SHBG and Hyperinsulinemia: We also examined T/SHBG (=FAI), DHEAS/SHBG, and AD/SHBG since SHBG has triple significance as an indicator in PCOS: its level is decreased by androgens; insulin as a marker of the metabolic state and hyperinsulinemia common in PCOS also decreases SHBG levels; and binding of androgens (especially testosterone, see FAI) to SHBG essentially affects the biological activity of androgens.