SHBG (sex hormone-binding globulin) is a hepatically-produced glycoprotein that serves as the primary transport protein for sex steroid hormones in plasma 1. The protein functions as a homodimer, with each dimer binding one molecule of steroid hormone, specifically testosterone, dihydrotestosterone, and estradiol with high affinity 2. SHBG regulates steroid hormone bioavailability by controlling their plasma concentrations and metabolic clearance rates 1. Beyond its transport function, emerging evidence suggests SHBG acts as a hepatokine with direct metabolic effects. Low SHBG levels are associated with insulin resistance, non-alcoholic fatty liver disease, and increased androgen bioavailability 1. Genetic variants in the SHBG gene, particularly the rs35785886 polymorphism with eight or more pentanucleotide repeats, are associated with increased polycystic ovary syndrome (PCOS) risk and reduced serum SHBG concentrations 3. SHBG levels correlate inversely with metabolic dysfunction, including dyslipidemia in postmenopausal women 4 and diabetes risk 5. Recent research indicates SHBG may have a causal role in type 2 diabetes pathogenesis, particularly in women, suggesting therapeutic potential for SHBG-raising treatments 5.