Sex hormone binding globulin concentration as a prepubertal marker for hyperinsulinaemia in obesity

Background-Overweight children become obese adults who are prone to develop the "metabolic syndrome" and premature coronary arterial disease (CAD). Aims-To assess whether sex hormone binding globulin (SHBG) is a potential m arker for hyperinsulinaemia/insulin resistance in prepubertal obese childre n. Methods-Twenty five obese children (body mass index (BMI) >2SD) who warrant ed investigation on clinical grounds were enrolled. Their insulin response to an oral glucose tolerance test was assessed. Results-Fourteen children were hyperinsulinaemic. Despite being matched for age and BMI, SHBG concentrations were below the sex related reference rang e in the hyperinsulinaemic group. Conclusion-Our results indicate that a subnormal SHBG concentration in a pr epubertal child is strongly predictive of hyperinsulinaemia. By measuring t he circulating SHBG concentration, it might be possible to identify those a t most risk of premature CAD, targeting them for lifestyle changes.