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LC-MSMS assays of urinary cortisol, a comparison between four in-house assays

  • Julie Brossaud EMAIL logo , Monique Leban , Jean-Benoit Corcuff , Florence Boux de Casson , Anne-Gaëlle Leloupp , Damien Masson , Valérie Moal and Kalyane Bach-Ngohou
Published/Copyright: January 8, 2018
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Clinical Chemistry and Laboratory Medicine (CCLM)
From the journal Clinical Chemistry and Laboratory Medicine (CCLM) Volume 56 Issue 7

Abstract

Background:

Twenty-four hour urinary free cortisol (UFC) determination can be used for screening and follow-up of Cushing syndrome (CS). As immunoassay methods lack specificity for UFC measurement, the use of high-performance liquid chromatography coupled to mass spectrometer (LC-MSMS) is recommended. The aim of our study was to compare UFC results using four LC-MSMS methods performed in four independent laboratories in order to evaluate interlaboratory agreement.

Methods:

Frozen aliquots of 24-h urine samples (78 healthy volunteers and 20 patients with CS) were sent to four different laboratories for analysis. Following liquid-liquid or solid-liquid extraction, UFC were determined using four different LC-MSMS assay.

Results:

UFC intra- and interassays variation coefficients were lower than 10% for each centre. External quality control results were not significantly different. UFC normal ranges (established from healthy volunteers) were 17–126, 15–134, 12–118 and 27–157 nmol/day, respectively. Classification of UFC from healthy volunteers and patients with CS using a 95th percentile threshold was similar. However, for extreme UFC values (<50 or >270 nmol/day), negative or positive bias was noted.

Conclusions:

Even for highly specific methods such as LC-MSMS, variations of results can be found depending on analytical process. Validation of LC-MSMS methods including determination of the reference range is essential.

Keywords: analytical process; 24-h urinary free cortisol; interlaboratory agreement; liquid chromatography-tandem mass spectrometry
Corresponding author: Dr. Julie Brossaud, Department of Nuclear Medicine, University Hospital of Bordeaux, Bordeaux, France, Phone: +(33) 557521501
aGBS study group of the Société Française de Médecine Nucléaire.

Acknowledgments

The authors are grateful to Evelyne Elain and Medhi Sakka for technical assistance, to Christian Renaud for analytical expertise, to Nolwenn Graveline for quality expertise and to Alison Mc Lean for English revision of the manuscript.

  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 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 offers supplementary material (https://doi.org/10.1515/cclm-2017-0806).

Received: 2017-9-6
Accepted: 2017-11-30
Published Online: 2018-1-8
Published in Print: 2018-6-27

©2018 Walter de Gruyter GmbH, Berlin/Boston

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https://doi.org/10.1515/cclm-2017-0806
Keywords for this article
analytical process; 24-h urinary free cortisol; interlaboratory agreement; liquid chromatography-tandem mass spectrometry

Articles in the same Issue

  1. Frontmatter
  2. Editorial
  3. Free light chains in the cerebrospinal fluid. Do we still need oligoclonal IgG?
  4. Reviews
  5. Obese phenotype and natriuretic peptides in patients with heart failure with preserved ejection fraction
  6. Prognostic value of HE4 in patients with ovarian cancer
  7. Opinion Paper
  8. Laboratory hemostasis: from biology to the bench
  9. Genetics and Molecular Diagnostics
  10. Multicenter validation study for the certification of a CFTR gene scanning method using next generation sequencing technology
  11. General Clinical Chemistry and Laboratory Medicine
  12. IL8 and IL16 levels indicate serum and plasma quality
  13. “Send & hold” clinical decision support rules improvement to reduce unnecessary testing of vitamins A, E, K, B1, B2, B3, B6 and C
  14. CSF free light chain identification of demyelinating disease: comparison with oligoclonal banding and other CSF indexes
  15. Search for new biomarkers of pediatric multiple sclerosis: application of immunoglobulin free light chain analysis
  16. The importance of detecting anti-DFS70 in routine clinical practice: comparison of different care settings
  17. Higher D-lactate levels are associated with higher prevalence of small dense low-density lipoprotein in obese adolescents
  18. LC-MSMS assays of urinary cortisol, a comparison between four in-house assays
  19. Optimized angiotensin-converting enzyme activity assay for the accurate diagnosis of sarcoidosis
  20. Quantitative urine test strip reading for leukocyte esterase and hemoglobin peroxidase
  21. Performance evaluation of cobas HBV real-time PCR assay on Roche cobas 4800 System in comparison with COBAS AmpliPrep/COBAS TaqMan HBV Test
  22. Systematic comparison of routine laboratory measurements with in-hospital mortality: ICU-Labome, a large cohort study of critically ill patients
  23. Reference Values and Biological Variations
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  25. Plasma midregional proadrenomedullin (MR-proADM) concentrations and their biological determinants in a reference population
  26. Cancer Diagnostics
  27. Analytical validation of the Hevylite assays for M-protein quantification
  28. Cardiovascular Diseases
  29. Assessing matrix, interferences and comparability between the Abbott Diagnostics and the Beckman Coulter high-sensitivity cardiac troponin I assays
  30. Infectious Diseases
  31. Evaluation of a novel prognostic score based on thrombosis and inflammation in patients with sepsis: a retrospective cohort study
  32. Letters to the Editor
  33. Independent evaluation using fresh patient samples under real clinical conditions is vital for confirming the suitability and marketability of any new HbA1c assay. An example
  34. Anti-streptavidin antibodies mimicking heterophilic antibodies in thyroid function tests
  35. Site-specific DNA methylation detection based on enzyme-linked immunosorbent assay using recombinant methyl-CpG binding protein
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