Assay of unbound cortisol in plasma

ROBIN, P.; PREDINE, J.; MILGROM, E.

doi:10.1210/jcem-46-2-277

Cited by 52Adrenal Hormones and DisordersClinical Laboratory Practices and Quality ControlStress Responses and Cortisol

Assay of unbound cortisol in plasma

ROBIN, P., PREDINE, J., MILGROM, E.·1978·The Journal of Clinical Endocrinology & Metabolism

DOI 10.1210/jcem-46-2-277

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Abstract

A method for measuring the unbound fraction of plasma cortisol which is suitable for clinical use is described. It is shown that unless some precise experimental conditions are fulfilled, important errors may result when determining the unbound fraction of the hormone. The assay is practical (2 ml of plasma are necessary) and reproducible (coefficient of variation: 2.7% within the same assay and 3.1% in different assays). Unbound cortisol measured at 0800 h in 86 healthy individuals was 9.7 +/- 2.6% (SD) of total cortisol and 15.0 +/- 8.5 ng/ml of plasma (temperature: 37 C). No significant difference was found between men and women or according to age. In most cases, variations of unbound plasma cortisol were more important than the variations of total plasma cortisol. This explains why unbound cortisol was a better discriminator in some pathological conditions. In Cushing's syndrome unbound cortisol was found to be increased on the average 2.9 fold whereas total cortisol was only increased by 53%. Unbound cortisol was especially high (24.7 +/- 3.8% of total cortisol and 78 +/- 18.5 ng/ml of plasma) in Cushing's syndrome due to adrenal carcinoma. In adrenal insufficiency, unbound cortisol averaged 6% of total cortisol and 1.4 ng/ml of plasma.

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Plasma cortisol measurements reflect both bound and unbound (biologically active) components.
“Plasma cortisol measurements reflect both bound and unbound (biologically active) components.(65)”
From Effects of Mindfulness-Based Stress Reduction on Experimental Pain Sensitivity and Cortisol Responses in Women with Early Life Abuse: A Randomized Controlled Trial (2021) · cites this paper as [65]

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Authors: ROBIN, P., PREDINE, J., & MILGROM, E.
Affiliations: Inserm (FR)
Venue: The Journal of Clinical Endocrinology & Metabolism
Publisher: The Endocrine Society
Published: 1978-02
Volume: 46
Issue: 2
Pages: 277-283
ISSN: 0021-972X (ISSN-L)
1945-7197
DOI: 10.1210/jcem-46-2-277
OpenAlex: W2008540856
Cited by: 52
References: 19
Citations by year: 2020: 2 · 2019: 1 · 2015: 2 · 2013: 1
FWCI: 2.42
Type: journal article
Language: en
Open access: closed
Locations: The Journal of Clinical Endocrinology & Metabolism (publishedVersion)
PubMed (publishedVersion)
Topics: Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Adrenal Hormones and Disorders
Health Sciences › Medicine › Physiology › Clinical Laboratory Practices and Quality Control
Life Sciences › Neuroscience › Behavioral Neuroscience › Stress Responses and Cortisol
Keywords: plasma cortisol, cortisol binding, Cushing's syndrome, adrenocortical carcinoma, adrenal insufficiency, cortisol assay, assay reproducibility, healthy reference values
MeSH terms: Addison Disease, Cushing Syndrome, Dexamethasone, Humans, Hydrocortisone, Hypopituitarism, Membranes, Artificial, Methods, Temperature, Ultrafiltration

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Assay of unbound cortisol in plasma

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