SHBG and Hyperinsulinemia: Hyperinsulinemia is responsible for metabolic and cardiovascular complications [18], as well as decreasing sex hormone binding globulin (SHBG) production in the liver (resulting in an increase of free and bioactive androgen levels in the circulation) and potentiating the luteinizing hormone (LH)-dependent effect on the ovarian cells, leading to the enhanced synthesis of androgens [5].