Sex hormone-binding globulin during puberty in normal and hyperandrogenic girls

Human sex hormone-binding globulin (SHBG) regulates the cellular bioavailab ility of SHBG-bound steroid hormones. Subtle decreases in plasma SHBG level s during puberty have a perceptible effect on the androgen-estrogen balance . This SHBG decrease is more pronounced in girls with premature pubarche wh o are at risk to develop functional ovarian hyperandrogenism as well as ins ulin resistance syndrome. Insulin is a potent inhibitor of SHBG production in the liver, and there is now evidence. that SHBG is a marker of hyperinsu linemia and insulin resistance that can be associated in both obese and non -obese patients with polycystic ovary syndrome. Therefore, low SHBG could b e a useful tool for identifying presymptomatic individuals with diabetes me llitus type 2 including those with androgen disorders.