Polycystic ovary syndrome (PCOS) is one of the most common
endocrine diseases causing
infertility in women of childbearing age. It is characterized by hyperandrogenemia (HA), chronic
anovulation, and polycystic ovary morphology (PCOM). Most women with PCOS have metabolic abnormalities.
Sex hormone-binding globulin (SHBG), a transport carrier that binds
estrogen and
androgens and regulates their
biological activity, is usually used as an
indicator of
hyperandrogenism in women with PCOS. Low serum SHBG levels are considered a
biomarker of metabolic abnormalities and are associated with
insulin resistance (IR), HA, and abnormal
glucose and lipid metabolism in PCOS patients. SHBG is also related to the long-term prognosis of PCOS, whereas SHBG gene polymorphism is associated with PCOS risk. In addition, the administration of
metformin (MET),
glucagon-like peptide-1 receptor agonists (GLP-1 RAs),
thiazolidinediones (TZDs), compound
oral contraceptives (COCs), as well as nutrient supplements such as
inositol (MI),
vitamin D, and synbiotics can regulate SHBG levels to ameliorate PCOS complications and improve prognosis. This review focuses on the interaction between SHBG and various PCOS complications as well as the regulation of SHBG by various drugs and nutrients and its
therapeutic effects on PCOS.