SHBG and obesity due to melanocortin 4 receptor deficiency: Regarding the link between obesity and polycystic ovary syndrome (PCOS), there is some evidence that obesity might impact the risk of PCOS through insulin resistance and compensatory hyperinsulinemia, which increases ovarian/adrenal androgen production, as well as sex hormone-binding globulin (SHBG) suppression, which increases androgen bioavailability [45].