Razaw O. Ibrahim a, Shirwan H. Omer b, and Chro N. Fattah c

a Department of Physiology, College of  Medicine, University of Kirkuk

b Department of Physiology, College of Medicine, University of Sulaimani, Kurdistan Region, Iraq. 

c Department of Gynecology and Obstetrics, College of Medicine, University of Sulaimani, Kurdistan Region, Iraq. 


Submitted: 20/5/2019; Accepted: 1/11/2019; Published: 21/12/2019

DOI Link: https://doi.org/10.17656/jsmc.10229 



Sex hormone-binding globulin is a glycoprotein synthesized by liver cells; it binds to sex steroid hormones & regulate their bioavailability. Polycystic ovarian syndrome is a neuroendocrine disorder characterized by anovulation or oligoovulatione, hyperandrogenism, and signs of insulin resistance. Recently reverse correlation between SHBG & obesity, PCOS (Polycystic ovarian syndrome) and insulin resistance has been recorded.


This study aimed to compare serum SHBG levels between PCOS & healthy women and, to determine the effect of BMI on its level. In addition to that, to provide information about the effect of age on serum SHBG levels in both groups of the study.

Patients and Methods

This was a case-control study involved one hundred women, 60 women with PCOS were subfertile (study group) & 40 healthy normal (control group). Five ml of blood obtained from all the patients & control women at the follicular phase of the menstrual cycle. Serum level of SHBG, free testosterone, estrogen & AMH were measured by using the ELISA technique. The studied women were divided into subgroups according to their ages & the women with PCOS were subdivided into four subgroups according to their clinical & biochemical markers.


There was no statistically significant difference in the serum level of SHBG between subfertile PCOS & control women. Its levels were significantly lower in women with a BMI of ≥25 than normal-weight women in both groups. Serum level of SHBG in normal weight (BMI <25) subfertile PCOS women was significantly lower than normal-weight healthy women p=0.009. In the control group, a weak negative correlation between age &SHBG observed r=-0.33, while this correlation was insignificant in subfertile PCOS women. No correlation between SHBG & other hormonal parameters recorded. Also, the insignificant difference in SHBG level among PCOS subgroups found F=2.061,p=0.116.


Both obesity & PCOS affect the serum level of SHBG but the effect of obesity is more potent. Serum levels of SHBG decline with age but the hormonal disturbances in PCOS patients becloud this physiological decline. 


SHBG, Sex hormone-binding globulin, PCOS, Obesity, Age, Sex Steroid Hormones.


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