Endocrinology

Cortisol-Binding Globulin (CBG)

Optimal Result: 19 - 45 mg/L, or 1.90 - 4.50 mg/dL.

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.

What does it mean if your Cortisol-Binding Globulin (CBG) result is too low?

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).

What does it mean if your Cortisol-Binding Globulin (CBG) result is too high?

Circulating levels increase in:

• Pregnancy
• Estrogen therapy
• Chronic, active hepatitis 
• Inherited abnormality

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