Cortisol-binding globulin (CBG) is a serum alpha-2-globulin-binding protein with high affinity and limited capacity for cortisol. It binds most (±92%) of the serum cortisol; the remaining cortisol (±8%) circulates in a free form or bound to albumin.
Cortisol-binding globulin (CBG) is synthesized in the liver.
The Cortisol-binding globulin (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, β-lipotropin, urinary cortisol (by HPLC), or free cortisol in plasma or serum.
Low due to:
• Hyperinsulinemic states
• Nephrotic syndrome
• Severe liver disease
• Malnutrition
• Newborn
• Inherited abnormality
Insulin may inhibit synthesis, a fact that might explain the low CBG levels observed in hyperinsulinemic states (eg, diabetes, obesity, PCO).
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Circulating levels increase in:
• Pregnancy
• Estrogen therapy
• Chronic, active hepatitis
• Inherited abnormality
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