Human sex hormone-binding globulin (SHBG) regulates the cellular bioavailability of SHBG-bound steroid hormones. Subtle decreases in plasma SHBG levels during puberty have a perceptible effect on the androgen-estrogen balance. This SHBG decrease is more pronounced in girls with premature pubarche who are at risk to develop functional ovarian hyperandrogenism as well as insulin resistance syndrome. Insulin is a potent inhibitor of SHBG production in the liver, and there is now evidence that SHBG is a marker of hyperinsulinemia and insulin resistance that can be associated in both obese and non-obese patients with polycystic ovary syndrome. Therefore, low SHBG could be a useful tool for identifying presymptomatic individuals with diabetes mellitus type 2 including those with androgen disorders.