ECE2020 Audio ePoster Presentations Adrenal and Cardiovascular Endocrinology (121 abstracts)
Comparability of steroid hormone measurement among 9 European laboratories using liquid chromatography-tandem mass spectrometry (LC-MS/MS): Impact of the blood derivative and of calibration
Flaminia Fanelli 1 , Marco Mezzullo 1 , Elena Nardi 2 , Marco Cantù 3 , Johanna M Lindner 4 , Mirko Peitzsch 5 , James M Hawley 6 , Stephen J Bruce 7 , Annemieke C Heijboer 8 , Mariette T Ackermans 8 , Jody Van den Ouweland 9 , Daniel Koeppl 10 , Graeme Eisenhofer 5 , Manfred Rauh 10 , Brian Keevil 6 , Michael Vogeser 4 & Uberto Pagotto 1
1Endocrinology Unit, Center for Applied Biomedical Research, Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy; 2Laboratory of Biostatistics, Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy; 3Laboratory of Clinical Biochemistry and Pharmacology, Department of Laboratory Medicine EOLAB, Ente Ospedaliero Cantonale, Bellinzona, Switzerland; 4Institute of Laboratory Medicine, Hospital of the University of Munich (LMU), Munich, Germany; 5Institute of Clinical Chemistry and Laboratory Medicine, University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany; 6Manchester NHS Foundation Trust, Department of Clinical Biochemistry, University Hospital South Manchester, Manchester, United Kingdom; 7University Hospital of Lausanne (CHUV), Clinical Chemistry Laboratory, Lausanne, Switzerland; 8VU Medical Center - Academic Medical Center University Hospital, Endocrine Laboratory, Department of Clinical Chemistry, Amsterdam, Netherlands; 9Canisius-Wilhelmina Hospital, Department of Clinical Chemistry, Nijmegen, Netherlands; 10University Hospital of Erlangen, Department of Pediatrics and Adolescent Medicine, Erlangen, Germany
Background: LC-MS/MS is recommended for accurately measuring circulating steroids. However, laboratories using LC-MS/MS adopt various pre-analytical and analytical strategies, and little is known about comparability of results. Whether different blood derivatives impact LC-MS/MS measurements is unclear, and the benefit of unifying the calibration system among laboratories was not tested.
Aim: Comparisons of LC-MS/MS measurements of circulating aldosterone (Al), corticosterone (B), cortisone (E), cortisol (F), 11-deoxycortisol (11S), 17OH-progesterone (17OHP4), androstenedione (A4), testosterone (T) and DHEAS among 9 European centers. Analysis of the impact of different blood specimens. Assessment of potential benefit of unifying the calibration system.
Methods: Thirteen female and 13 male adult patients in fasting state provided blood between 0800–0900 h into gel separator (gel-serum), beads clot-activator (beads-serum) and Li-heparin (plasma) tubes. Each laboratory analyzed two aliquots of 78 total samples according to laboratory specific procedures. Quantitation was obtained using in house, EUM01041 (BSN, Italy) (external set 1) and 6PLUS1 (Chromsystems, Germany) (external set 2) calibrators. Data were analyzed as inter-laboratory CV.
Results: Median (min-max) CV% were: female range-T, 6.2 (3.0−12.5); E, 6.4 (2.9−12.6); male range-T, 7.0 (4.1−10.9); DHEAS, 7.7 (4.3−14.0); B, 10.9 (4.2−26.5); A4, 11.0 (6.5−21.6); F, 13.0 (6.4−27.3); 11S, 13.5 (5.4−39.0); 17OHP4, 13.8 (6.3−34.0) and Al, 14.4 (6.0−24.1). Samples showing CV > 15% were 0.0% for T, E and DHEAS, and 16.7, 43.6 and 44.9% for B, 17OHP4 and Al, respectively, with minimal differences among specimens. When gel-serum, plasma and beads-serum were separately analyzed, cases with CV > 15% were 38.5, 7.7 and 0.0% for A4, 61.5, 30.8 and 26.9% for 11S, and 61.5, 30.8 and 30.8% for F, respectively. When changing in house calibration with external sets 1 and 2, samples showing CV > 15% were 15.4, 3.8 and 6.4% for A4; 16.7, 32.1 and 26.9% for B; 39.7, 38.5 and 73.1% for 11S; 41.0, 0.0 and 0.0% for F; 43.6, 66.7 and 24.4% for 17OHP4; 44.9, 47.4 and 28.2% for Al; and overall < 5% for T, DHEAS and E.
Conclusions: Inter-laboratory variability was good for T, DHEAS and E, moderate for A4 and B, and poor for 11S, Al, 17OHP4 and F. A4, 11S and F variability worsened with the gel-serum specimen. Unifying the calibration system dramatically improved A4 and F, worsened B, and variably impacted 11S, 17OHP4 and Al measurement comparability. Our data suggest that blood derivatives should be carefully evaluated by each procedure. Caution is required when adopting external calibration as it may not result in improving the harmonization of results.
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Endocrine Abstracts
ISSN 1470-3947 (print) | ISSN 1479-6848 (online)
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