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Cardiovascular risk starts early in life; therefore, it is of interest to clarify the relation between puberty, sex hormones, insulin resistance and lipid levels in children. This is a cross sectional study of 365 school students (8–18 years of age). We analyzed the associations of sex hormones (testosterone, free androgen index, estradiol, free estradiol index) and sex hormone-binding globulin (SHBG) with insulin resistance and lipid levels. Analyses were performed in prepubertal versus adolescent girls and boys. Among prepubertal boys, estradiol was significantly associated with increased log homeostasis model assessment-estimated insulin resistance (HOMA-IR; B = 0.9, model R² = 0.62, p < 0.001) and insulin levels (B = 0.8, model R² = 0.58, p < 0.001). Testosterone was associated with increased high-density lipoprotein cholesterol (HDL-C) levels among prepubertal boys (B = 10, model R² = 0.42, p = 0.04). Among adolescent girls, SHBG was significantly associated with decreased HOMA-IR (B = –0.8, model R² = 0.34, p = 0.01) and insulin levels (B = –0.7, model R² = 0.34, p = 0.01). SHBG was also related to increased HDL-C levels among prepubertal (B = 24, model R² = 0.42, p = 0.047) and adolescent girls (B = 21, model R² = 0.44, p = 0.002). In conclusion, sex hormone levels and SHBG have important effects on HDL-C and insulin resistance among children and adolescents.

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