Age- and sex-adjusted reference intervals for steroid hormones measured by liquid chromatography‑tandem mass spectrometry (LC-MS/MS) using a widely available kit

Objective: Measurements utilizing commercially available sets of reagents for determination of steroid hormone profiles by liquid chromatography-tandem-mass-spectrometry (LC MS/MS) become increasingly important for routine laboratories. However, method specific publications of reference intervals obtained from sufficiently large studies are often missing.

Methods: After validation of performance characteristics, a widely available kit for steroid analysis by LC MS/MS was used to measure concentrations of 15 endogenous steroids (aldosterone, cortisol, cortisone, corticosterone, 11 deoxycortisol, 21 deoxycortisol, dehydroepiandrosterone sulfate, estradiol, testosterone, androstenedione, dihydrotestosterone, dehydroepiandrosterone, 17 hydroxyprogesterone, 11 deoxycorticosterone, progesterone) in more than 500 blood samples from a population based study. While randomly selected from a larger cohort, the samples equally represented both sexes, and covered a wide range of adult age groups. Age- and sex-specific reference intervals were calculated, and correlation with body mass index (BMI) was assessed.

Results: Performance characteristics of the assay matched expectations for 9 of 15 steroids. For most of them, reference intervals obtained from our study population were comparable to those reported by others, with age and sex being the major determinants. A sex-specific correlation with BMI was found for seven steroids. We identified limitations regarding sensitivity of the method for quantification of progesterone in males and postmenopausal females. Concentrations of aldosterone, 21-deoxycortisol, estradiol, 11 deoxycorticosterone and dihydrotestosterone could not be quantified in a large percentage of samples.

Conclusions: The reference intervals for 9 steroids will support meaningful interpretation for steroid profiles as measured by a widely used kit for LC MS/MS based quantification. Laboratories using such kits must be aware of potential limitations in sensitivity for some steroids included in the profile.

 

Comments:

Summary of the Study: The objective of this study was to establish reference intervals for 15 endogenous steroids using a commercially available kit for liquid chromatography-tandem-mass-spectrometry (LC MS/MS). The researchers validated the performance characteristics of the assay and analyzed more than 500 blood samples from a population-based study, representing both sexes and various adult age groups. Age- and sex-specific reference intervals were calculated for 15 steroids, and the correlation between steroid levels and body mass index (BMI) was assessed.

Results and Findings:

1. **Performance Characteristics:** The assay met expectations for 9 out of 15 steroids, indicating reliable results for these compounds.

2. **Reference Intervals:** Reference intervals obtained for most steroids were comparable to previous reports, with age and sex being the major factors influencing steroid levels. This information is valuable for interpreting steroid profiles in routine laboratory analyses.

3. **Correlation with BMI:** Seven steroids showed a sex-specific correlation with BMI, highlighting the influence of body composition on steroid hormone levels.

4. **Limitations:** The study identified limitations in the sensitivity of the method for quantifying progesterone in males and postmenopausal females. Additionally, certain steroids (aldosterone, 21-deoxycortisol, estradiol, 11 deoxycorticosterone, and dihydrotestosterone) could not be reliably quantified in a significant percentage of samples, indicating potential challenges in accurately measuring these compounds using the kit.

Conclusion: The study provides essential reference intervals for 9 steroids, aiding in the meaningful interpretation of steroid profiles analyzed through a widely used LC MS/MS kit. However, laboratories utilizing such kits should be mindful of the limitations in sensitivity for specific steroids, which could impact the accuracy of results. This knowledge is crucial for ensuring the reliability of steroid hormone measurements in clinical and research settings.

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Related Targets

Glucocorticoid Receptor