SHBG and hyperinsulinism: Hyperinsulinemia also alters the gonadotropin-releasing hormone (GnRH) pulse secretion pattern, suppresses the sex hormone-binding globulin (SHBG) and potentiates ovarian androgen production in women with PCOS (Bhattacharya and Jha, 2011; Hart et al., 2011; Huang et al., 2011; Lass et al., 2011; Rathsman et al., 2012; Wedin et al., 2012).