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HelpTEST ID SHBG1 Sex Hormone-Binding Globulin, Serum
Reporting Name
Sex Hormone-Binding Globulin, SSpecimen Type
SerumSpecimen Required
Supplies: Sarstedt Aliquot Tube, 5 mL (T914)
Collection Container/Tube:
Preferred: Serum gel
Acceptable: Red top
Submission Container/Tube: Plastic vial
Specimen Volume: 1 mL serum
Collection Instructions: Centrifuge and aliquot serum into a plastic vial.
Specimen Minimum Volume
Serum: 0.5 mL
Specimen Stability Information
| Specimen Type | Temperature | Time |
|---|---|---|
| Serum | Refrigerated (preferred) | 14 days |
| Frozen | 90 days | |
| Ambient | 7 days |
Method Name
Immunoenzymatic Assay
Reject Due To
| Gross hemolysis | Reject |
| Gross lipemia | OK |
| Gross icterus | OK |
Reference Values
CHILDREN:
Males
|
Tanner Stages |
Mean Age |
Reference Interval (nmol/L) |
|
Stage I |
10.4 |
17-135 |
|
Stage II |
11.1 |
21-114 |
|
Stage III |
12.7 |
12-138 |
|
Stage IV |
14.5 |
7.7-67 |
|
Stage V |
14.2 |
3.9-40 |
Females
|
Tanner Stages |
Mean Age |
Reference Interval (nmol/L) |
|
Stage I |
10.5 |
16-182 |
|
Stage II |
10.9 |
24-121 |
|
Stage III |
12.5 |
18-87 |
|
Stage IV |
14 |
7.7-108 |
|
Stage V |
14.9 |
10-79 |
ADULTS:
Males
≥18 years: 13.3-89.5 nmol/L
Females
18-46 years: 18.2-135.5 nmol/L
47-91 years: post-menopausal: 16.8-125.2 nmol/L
Reference values for pregnant women have not been established.
Day(s) Performed
Monday through Saturday
Report Available
1 to 3 daysSpecimen Retention Time
14 daysPerforming Laboratory
Mayo Clinic Laboratories in Rochester
CPT Code Information
84270
Forms
If not ordering electronically, complete, print, and send General Test Request (T239) with the specimen.
Useful For
Diagnosis and follow-up of women with signs or symptoms of androgen excess (eg, polycystic ovarian syndrome and idiopathic hirsutism)
An adjunct in monitoring sex-steroid and antiandrogen therapy
An adjunct in the diagnosis of disorders of puberty
An adjunct in the diagnosis and follow-up of anorexia nervosa
An adjunct in the diagnosis of thyrotoxicosis (tissue marker of thyroid hormone excess)
A possible adjunct in diagnosis and follow-up of insulin resistance and cardiovascular and type 2 diabetes risk assessment, particularly in women
Highlights
Sex hormone-binding globulin (SHBG) is a major carrier protein for sex steroids in the blood.
Determination of SHBG concentrations is useful in the investigation of cases of suspected androgen excess, such as polycystic ovarian syndrome or idiopathic hirsutism.
Sex hormone-binding globulin concentration measurements may be useful in the evaluation of infertility, disorders of puberty, thyrotoxicosis, and in the monitoring of sex-steroid and anti-androgen therapies.
Clinical Information
Sex hormone-binding globulin (SHBG), a 95 kDa homodimer, is the blood transport protein for testosterone and estradiol. SHBG is mainly produced in the liver and has a half-life of approximately seven days. SHBG binds reversibly to sex steroids. SHBG has a relatively high-binding affinity to dihydrotestosterone (DHT), medium affinity to testosterone and estradiol, and exhibits a low affinity to estrone, dehydroepiandrosterone, androstenedione, and estriol. Albumin, which exists at physiologically higher concentrations than SHBG, also binds to sex steroids, although with a much lower binding affinity (eg, about 100 times lower for testosterone).
Decreased SHBG serum concentrations are associated with conditions in which elevated androgen concentrations are present or the effect of androgen on its target organs is excessive. Because of the high-binding affinity of SHBG to DHT as compared to estradiol, SHBG has profound effects on the balance between bioavailable androgens and estrogens. Increased SHBG concentrations may be associated with signs and symptoms of hypogonadism in men while decreased concentrations can result in androgenization in women. SHBG is regulated by insulin, and a low SHBG concentration often indicates insulin resistance and, consequently, may be a predictor of type 2 diabetes.
Endogenous or exogenous thyroid hormones or estrogens increase SHBG concentrations. In men, there also is an age-related gradual rise, possibly secondary to the mild age-related fall in testosterone production. This process can result in bioavailable testosterone concentrations that are much lower than would be expected based on total testosterone measurements alone.
Cautions
In rare cases, some individuals can develop antibodies to mouse or other animal antibodies (often referred to as human anti-mouse antibodies [HAMA] or heterophile antibodies), which may cause interference in some immunoassays. Caution should be used in interpretation of results, and the laboratory should be alerted if the result does not correlate with the clinical presentation.
For patients presenting with cirrhosis or subclinical thyroid conditions, carefully evaluate results as these conditions can potentially cause erroneous sex hormone-binding globulin results.
Sex hormone-binding globulin results should be interpreted considering the total clinical presentation of the patient, including symptoms, clinical history, data from additional tests, and other appropriate information.
Method Description
The Access SHBG Sex Hormone-Binding Globulin assay is a sequential 2-step immunoenzymatic (sandwich) assay. Patient sample is added to a reaction vessel along with paramagnetic particles coated with monoclonal anti-SHBG antibody and saline buffer with proteins. After incubation in a reaction vessel, materials bound to the solid phase are held in a magnetic field, while unbound materials are washed away. A second monoclonal anti-SHBG antibody conjugated to alkaline phosphatase is added to the reaction vessel. After the second incubation in the reaction vessel, materials bound to the solid phase are held in a magnetic field, while unbound materials are washed away. Then, the chemiluminescent substrate is added to the vessel, and light generated by the reaction is measured with a luminometer. The light production is directly proportional to the concentration of SHBG in the sample. The amount of analyte in the sample is determined from a stored, multi-point calibration curve.(Package insert: Access SHBG Sex Hormone-Binding Globulin, A48617. Beckman Coulter, Inc; 04/2020)