SHBG and hyperinsulinism: This condition, called hyperinsulinemia, accelerates lipogenesis with increased production of free fatty acids, reduces levels of sex hormone binding globulin (SHBG), increases luteinizing hormone (LH) and follicle stimulating hormone (FSH) levels, and, finally, leads to an increase in the production of ovarian androgens and also in their biologically active portion potentially leading to hyperandrogenism (Figure 2) [6, 7].