An LC-MS/MS method for steroid profiling during adrenal venous sampling for investigation of primary aldosteronism
Abstract
Background Steroid profiling for diagnosis of endocrine disorders featuring disordered production of steroid hormones is now possible from advances in liquid chromatography with tandem mass spectrometry (LC-MS/MS). Adrenal venous (AV) measurements of aldosterone and cortisol are a standard practice in the clinical work-up of primary aldosteronism, but do not yet take advantage of steroid profiling.Methods A novel LC-MS/MS based method was developed for simultaneous measurement of 15 adrenal steroids: aldosterone, corticosterone, 11-deoxycorticosterone, progesterone, pregnenolone, cortisone, cortisol, 11-deoxycortisol, 17-hydroxyprogesterone, androstenedione, dehydroepiandrosterone, dehydroepiandrosterone-sulfate, 21-deoxycortisol, 18-oxocortisol and 18-hydroxycortisol. These were compared in peripheral venous (pV) and AV plasma from 70 patients undergoing AV sampling with and without cosyntropin stimulation. Aldosterone and cortisol levels measured by LC-MS/MS were compared with those measured by immunoassay.Results Reproducibility of measurements with coefficients of variation ≤10% as well as analytical sensitivity sufficient to measure low pV levels particularly of aldosterone demonstrate the utility of the assay for profiling adrenal steroids in primary aldosteronism. Method comparisons indicated assay and concentration dependent differences of cortisol and aldosterone concentrations measured by immunoassay and LC-MS/MS. Median AV/pV ratios of 11-deoxycortisol (53.0), 17-hydroxyprogesterone (33.4), pregnenolone (62.4), androstenedione (40.6) and dehydroepiandrosterone (33.3) were 2.9- to, 5.4-fold larger than those for cortisol (11.6), with additionally generally larger increases than for cortisol with than without cosyntropin stimulation.Conclusion Our LC-MS/MS assay, in addition to improvements over existing immunoassay measurements of aldosterone and cortisol, offers profiling of 13 other adrenal steroids, providing a potentially useful method for the clinical work-up of patients with primary aldosteronism. In particular, the larger AV/pV ratios of several steroids compared to cortisol suggest more sensitive alternatives to the latter for assessing positioning of AV sampling catheters.
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Several sensitive and robust LC-MS/MS methods for multiple steroids have been developed in recent years and many methods meet the requirements for clinical applications.
“Several sensitive and robust LC-MS/MS methods for multiple steroids have been developed in recent years and many methods meet the re quirements for clinical applications [5 -16].”
Previously published methods including multiple steroid metabolites used larger sample volumes (150-500 μL) and/or longer total run-times (13.5-17 min).
“Previously published methods including multiple steroid metabolites used either larger sample volumes from 150-500 µ L and/or longer total rum-times from 13.5-17 min. [5,7,9,14,22].”
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Metabolic Subtyping of Adrenal Tumors: Prospective Multi-Center Cohort Study in Korea
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Self-citationAdrenal Hormone Interactions and Metabolism: A Single Sample Multi-Omics Approach
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Aldosterone Synthase Inhibition Improves Glucose Tolerance in Zucker Diabetic Fatty (ZDF) Rats
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Self-citationFemale sex hormones exacerbate retinal neurodegeneration
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Progress in the Management of Primary Aldosteronism
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Self-citationGeneration of glucocorticoid-producing cells derived from human pluripotent stem cells
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Generation and characterization of a mitotane-resistant adrenocortical cell line
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Self-citationRole of Adrenal Vein Sampling in Guiding Surgical Decision in Primary Aldosteronism
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Steroid Hormone Production in Patients with Aldosterone Producing Adenomas
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Self-citationEffect of Dietary Sodium Modulation on Pig Adrenal Steroidogenesis and Transcriptome Profiles
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Mass Spectrometry-Based Steroid Profiling: Meeting Unmet Clinical Needs
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Diagnostic criteria for adrenal venous sampling
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Self-citationA LC-MS/MS method to simultaneously profile 14 free monosaccharides in biofluids
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Self-citationQuantitative MALDI-MS/MS assay for serum cortisol through charged derivatization
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HIF1α controls steroidogenesis under acute hypoxic stress
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Self-citationTransplantation of porcine adrenal spheroids for the treatment of adrenal insufficiency
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- Authors
- Peitzsch, M., Dekkers, T., Haase, M., Sweep, F. C. G. J., Quack, I., Antoch, G., Siegert, G., Lenders, J. W. M., Deinum, J., Willenberg, H. S., & Eisenhofer, G.
- Affiliations
- University Hospital Carl Gustav Carus (DE)
- Radboud University Medical Center (NL)
- Heinrich Heine University Düsseldorf (DE)
- Radboud University Nijmegen (NL)
- Corresponding author
- Peitzsch, Mirko
- ORCID
- Venue
- The Journal of Steroid Biochemistry and Molecular Biology
- Publisher
- Elsevier BV
- Published
- 2015-01
- Volume
- 145
- Pages
- 75-84
- ISSN
- 0960-0760 (ISSN-L)
- OpenAlex
- W1975240351
- Cited by
- 169
- References
- 45
- Citations by year
- 2026: 17 · 2025: 17 · 2024: 10 · 2023: 18 · 2022: 19 · 2021: 19 · 2020: 17 · 2019: 11 · 2018: 6 · 2017: 17 · 2016: 9 · 2015: 9
- FWCI
- 9.36
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- The Journal of Steroid Biochemistry and Molecular Biology (publishedVersion)
- PubMed (publishedVersion)
- Radboud Repository (Radboud University) (submittedVersion)
- Topics
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Hormonal Regulation and Hypertension
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Adrenal Hormones and Disorders
- Health Sciences › Medicine › Surgery › Adrenal and Paraganglionic Tumors
- Keywords
- primary aldosteronism, adrenal vein sampling, steroid profiling, adrenal steroids, aldosterone, cortisol, cosyntropin stimulation, 11-deoxycortisol, 17-hydroxyprogesterone, pregnenolone, dehydroepiandrosterone, androstenedione
- MeSH terms
- Adrenal Glands, Adult, Aged, Chromatography, Liquid, Cosyntropin, Female, Humans, Hydrocortisone, Hyperaldosteronism, Immunoassay, Male, Middle Aged, Steroids, Reproducibility of Results, Tandem Mass Spectrometry
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