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Lower accuracy of testosterone, cortisol, and free T4 measurements using automated immunoassays in people undergoing hemodialysis.
Jansen, Heleen I; van Herwaarden, Antonius E; Huijgen, Henk J; Vervloet, Marc G; Hillebrand, Jacquelien J; Boelen, Anita; Heijboer, Annemieke C.
Affiliation
  • Jansen HI; Department of Clinical Chemistry, Endocrine Laboratory, Amsterdam UMC Location Vrije Universiteit Amsterdam, Amsterdam, The Netherlands.
  • van Herwaarden AE; Amsterdam Gastroenterology, Endocrinology & Metabolism, Amsterdam, The Netherlands.
  • Huijgen HJ; Department of Clinical Chemistry, Endocrine Laboratory, Amsterdam UMC Location University of Amsterdam, Amsterdam, The Netherlands.
  • Vervloet MG; Department of Laboratory Medicine, Radboud University Medical Center, Nijmegen, The Netherlands.
  • Hillebrand JJ; Department of Clinical Chemistry, Red Cross Hospital, Beverwijk, The Netherlands.
  • Boelen A; Department of Nephrology, Amsterdam UMC Vrije Universiteit Amsterdam, Amsterdam, The Netherlands.
  • Heijboer AC; Amsterdam Gastroenterology, Endocrinology & Metabolism, Amsterdam, The Netherlands.
Clin Chem Lab Med ; 61(8): 1436-1445, 2023 07 26.
Article de En | MEDLINE | ID: mdl-36877870
ABSTRACT

OBJECTIVES:

Hormone measurements using automated immunoassays (IAs) can be affected by the sample matrix. Liquid chromatography tandem-mass spectrometry (LC-MS/MS) is less affected by these matrix effects. In clinical laboratories, testosterone, cortisol and, free thyroxine (FT4) are often measured using IAs. Renal failure alters serum composition in blood samples from people undergoing hemodialysis (HDp) and have, therefore, a complex serum constitution compared to healthy controls (HC). The goal of this study was to investigate the accuracy of testosterone, cortisol, and FT4 measurements in samples of HDp and to get more insight in the interfering factors.

METHODS:

Thirty serum samples from HDp and HC were collected to measure testosterone, cortisol, and FT4 using a well standardized isotope dilution (ID)-LC-MS/MS method and 5 commercially available automated IAs (Alinity, Atellica, Cobas, Lumipulse, UniCel DXI). Method comparisons between LC-MS/MS and IAs were performed using both HDp and HC samples.

RESULTS:

Average bias from the LC-MS/MS was for testosterone, cortisol, and FT4 immunoassays respectively up to 92, 7-47 and 16-27% more in HDp than in HC samples and was IA dependent. FT4 IA results were falsely decreased in HDp samples, whereas cortisol and testosterone concentrations in females were predominantly falsely increased. Correlation coefficients between LC-MS/MS and IA results were lower in HDp compared to HC samples.

CONCLUSIONS:

Several IAs for testosterone (in women), cortisol, and FT4 are less reliable in the altered serum matrix of samples of HDp than in HC. Medical and laboratory specialists should be aware of these pitfalls in this specific population.
Sujet(s)
Mots clés

Texte intégral: 1 Collection: 01-internacional Base de données: MEDLINE Sujet principal: Testostérone / Hydrocortisone Limites: Female / Humans Langue: En Journal: Clin Chem Lab Med Sujet du journal: QUIMICA CLINICA / TECNICAS E PROCEDIMENTOS DE LABORATORIO Année: 2023 Type de document: Article Pays d'affiliation: Pays-Bas

Texte intégral: 1 Collection: 01-internacional Base de données: MEDLINE Sujet principal: Testostérone / Hydrocortisone Limites: Female / Humans Langue: En Journal: Clin Chem Lab Med Sujet du journal: QUIMICA CLINICA / TECNICAS E PROCEDIMENTOS DE LABORATORIO Année: 2023 Type de document: Article Pays d'affiliation: Pays-Bas