Cortisol-Binding Globulin (CBG)
Clinical Use
Useful in evaluating unexplained
cortisol concentrations
Reference Range
Adults
Children
Preterm infants (<8 d)
Pediatric data from Pediatr Res.1994;37:
112-116.
Interpretive Information
Pregnancy
Estrogen therapy
Chronic, active hepatitis
Inherited abnormality
Hyperinsulinemic states
Nephrotic syndrome
Severe liver disease
Malnutrition
Newborn
Inherited abnormality
37371X
Clinical Background
Cortisol-binding globulin (CBG) is a
serum alpha-2-globulin-binding
protein with high affinity and limited
capacity for cortisol. It binds most
mg/L (92%) of the serum cortisol; the
19-45 remaining cortisol (8%) circulates in
a free form or bound to albumin.
6-26 CBG is synthesized in the liver.
Circulating levels increase in preg-
nancy or after administration of
estrogen or oral contraceptives. Insulin
may inhibit synthesis, a fact that might
explain the low CBG levels observed in
hyperinsulinemic states (eg, diabetes,
obesity, PCO). CBG levels are also
reduced in nephrotic syndrome,
starvation, or severe chronic liver
disease.
The CBG assay is helpful in assessing
unexpected values of blood cortisol.
Other assays useful in diagnosis and
therapy of cortisol abnormalities
include plasma cortisol, ACTH,
-lipotropin, urinary cortisol (by
HPLC), or free cortisol in plasma or
serum.
Method
Radioimmunoassay (RIA)
Analytical sensitivity: 0.1 mg/L
Specimen Requirements
1 mL refrigerated serum
0.2 mL minimum
No additive red top preferred
SST red top acceptable
52