SHBG and hyperinsulinism: The most important biological mechanisms mediating the unfavourable influence of the above factors are hyperinsulinemia and insulin resistance, the activities of IGFs and IGF binding proteins, sex hormones and SHBG, general and adipose tissue low-grade inflammation, changes in adipose tissue production of adipokines and vascular growth factors, oxidative stress, endocrine disruptors, and alterations in immune function.