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

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 concentrations it might be possible to identify those at most risk of premature CAD, targeting them for life-style changes.