Sex hormone binding globulin concentration as a prepubertal marker for hyperinsulinaemia in obesity

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Abstract
BACKGROUND Overweight children become obese adults who are prone to develop the “metabolic syndrome” and premature coronary arterial disease (CAD). AIMS To assess whether sex hormone binding globulin (SHBG) is a potential marker for hyperinsulinaemia/insulin resistance in prepubertal obese children. METHODS Twenty five obese children (body mass index (BMI) >2SD) who warranted investigation on clinical grounds were enrolled. Their insulin response to an oral glucose tolerance test was assessed. RESULTS Fourteen children were hyperinsulinaemic. Despite being matched for age and BMI, SHBG concentrations were below the sex related reference range in the hyperinsulinaemic group. CONCLUSION Our results indicate that a subnormal SHBG concentration in a prepubertal child is strongly predictive of hyperinsulinaemia. By measuring the circulating SHBG concentration, it might be possible to identify those at most risk of premature CAD, targeting them for lifestyle changes.