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Immunoassay or LC-MS/MS for the measurement of salivary cortisol in children?

  • Yoon Ju Bae , Alexander Gaudl , Sonia Jaeger , Stephanie Stadelmann , Andreas Hiemisch , Wieland Kiess , Anja Willenberg , Michael Schaab , Kai von Klitzing , Joachim Thiery , Uta Ceglarek , Mirko Döhnert and Juergen Kratzsch EMAIL logo
Published/Copyright: November 12, 2015
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Clinical Chemistry and Laboratory Medicine (CCLM)
From the journal Clinical Chemistry and Laboratory Medicine (CCLM) Volume 54 Issue 5

Abstract

Background:

Dysregulation of the adrenal cortex has been assessed with measurement of salivary cortisol. So far salivary cortisol is routinely measured with immunoassay (IA). However, liquid chromatography-tandem mass spectrometry (MS) is known to offer better specificity. We compared the concentrations of salivary cortisol measured by MS and IA at basal and stress induced conditions and evaluated reasons for the difference in method-dependent cortisol results.

Methods:

Saliva samples (n=2703) were collected from 169 children (age range: 8–14 years; 81 healthy children; 55 with internalizing and 33 with externalizing disorders) under circadian conditions and during the Trier Social Stress Test for Children (TSST-C). Biochemical analyses were performed with MS for cortisol and cortisone, IA (IBL, RE62011) for cortisol, and enzyme kinetic assay for α-amylase.

Results:

MS and IA showed mostly comparable results for circadian activity and TSST-C response with similar statistical power. However, IA measured cortisol concentrations about 2.39-fold higher than MS. We found that this difference in measured values between MS and IA was mainly due to different standardization of IA compared to MS. In addition, at cortisol IA concentration below 5 nmol/L, cross-reactivity with cortisone was found to contribute to the lower concordance between MS and IA.

Conclusions:

Immunoassay and LC-MS/MS were largely comparable in the interpretation of salivary cortisol dynamics in stress research. But the IA method revealed a restricted accuracy in the measuring range below 5 nmol/L.

Keywords: α-amylase interference; cortisone cross-reactivity; immunoassay; liquid chromatography tandem mass spectrometry; salivary cortisol; standardization; Trier Social Stress Test for Children
Corresponding author: Prof. Dr. Juergen Kratzsch, Institute of Laboratory Medicine, Clinical Chemistry and Molecular Diagnostics, University of Leipzig, Paul-List Str. 13-15, 04103 Leipzig, Germany, Phone: +49 341 97 22241, Fax: +49 341 97 22249
aYoon Ju Bae and Alexander Gaudl contributed equally as first authors.bMirko Döhnert and Juergen Kratzsch contributed equally as senior authors.

Acknowledgments

We thank Mrs Elke Jäschke and Ms Tuyen Pham for their contribution in the facilitation of the biochemical analyses.

  1. Author contributions: All the authors have accepted responsibility for the entire content of this submitted manuscript and approved submission.

  2. Research funding: This project was funded by LIFE (the Leipzig Research Centre for Civilization Diseases). LIFE is funded by means of the European Union, by the European Regional Development Fund (ERDF) and by means of the Free State of Saxony within the framework of the excellence initiative.

  3. Employment or leadership: None declared.

  4. Honorarium: None declared.

  5. Competing interests: The funding organization(s) played no role in the study design; in the collection, analysis, and interpretation of data; in the writing of the report; or in the decision to submit the report for publication.

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Supplemental Material:

The online version of this article (DOI: 10.1515/cclm-2015-0412) offers supplementary material, available to authorized users.

Received: 2015-4-30
Accepted: 2015-10-10
Published Online: 2015-11-12
Published in Print: 2016-5-1

©2016 Walter de Gruyter GmbH, Berlin/Boston

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https://doi.org/10.1515/cclm-2015-0412
Keywords for this article
α-amylase interference; cortisone cross-reactivity; immunoassay; liquid chromatography tandem mass spectrometry; salivary cortisol; standardization; Trier Social Stress Test for Children

Articles in the same Issue

  1. Frontmatter
  2. Editorial
  3. Protein S100B: from cancer diagnostics to the evaluation of mild traumatic brain injury
  4. Reviews
  5. Capillary electrophoresis based on nucleic acid detection for diagnosing human infectious disease
  6. Oxidative damage and the pathogenesis of menopause related disturbances and diseases
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  10. Effective quality management practices in routine clinical next-generation sequencing
  11. Analysis of PMP22 duplication and deletion using a panel of six dinucleotide tandem repeats
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  17. Measurement of factor XIII (FXIII) activity by an automatic ammonia release assay using iodoacetamide blank-procedure: no more overestimation in the low activity range and better detection of severe FXIII deficiencies
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