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Sex steroid hormone stability in serum tubes with and without separator gels

  • Sophie Hepburn ORCID logo EMAIL logo , Michael J.P. Wright , Conchita Boyder , Renee C. Sahertian , Ben Lu , Rui Zhang , Chris P. White and Andrea R. Horvath
Published/Copyright: February 12, 2016
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Clinical Chemistry and Laboratory Medicine (CCLM)
From the journal Clinical Chemistry and Laboratory Medicine (CCLM) Volume 54 Issue 9

Abstract

Background:

A pilot study showing a decrease in androstenedione concentration in serum collected into gel-containing serum tubes (STs) triggered an investigation of the effect of serum collection tube on steroid hormone stability.

Methods:

In the main study, two tube types were examined: BD Vacutainer® SST™II Advance and BD Vacutainer® Serum Tube. Forty-seven serum samples from apparently healthy volunteers were collected and analysed by liquid chromatography-tandem mass spectrometry (LC-MS/MS) for testosterone, androstenedione, 17-hydroxyprogesterone (17-OHP) (n=20); and oestradiol (n=27). Primary specimens were centrifuged once, maintained at room temperature and extracted within 2 h for day zero (d0) results. To assess stability following refrigeration (2–8 °C), aliquots were taken from the primary tube on day one (d1) and day five (d5) and analysed immediately. Differences in measurand concentration between tubes at d0 and following storage (d1 and d5) were evaluated for statistical significance.

Results:

There was a progressive and statistically significant decrease in androstenedione concentration from d0 to d5 (p<0.001) in the SST™II tubes. In addition, there was a statistically significant reduction in testosterone, 17-OHP and oestradiol concentrations at d5 (p<0.01). Interestingly, oestradiol and testosterone concentrations increased with time in plain STs (p<0.01). The only change likely to have a clinical impact was that of androstenedione in serum gel tubes.

Conclusions:

To optimise conditions and to reduce pre-analytical error we recommend the use of plain serum collection tubes for androstenedione and rapid separation of serum from cells when oestradiol and testosterone are requested.

Keywords: blood specimen collection; serum gel tubes; serum tubes without gel; specimen handling; steroids; tandem mass spectrometry
Corresponding author: Sophie Hepburn, SEALS Department of Clinical Chemistry and Endocrinology, Prince of Wales Hospital, Sydney, NSW 2031, Australia, Phone: +61-2-9382-4601, Fax: +61-2-9382-9099, E-mail: .

Acknowledgments

The authors would like to acknowledge the assistance of Craig Aurand and David Bell from Supelco (Sigma Aldrich, Bellefonte, PA, USA) for their assistance with the oestradiol assay; Lee Williams and Claire Desbrow from Biotage (Ystrad Mynach, UK) for their assistance with the SLE applications; and Chris Hodgkins from SCIEX (Mulgrave, Victoria, Australia) for assistance in developing the LC-MS/MS applications. Our thanks also go to Sverre Sandberg and Wytze Oosterhuis for their wisdom regarding approaches to pre-analytical performance specifications.

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

  2. Research funding: None declared.

  3. Employment or leadership: None declared.

  4. Honorarium: None declared.

  5. Competing interests: The funding organisation(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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Received: 2015-11-17
Accepted: 2015-12-30
Published Online: 2016-2-12
Published in Print: 2016-9-1

©2016 Walter de Gruyter GmbH, Berlin/Boston

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https://doi.org/10.1515/cclm-2015-1133
Keywords for this article
blood specimen collection; serum gel tubes; serum tubes without gel; specimen handling; steroids; tandem mass spectrometry

Articles in the same Issue

  1. Frontmatter
  2. Editorials
  3. The Theranos phenomenon, scientific transparency and freedom of speech
  4. Holotranscobalamin: in the middle of difficultly lies opportunity
  5. Review
  6. Laboratory and clinical risk assessment to treat myelodysplatic syndromes
  7. Mini Review
  8. Quantitative nucleic acid amplification by digital PCR for clinical viral diagnostics
  9. Genetics and Molecular Diagnostics
  10. Hybrid minigene splicing assay verified the pathogenicity of a novel splice site variant in the dystrophin gene of a Chinese patient with typical Duchenne muscular dystrophy phenotype
  11. General Clinical Chemistry and Laboratory Medicine
  12. Prospective validation of an automated chemiluminescence-based assay of renin and aldosterone for the work-up of arterial hypertension
  13. Sex steroid hormone stability in serum tubes with and without separator gels
  14. Reduced absorption and enhanced synthesis of cholesterol in patients with cystic fibrosis: a preliminary study of plasma sterols
  15. An International Standard for holotranscobalamin (holoTC): international collaborative study to assign a holoTC value to the International Standard for vitamin B12 and serum folate
  16. A technical and clinical evaluation of a new assay for inhibin A and its use in second trimester Down syndrome screening
  17. Investigation on the ability of first trimester glycodelin and angiopoietin-2 to predict small-for-gestational age pregnancies at delivery
  18. Plasma total C-terminal agrin fragment (tCAF) as a marker for kidney function in patients with chronic kidney disease
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  24. Derivation of level-specific reference change values (RCV) from a health screening database and optimization of their thresholds based on clinical utility
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