Fasting insulin shows a positive correlation with androgen levels in women with PCOS.152 Insulin stimulates increased production of androgens in theca cells isolated from women with PCOS, which effect is mediated by the insulin receptor.153 Furthermore, excess insulin inhibits liver sex hormone-binding globulin synthesis, which increased the delivery of free androgens to target tissue. Here, SHBG is linked to polycystic ovary syndrome.