Multiplexed steroid profiling of gluco- and mineralocorticoids pathways using a liquid chromatography tandem mass spectrometry method
Abstract
Serum steroid assays are major tools in the clinical evaluation of adrenal disorders. The main adrenal steroids are routinely measured with immunoassays. However, chromatographic methods are known to offer better specificity. We report a liquid chromatography-tandem mass spectrometry (LC-MS/MS) assay for simultaneous quantification of 15 adrenal steroids targeting the mineralo- and gluco-corticosteroid pathways. Serum steroids combined with deuterated internal standards were extracted using successive protein precipitation and solid phase extraction steps. Cortisol, cortisone, 11-deoxycortisol, 17-hydroxyprogesterone, 21-deoxycortisol, progesterone, 11-deoxycorticosterone, corticosterone, 11-dehydrocorticosterone, 18-hydroxycorticosterone, 18-hydroxy-11-deoxycorticosterone, aldosterone, dehydroepiandrosterone sulfate, testosterone and androstenedione were resolved in fourteen minutes using a BEH C18 column coupled to a methanol-ammonium formate gradient. Detection was performed using multiple reaction monitoring quantitation. Routinely determined steroid levels by immunoassays were compared to those measured by LC-MS/MS. This method was applied to assess steroid profiles in congenital adrenal hyperplasia (CAH) patients with 21-hydroxylase deficiency. Low quantification limits depending on each steroid (ranging from 0.015ng/mL for aldosterone to 20ng/mL for DHEAS) are adapted to the clinical use. Recoveries of steroids range from 64% for 21-deoxycortisol to 101% for cortisol and are fully corrected by internal standards. A good linearity with R>0.989 is obtained for each compound. The inter-day variation coefficients ranged from 4.7% for cortisol to 16.3% for 11-deoxycorticosterone. The immunoassay for cortisol (Immulite 2000, Siemens) showed acceptable agreement with LC-MS/MS (bias +7.2%). However, Bland-Altman plots revealed large negative bias for aldosterone (-33.4%, AldoCT, CisBio international), for 17-hydroxyprogesterone at concentrations below 2ng/mL (-74.1%, OHP-CT MP Biomedical), for androstenedione (-80.3%, RIA D4, Beckman Coulter) and for 11-deoxycortisol (-125.3%, Diasource Immunoassays). Finally, the analysis of samples from 21-hydroxylase defective patients demonstrated the potential usefulness of multiplexed steroid profiling for the diagnosis and/or monitoring of different forms of congenital adrenal hyperplasia. This LC-MS/MS method provides highly sensitive and specific assessments of mineralo- and glucocorticoids pathways from a small volume sample and is therefore a promising potent tool for clinical and experimental endocrine studies.
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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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- Authors
- Travers, S., Martinerie, L., Bouvattier, C., Boileau, P., Lombès, M., & Pussard, E.
- Affiliations
- Université Paris-Sud (FR)
- Université de Versailles Saint-Quentin-en-Yvelines (FR)
- Corresponding author
- Pussard, Eric
- Venue
- The Journal of Steroid Biochemistry and Molecular Biology
- Publisher
- Elsevier BV
- Published
- 2017-01
- Volume
- 165
- Issue
- Pt B
- Pages
- 202-211
- ISSN
- 0960-0760 (ISSN-L)
- OpenAlex
- W2473953302
- Cited by
- 81
- References
- 40
- Citations by year
- 2026: 8 · 2025: 3 · 2024: 4 · 2023: 11 · 2022: 6 · 2021: 8 · 2020: 7 · 2019: 20 · 2018: 4 · 2017: 9 · 2016: 1
- FWCI
- 11.38
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- The Journal of Steroid Biochemistry and Molecular Biology (publishedVersion)
- PubMed (publishedVersion)
- HAL (submittedVersion)
- Funders
- Institut National de la Santé et de la Recherche Médicale
- Cardiovasculaire-Obésité-Rein-Diabète-Domaine d’Intérêt Majeur
- Waters Xevo TQS triple-quadrupole mass spectrometer
- Valerie Steiner and Cécile Dupuy for their advice in the first steps of method development
- Topics
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Adrenal Hormones and Disorders
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Biology › Metabolomics and Mass Spectrometry Studies
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Hormonal Regulation and Hypertension
- Keywords
- adrenal steroids, mineralocorticoids, glucocorticoids, congenital adrenal hyperplasia, 21-hydroxylase deficiency, cortisol, aldosterone, 17-hydroxyprogesterone, dehydroepiandrosterone sulfate, androstenedione, adrenal disorders, immunoassay comparison
- MeSH terms
- Adrenal Hyperplasia, Congenital, Child, Chromatography, High Pressure Liquid, Chromatography, Liquid, Glucocorticoids, Humans, Immunoassay, Mineralocorticoids, Mutation, Regression Analysis, Steroids, Reproducibility of Results, Tandem Mass Spectrometry, Limit of Detection
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