAS in PCOS might be explained by differences in the modulatory influence of insulin on adrenal steroidogenesis as a function of prevalence of obesity in various PCOS populations, beyond the differences of age, phenotypes or the criteria used to evaluate the insulinemic secretory pattern and insulin resistance. Here, INS is linked to obesity due to melanocortin 4 receptor deficiency.