ALTERATIONS IN SERUM CORTISOL AND ITS BINDING CHARACTERISTICS IN ANOREXIA-NERVOSA

The binding capacity and apparent binding affinity of corticosteroid-binding globulin (CBG) for cortisol was studied in 20 women hospitalized for anorexia nervosa. The binding capacity for cortisol, as determined kinetically at 0.degree. C by Scatchard analysis was similar in anorectic patients and control subjects, with mean values of 26.9 and 21.9 .mu.g/100 ml, respectively. The mean apparent affinity constant of CBG for cortisol was significantly (P < 0.01) lower (14.1 .times. 108 M-1) than that in control subjects (22.3 .times. 108 M-1) and was similar in blood drawn at 0830 and 2000 h. Mean morning total serum cortisol concentrations were higher in anorectic women (23.3 .mu.g/100 ml) than in controls (10.0 .mu.g/100 ml; P < 0.001) and frequently exceeded the binding capacity of CBG. Diurnal variation was present. Mean serum 17.beta.-estradiol levels were low (40.0 pg/ml) and serum progesterone was essentially absent, but mean serum testosterone levels were within the normal range. Eight patients who were retested after weight gain, when they were between 76-100% of ideal body weight, exhibited no significant changes in serum steroids or in the binding capacity or apparent affinity of CBG for cortisol.