Dried Blood Spot Testing for Seven Steroids Using Liquid Chromatography-Tandem Mass Spectrometry With Reference Interval Determination in the Korean Population.
10.3343/alm.2015.35.6.578
- Author:
Borahm KIM
1
;
Mi Na LEE
;
Hyung Doo PARK
;
Jong Won KIM
;
Yun Sil CHANG
;
Won Soon PARK
;
Soo Youn LEE
Author Information
1. Department of Laboratory Medicine and Genetics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea. suddenbz@skku.edu
- Publication Type:Original Article ; Research Support, Non-U.S. Gov't
- Keywords:
Mass spectrometry;
Method validation;
Congenital adrenal hyperplasia;
Steroid;
Korea;
Reference interval
- MeSH:
Adult;
Asian Continental Ancestry Group;
Child;
*Chromatography, High Pressure Liquid/standards;
Dried Blood Spot Testing;
Female;
Humans;
Infant, Newborn;
Infant, Premature;
Male;
Reference Values;
Republic of Korea;
Steroids/*blood/standards;
*Tandem Mass Spectrometry/standards
- From:Annals of Laboratory Medicine
2015;35(6):578-585
- CountryRepublic of Korea
- Language:English
-
Abstract:
BACKGROUND: Conventional screening for congenital adrenal hyperplasia (CAH) using immunoassays generates a large number of false-positive results. A more specific liquid chromatography-tandem mass spectrometry (LC-MS/MS) method has been introduced to minimize unnecessary follow-ups. However, because of limited data on its use in the Korean population, LC-MS/MS has not yet been incorporated into newborn screening programs in this region. The present study aims to develop and validate an LC-MS/MS method for the simultaneous determination of seven steroids in dried blood spots (DBS) for CAH screening, and to define age-specific reference intervals in the Korean population. METHODS: We developed and validated an LC-MS/MS method to determine the reference intervals of cortisol, 17-hydroxyprogesterone, 11-deoxycortisol, 21-deoxycortisol, androstenedione, corticosterone, and 11-deoxycorticosterone simultaneously in 453 DBS samples. The samples were from Korean subjects stratified by age group (78 full-term neonates, 76 premature neonates, 89 children, and 100 adults). RESULTS: The accuracy, precision, matrix effects, and extraction recovery were satisfactory for all the steroids at three concentrations; values of intra- and inter-day precision coefficients of variance, bias, and recovery were 0.7-7.7%, -1.5-9.8%, and 49.3-97.5%, respectively. The linearity range was 1-100 ng/mL for cortisol and 0.5-50 ng/mL for other steroids (R2>0.99). The reference intervals were in agreement with the previous reports. CONCLUSIONS: This LC-MS/MS method and the reference intervals validated in the Korean population can be successfully applied to analyze seven steroids in DBS for the diagnosis of CAH.
