SHBG and obesity due to melanocortin 4 receptor deficiency: The ability of the adipose tissue to accumulate sex hormones within adipocytesand also to metabolize and interconvert them through local enzymatic reactionscan significantly affect the functional status of the reproductive axis.Increased tissue adipocyte mass in obesity may alter the balance between thebioavailability of estrogens, androgens and circulating sex hormones, whichaltered plasma levels and SHBG could lead to clinical manifestations anddysfunction of the hypothalamic-pituitary-gonadal axis (HPG) (Oliveira & Lemos, 2010).