Search

Highlights • A GC–MS/MS based method for quantification of sex steroids in children is presented. • Adrostenedione, dihydrotestosterone, testosterone, estrone, estradiol were analyzed. • The GC–MS/MS- based method was sensitive enough for use in pediatric applications. • Reference intervals were established in relation to sex and pubertal maturation. Abstract Background Androgen and estrogen determinations serve as important diagnostic markers in a variety of clinical conditions. However, one challenge is to enhance assay sensitivity for determination in the lowest range, such as in prepubertal children. We here present a recently developed gas chromatography–tandem mass spectrometry (GC–MS/MS) method for determination of androstenedione (A 4), dihydrotestosterone (DHT), testosterone (T), estrone (E 1), and estradiol (E 2) in children, which we have compared with the sensitive radioimmunoassays; E 2 extraction-RIA and T-RIA. Methods Steroids were extracted in ethyl acetate n-hexane solution from serum spiked with isotopically labeled internal standard and derivatized sequentially with pentafluorobenzyl bromide, pentafluorobenzyl hydroxylamine and pentafluoropropionic acid anhydride and analyzed by GC–MS/MS using a triple quadrupole mass spectrometer operated in negative chemical ionization mode. Leftover routine samples (n = 414) were used to evaluate the concordance between GC–MS/MS and RIAs and the validity of GC–MS/MS for pediatrics; of these samples, 101 were from seemingly healthy children. Pubertal stage was recorded for reference interval evaluation. Results Lower limit of detection for A 4 , T, DHT, E 1 , and E 2 were 0.1 nmol/L, 0.1 nmol/L, 27 pmol/L, 9 pmol/L, and 2 pmol/L, respectively. Good agreement was found between GC–MS/MS and T-RIA (r = 0.98) as well as between GC–MS/MS and E 2 extraction-RIA (r = 0.98, for E 2 concentrations above 14 pmol/L). In boys, T and DHT increased significantly from prepuberty throughout pubertal development, and in girls the same increase was observed for E 1 and E 2. The greatest increase in A 4 for both genders, as well as E 1 and E 2 in boys and T and DHT in girls, occurred in mid to late puberty. Conclusions We report the development of a GC–MS/MS method sensitive enough to accurately determine serum levels of androgens and estrogens in children. [ABSTRACT FROM AUTHOR]

Background. Immunoassays have been criticized for poor accuracy at low testosterone concentrations. Mass spectrometry (MS) has been proposed as the only reliable method for testosterone determination. The aim of this study was to compare a sensitive testosterone radioimmunoassay (RIA) with results from different MS. Methods. We compared testosterone concentrations determined by a sensitive testosterone RIA, lower limit of detection 0.03 nmol/L and limit of quantitation 0.1 nmol/L, with four tandem MS that were included in an international external quality assessment program for laboratory medicine. We also compared the morning concentrations of testosterone in girls and boys at different pubertal stages, using results from the RIA, with reported values determined by LC-MS/MS, developed for androgen determination in children. Results. The mean (SD), concentrations were similar between RIA and MS: 1.5 (0.3) and 1.4 (0.4) in the child/women range (0.8-2.6 nmol/L) and 16.0 (3.7) and 17.8 (4.5) nmol/L for the adult male range (10.1-30.0 nmol/L), respectively. The ratio between RIA and MS versus results from mean values of the four MS methods was 1.0 (0.18); 1.1 (0.18) for child/women concentrations and 0.9 (0.13) for male testosterone concentrations. Furthermore, compared to the pediatric reference values determined by LC-MS/MS, the sensitive testosterone RIA delivered similar testosterone values across the different pubertal stages. Conclusions. The comparison between different tandem MS methods and a sensitive testosterone RIA illustrates that there are immunoassays that deliver clinically useful information in prepubertal and pubertal children. [ABSTRACT FROM AUTHOR]