Sex Hormone-Binding Globulin (SHBG) as an Early Biomarker and Therapeutic Target in Polycystic Ovary Syndrome
Open accessAbstract
Human sex hormone-binding globulin (SHBG) is a glycoprotein produced by the liver that binds sex steroids with high affinity and specificity. Clinical observations and reports in the literature have suggested a negative correlation between circulating SHBG levels and markers of non-alcoholic fatty liver disease (NAFLD) and insulin resistance. Decreased SHBG levels increase the bioavailability of androgens, which in turn leads to progression of ovarian pathology, anovulation and the phenotypic characteristics of polycystic ovarian syndrome (PCOS). This review will use a case report to illustrate the inter-relationships between SHBG, NAFLD and PCOS. In particular, we will review the evidence that low hepatic SHBG production may be a key step in the pathogenesis of PCOS. Furthermore, there is emerging evidence that serum SHBG levels may be useful as a diagnostic biomarker and therapeutic target for managing women with PCOS.
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Lower levels of sex hormone-binding globulin (SHBG) indicate anomalous cholesterol measurements connected to inhibited insulin signaling, such as in PCOS.
“Lower levels of the blood protein called sex hormone-binding globulin (SHBG) are advised to indicate the anomalous cholesterol measurements which are connected to inhibited insulin signaling, for instance, PCOS [112].”
From Nutritional and herbal interventions for polycystic ovary syndrome (PCOS): a comprehensive review of dietary approaches, macronutrient impact, and herbal medicine in management (2025) · cites this paper as [112]
Section 3.3 describes low SHBG as a biomarker of insulin resistance, and Section 4.3 discusses lower SHBG in women with PCOS. Section 4.3 also reports that treatment increased SHBG while reducing LDL cholesterol, but it does not establish that low SHBG indicates abnormal cholesterol measurements. Page numbers are unavailable in our copy. (LLM, conf=0.85)
Experimental — accuracy not yet measuredTogether with free T, SHBG has recently been recognized as a useful diagnostic marker and therapeutic target for managing women with PCOS.
“Together with free T, SHBG has recently been recognized a useful diagnostic marker and therapeutic target for managing women with PCOS [195].”
From Role of sex hormone-binding globulin in the free hormone hypothesis and the relevance of free testosterone in androgen physiology (2022) · cites this paper as [195]
Section 4.3 says SHBG may prove useful for PCOS diagnosis and treatment, and Section 5.3 links SHBG to the evaluation of free testosterone’s androgen effects. But the paper presents SHBG’s clinical utility as emerging, not established: Section 5.3 says it is not yet part of PCOS diagnostic criteria and may be less useful in adults taking oral contraceptives. Page numbers were not available in our copy. (LLM, conf=0.86)
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- Authors
- Qu, X., & Donnelly, R.
- Affiliations
- University of Technology Sydney (AU)
- University of Nottingham (GB)
- Corresponding author
- Qu, Xianqin
- Venue
- International Journal of Molecular Sciences
- Publisher
- MDPI AG
- Published
- 2020-11-01
- Volume
- 21
- Issue
- 21
- Pages
- 8191
- ISSN
- 1422-0067 (ISSN-L)
- PMC
- PMC7663738
- OpenAlex
- W3096809272
- Cited by
- 210
- References
- 114
- Citations by year
- 2026: 40 · 2025: 46 · 2024: 47 · 2023: 35 · 2022: 29 · 2021: 13
- FWCI
- 16.98
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- International Journal of Molecular Sciences (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion)
- UTS ePRESS (University of Technology Sydney) (submittedVersion)
- Topics
- Health Sciences › Medicine › Reproductive Medicine › Ovarian function and disorders
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Hormonal and reproductive studies
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Genetics › Genetic and Kidney Cyst Diseases
- Keywords
- sex hormone-binding globulin, polycystic ovary syndrome, non-alcoholic fatty liver disease, insulin resistance, diagnostic biomarkers, therapeutic target, PCOS pathogenesis
- MeSH terms
- Female, Humans, Insulin Resistance, Polycystic Ovary Syndrome, Sensitivity and Specificity, Sex Hormone-Binding Globulin, Biomarkers, Young Adult, Molecular Targeted Therapy, Non-alcoholic Fatty Liver Disease
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