1
|
Grötsch MK, Ehlert U. Allopregnanolone in the peripartum: Correlates, concentrations, and challenges - A systematic review. Psychoneuroendocrinology 2024; 166:107081. [PMID: 38759520 DOI: 10.1016/j.psyneuen.2024.107081] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/10/2024] [Revised: 04/12/2024] [Accepted: 05/09/2024] [Indexed: 05/19/2024]
Abstract
BACKGROUND Allopregnanolone (ALLO) is a metabolite of progesterone and a neuroactive steroid hormone. As a positive allosteric modulator of gamma-aminobutyric acid (GABA) receptors, ALLO seems to have antidepressant and anxiolytic effects, and was therefore approved as a specific medication for the treatment of postpartum depression in 2019. Despite the growing number of publications investigating ALLO levels, results on the biological and psychological correlates in the peripartum period remain inconsistent, possibly due to methodological challenges regarding measurement. To date, however, there is no systematic review examining the correlates, concentrations, and challenges in measuring ALLO in peripartum women. METHOD A systematic literature search of PubMed and PsycINFO was conducted in August 2023. Original research articles that measured ALLO concentrations in peripartum women were included. Reports were excluded if they were not original research, included non-human subjects, did not include peripartum women, did not include ALLO measurement as an outcome, included (pharmacological) interventions, constituted method validations, or used the same cohort as another study. RESULTS The literature search yielded 234 articles, and two articles were identified from other sources. After full-text screening, 19 articles (N = 1401) met the inclusion criteria, of which seven focused on biological correlates of ALLO and 12 on mood correlates. Of the latter, six found no association between ALLO and mood, four found a negative association, and two found a positive association. Overall, the results show an increase in ALLO levels during pregnancy and a decrease after birth, with levels then remaining low until six months postpartum. ALLO was most commonly measured in blood plasma and by gas chromatography-mass spectrometry (GC-MS). A significant matrix effect was found for blood serum and a significant method effect for radioimmunoassays (RIAs). A significant effect of time of measurement was found. CONCLUSION ALLO measurement shows method and matrix effects. ALLO levels are higher when measured in serum compared to in plasma, and when measured using RIA compared to other methods. Time of measurement, study design, and standardization of measurement also influence the reliability of measurement and the interpretation of results.
Collapse
Affiliation(s)
- Maria Katharina Grötsch
- Clinical Psychology and Psychotherapy, University of Zurich, Switzerland; Clinical Psychology and Psychotherapy, Binzmühlestrasse 14, Zurich 8050, Switzerland
| | - Ulrike Ehlert
- Clinical Psychology and Psychotherapy, University of Zurich, Switzerland; Clinical Psychology and Psychotherapy, Binzmühlestrasse 14, Zurich 8050, Switzerland.
| |
Collapse
|
2
|
Grissom NM, Glewwe N, Chen C, Giglio E. Sex mechanisms as nonbinary influences on cognitive diversity. Horm Behav 2024; 162:105544. [PMID: 38643533 DOI: 10.1016/j.yhbeh.2024.105544] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/31/2023] [Revised: 04/09/2024] [Accepted: 04/10/2024] [Indexed: 04/23/2024]
Abstract
Essentially all neuropsychiatric diagnoses show some degree of sex and/or gender differences in their etiology, diagnosis, or prognosis. As a result, the roles of sex-related variables in behavior and cognition are of strong interest to many, with several lines of research showing effects on executive functions and value-based decision making in particular. These findings are often framed within a sex binary, with behavior of females described as less optimal than male "defaults"-- a framing that pits males and females against each other and deemphasizes the enormous overlap in fundamental neural mechanisms across sexes. Here, we propose an alternative framework in which sex-related factors encompass just one subset of many sources of valuable diversity in cognition. First, we review literature establishing multidimensional, nonbinary impacts of factors related to sex chromosomes and endocrine mechanisms on cognition, focusing on value- based decision-making tasks. Next, we present two suggestions for nonbinary interpretations and analyses of sex-related data that can be implemented by behavioral neuroscientists without devoting laboratory resources to delving into mechanisms underlying sex differences. We recommend (1) shifting interpretations of behavior away from performance metrics and towards strategy assessments to avoid the fallacy that the performance of one sex is worse than another; and (2) asking how much variance sex explains in measures and whether any differences are mosaic rather than binary, to avoid assuming that sex differences in separate measures are inextricably correlated. Nonbinary frameworks in research on cognition will allow neuroscience to represent the full spectrum of brains and behaviors.
Collapse
Affiliation(s)
- Nicola M Grissom
- Department of Psychology, University of Minnesota, United States of America.
| | - Nic Glewwe
- Department of Psychology, University of Minnesota, United States of America
| | - Cathy Chen
- Department of Psychiatry and Behavioral Sciences, University of Minnesota, United States of America
| | - Erin Giglio
- Department of Psychology, University of Minnesota, United States of America
| |
Collapse
|
3
|
Fecteau KM, Winchell AJ, Blue SW, Appleman ML, Urbanski HF, Erikson DW. Comparison of assay methods for quantifying sex hormone concentrations across the menstrual cycle in rhesus macaques. Biol Reprod 2024:ioae063. [PMID: 38685627 DOI: 10.1093/biolre/ioae063] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/02/2024] Open
Abstract
Immunoassays have been the preferred method for steroid hormone analysis for more than 50 years. Automated immunoassays (AIAs) offer high-throughput, rapid data turnaround, and low cost for measuring steroid hormone concentrations. The application of liquid chromatography-tandem mass spectrometry (LC-MS/MS) for steroid quantification provides greater specificity and selectivity for individual steroids, the ability to simultaneously analyze multiple steroids, and high-throughput and automation. We compared AIA and LC-MS/MS for analysis of 17β-estradiol (E2) and progesterone (P4) over the course of several menstrual cycles in 12 rhesus macaques (Macaca mulatta). Serum samples were collected every four days across four menstrual cycles from each monkey. AIAs were performed on a Roche cobas e411 analyzer. Analysis of E2 and P4 was performed by LC-MS/MS on a Shimadzu-Nexera-LCMS-8060 instrument. Scatter plots with Passing-Bablok regression showed excellent agreement between AIA and LC-MS/MS for both E2 and P4. Bland-Altman plots revealed no bias for either method; however, AIA overestimated E2 at concentrations >140 pg/ml and underestimated P4 at concentrations >4 ng/ml compared to LC-MS/MS. A comparison of testosterone (T) concentrations measured by AIA and LC-MS/MS in the same samples was also performed. In contrast to E2 and P4, AIA and LC-MS/MS yielded significantly different results for T concentrations, with AIA consistently underestimating concentrations relative to those obtained by LC-MS/MS. Well-characterized AIAs are an excellent tool for daily monitoring of monkey menstrual cycles or providing single data points requiring fast turnaround. In certain situations where AIA may provide inaccurate estimations of E2 and P4 concentrations, LC-MS/MS assays are preferable.
Collapse
Affiliation(s)
- Kristopher M Fecteau
- Endocrine Technologies Core, Oregon National Primate Research Center, Beaverton, OR 97006
| | - Andrea J Winchell
- Endocrine Technologies Core, Oregon National Primate Research Center, Beaverton, OR 97006
| | - Steven W Blue
- Endocrine Technologies Core, Oregon National Primate Research Center, Beaverton, OR 97006
| | - Maria Luisa Appleman
- Division of Neuroscience, Oregon National Primate Research Center, Beaverton, OR 97006
| | - Henryk F Urbanski
- Division of Neuroscience, Oregon National Primate Research Center, Beaverton, OR 97006
- Division of Reproductive & Developmental Sciences, Oregon National Primate Research Center, Beaverton, OR 97006
| | - David W Erikson
- Endocrine Technologies Core, Oregon National Primate Research Center, Beaverton, OR 97006
| |
Collapse
|
4
|
Sardana K, Muddebihal A, Sehrawat M, Bansal P, Khurana A. An updated clinico-investigative approach to diagnosis of cutaneous hyperandrogenism in relation to adult female acne, female pattern alopecia & hirsutism a primer for dermatologists. Expert Rev Endocrinol Metab 2024; 19:111-128. [PMID: 38205927 DOI: 10.1080/17446651.2023.2299400] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/16/2023] [Accepted: 12/21/2023] [Indexed: 01/12/2024]
Abstract
INTRODUCTION Hyperandrogenism is a clinical state consequent to excess androgen production by the ovary, adrenals, or increased peripheral conversion of androgens. The varied manifestations of hyperandrogenism include seborrhea, acne, infertility, hirsutism, or overt virilization of which adult female acne, hirsutism, and female pattern hair loss are of clinical relevance to dermatologists. AREAS COVERED We limited our narrative review to literature published during period from 1 January 1985 to Dec 2022 and searched PubMed/MEDLINE, Web of Science (WOS), Scopus, and Embase databases with main search keywords were 'Hyperandrogenism,' 'Female,' 'Biochemical,' 'Dermatological', and 'Dermatology.' We detail the common etiological causes, nuances in interpretation of biochemical tests and imaging tools, followed by an algorithmic approach which can help avoid extensive tests and diagnose the common causes of hyperandrogenism. EXPERT OPINION Based on current data, total testosterone, sex hormone binding globulin, DHEAS, prolactin, free androgen index, and peripheral androgenic metabolites like 3-alpha diol and androsterone glucuronide are ideal tests though not all are required in all patients. Abnormalities in these biochemical investigations may require radiological examination for further clarification. Total testosterone levels can help delineate broadly the varied causes of hyperandrogenism. Serum AMH could be used for defining PCOM in adults.
Collapse
Affiliation(s)
- Kabir Sardana
- Atal Bihari Vajpayee Institute of Medical Sciences and Dr Ram Manohar Lohia Hospital, New Delhi, India
| | - Aishwarya Muddebihal
- Department of Dermatology, North DMC Medical College & Hindu Rao Hospital, Gandhi Square, Malka Ganj, Delhi, India
| | - Manu Sehrawat
- Department of Dermatology, Buckhinghumshire NHS Trust, Buckhinghumshire, UK
| | - Prekshi Bansal
- Department of Dermatology, Gian Sagar Medical College and Hospital, Banur, Punjab, India
| | - Ananta Khurana
- Atal Bihari Vajpayee Institute of Medical Sciences and Dr Ram Manohar Lohia Hospital, New Delhi, India
| |
Collapse
|
5
|
Barbosa-Moyano H, Zacariotti RL, de Oliveira CA. Validation of enzyme immunoassays for quantifying sex steroid hormones in tropical screech owls (Megascops choliba). Gen Comp Endocrinol 2024; 345:114386. [PMID: 37748527 DOI: 10.1016/j.ygcen.2023.114386] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/07/2023] [Revised: 09/19/2023] [Accepted: 09/20/2023] [Indexed: 09/27/2023]
Abstract
Androgens and estrogens are steroid hormones that regulate reproductive processes in both males and females. Monitoring plasma levels of these steroids or their metabolites present in feces, offers diagnostic support for assessing the reproductive status of animals. Immunoassays are commonly used methods for quantifying these hormones, but their protocols require species-specific validation to ensure reliability. The objective of this study was to perform analytically and biologically validation of enzyme immunoassay (EIA) kits for measuring testosterone (T), estradiol (E2), faecal androgen metabolites (fAM), and faecal estrogenic metabolites (fEM) in the tropical screech owl (Megascops choliba). Serum and fecal samples were collected from six adult females and six males both before and during breeding season, with males' gonadal activity assessed using electroejaculation (EE). The parallelism test confirmed the immunogenic similarity of the antigens in the estradiol and testosterone standards and the antigens in the serum samples and fecal extracts of M. choliba. Additionally, the EIA kits displayed nearly 100% recovery rates, and showed coefficients of variation ranging from 8% to 14% at the intra-assay level and from 10% to 16% at the inter-assay level, underscoring result reliability and consistency. In males, the highest serum T and fAM levels were recorded concurrently with the presence of spermatozoa in samples collected via EE. Although females did not exhibit oviposition events, significantly higher E2 and fEM levels were observed in August compared to May, suggesting potential seasonal variations in estrogenic hormone production. Fecal androgen and estrogen levels were significantly different between sexes in August, with males having higher fAM and females having higher fEM levels. Overall, the immunoassays validated in this study were found to be efficient in diagnosing reproductive activity in owls.
Collapse
Affiliation(s)
- Heriberto Barbosa-Moyano
- Departamento de Reprodução Animal, Faculdade de Medicina Veterinária e Zootecnia, Universidade de São Paulo, São Paulo, SP, Brazil.
| | | | - Claudio Alvarenga de Oliveira
- Departamento de Reprodução Animal, Faculdade de Medicina Veterinária e Zootecnia, Universidade de São Paulo, São Paulo, SP, Brazil
| |
Collapse
|
6
|
Sandström A, Bixo M, Bäckström T, Möller A, Turkmen S. Altered GABA A receptor function in women with endometriosis: a possible pain-related mechanism. Acta Obstet Gynecol Scand 2023; 102:1316-1322. [PMID: 36944570 PMCID: PMC10541155 DOI: 10.1111/aogs.14559] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2022] [Revised: 03/02/2023] [Accepted: 03/07/2023] [Indexed: 03/23/2023]
Abstract
INTRODUCTION The mechanism underlying endometriosis-related pain remains poorly understood. Previous studies have indicated that γ-aminobutyric acid (GABA) type A (GABAA ) receptors and GABAergic substances (eg endogenous neurosteroids) play important mechanistic roles in various pain conditions. Our primary objective was to compare GABAA receptor function between women with endometriosis and healthy controls by performing a challenge test with diazepam, a GABAA receptor agonist, using the saccadic eye velocity as the main outcome. The secondary objective was to investigate the relation between GABAA receptor function and serum levels of allopregnanolone, an endogenous positive modulator of the GABAA receptor, in the participating women. MATERIAL AND METHODS 15 women with pelvic pain and laparoscopically confirmed endometriosis and 10 healthy, symptom-free, control women, aged 18-40 years, underwent the diazepam challenge test during the follicular phase of the menstrual cycle. Basal serum allopregnanolone levels were measured prior to diazepam injection. RESULTS Compared with healthy controls, women with pelvic pain and confirmed endometriosis had a significantly smaller change in saccadic eye velocity after GABAA receptor stimulation with diazepam, indicating lower sensitivity to diazepam. The saccadic eye velocity response was not correlated with the serum allopregnanolone levels. CONCLUSIONS Women with painful endometriosis show altered GABAA receptor function, depicted as a muted response to an exogenous GABAA receptor agonist.
Collapse
Affiliation(s)
- Anton Sandström
- Department of Clinical Sciences, Obstetrics and GynecologyUmea UniversityUmeaSweden
- Department of Obstetrics and GynecologySundsvall County HospitalSundsvallSweden
| | - Marie Bixo
- Department of Clinical Sciences, Obstetrics and GynecologyUmea UniversityUmeaSweden
| | - Torbjörn Bäckström
- Department of Clinical Sciences, Obstetrics and GynecologyUmea UniversityUmeaSweden
| | - Anna Möller
- Department of Obstetrics and GynecologyStockholm South General HospitalStockholmSweden
- Department of Clinical Science and EducationKarolinska InstitutetStockholmSweden
| | - Sahruh Turkmen
- Department of Clinical Sciences, Obstetrics and GynecologyUmea UniversityUmeaSweden
- Department of Obstetrics and GynecologySundsvall County HospitalSundsvallSweden
| |
Collapse
|
7
|
Conley AJ, Gonzales KL, Erb HN, Christensen BW. Progesterone Analysis in Canine Breeding Management. Vet Clin North Am Small Anim Pract 2023:S0195-5616(23)00080-3. [PMID: 37385875 DOI: 10.1016/j.cvsm.2023.05.007] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/01/2023]
Abstract
Progesterone is a worthwhile addition to the clinical assessment of cycle stage for breeding, elective cesarian delivery, and reproductive management in the bitch if reliably measured. Clinical decisions based on systemic progesterone concentrations also require the rapid return of results. Most commercially accessible analyses capable of returning results within a day still rely primarily on immunoassays of one kind or another. Point-of-care instruments utilizing similar technology have been developed more recently to enable results to be generated in-house. Repeated monitoring of progesterone on whatever platform can be useful if consistent collection and analysis protocols ensure acceptable precision, accuracy, and repeatability.
Collapse
Affiliation(s)
- Alan J Conley
- Department of Population Health & Reproduction, School of Veterinary Medicine, University of California, Davis, CA 95616, USA.
| | - Kris L Gonzales
- Guide Dogs for the Blind, California Campus, PO Box 151200, San Rafael, CA 94915, USA
| | - Hollis N Erb
- Department of Population Medicine and Diagnostic Sciences, Cornell University College of Veterinary Medicine, Ithaca, NY 14853, USA
| | | |
Collapse
|
8
|
Dukic J, Ehlert U. Longitudinal Course of Sex Steroids From Pregnancy to Postpartum. Endocrinology 2023; 164:bqad108. [PMID: 37450580 PMCID: PMC10499333 DOI: 10.1210/endocr/bqad108] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/18/2023] [Revised: 07/10/2023] [Accepted: 07/11/2023] [Indexed: 07/18/2023]
Abstract
CONTEXT Sex steroids (SS) typically rise during pregnancy and decline after birth, but no consistent reference values exist for these hormonal courses. We aimed to establish an overview of SS secretion patterns during the peripartum and to better understand how SS contribute to maternal and fetal pathologies. EVIDENCE ACQUISITION A systematic literature search was conducted in accordance with the PRISMA guidelines using PubMed, Cochrane Library, and PsycINFO. Additionally, we conducted a supplementary manual search of references. Observational studies published in English and assessing estradiol, progesterone, and testosterone over the course of the peripartum in physically healthy female subjects were included, without restrictions on year of publication. Extracted data were analyzed descriptively and visually. EVIDENCE SYNTHESIS SS increase progressively during pregnancy, with an extremely wide range of reported concentrations, especially in the third trimester. In fact, reported concentrations varied up to 5000-fold at comparable measurement time points. CONCLUSIONS A comprehensive understanding of the influence of SS levels on associated maternal and fetal pathologies is currently hindered by 2 main factors. First, reported SS levels vary widely during the peripartum period. Second, the current state of knowledge on how SS are associated with pathologies in mothers and babies is largely based on correlational studies, and causality thus remains unclear. Consequently, we recommend the development of a systematic reference framework that follows the suggestions presented in this review. This would enable the establishment of SS reference values for a healthy population, resulting in the possibility to draw conclusions about deviations and related pathologies.
Collapse
Affiliation(s)
- Jelena Dukic
- Department of Clinical Psychology and Psychotherapy, University of Zurich, 8050 Zurich, Switzerland
| | - Ulrike Ehlert
- Department of Clinical Psychology and Psychotherapy, University of Zurich, 8050 Zurich, Switzerland
| |
Collapse
|
9
|
Casals G, Costa RF, Rull EU, Escobar-Morreale HF, Argente J, Sesmilo G, Biagetti B. Recommendations for the measurement of sexual steroids in clinical practice. A position statement of SEQC ML/SEEN/SEEP. ADVANCES IN LABORATORY MEDICINE 2023; 4:52-69. [PMID: 37359897 PMCID: PMC10197192 DOI: 10.1515/almed-2023-0020] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/20/2022] [Accepted: 01/19/2023] [Indexed: 06/28/2023]
Abstract
The proper clinical approach to a wide range of disorders relies on the availability of accurate, reproducible laboratory results for sexual steroids measured using methods with a high specificity and sensitivity. The chemiluminescent immunoassays currently available have analytical limitations with significant clinical implications. This position statement reviews the current limitations of laboratory techniques for the measurement of estradiol and testosterone and their impact on diverse clinical scenarios. A set of recommendations are provided to incorporate steroid hormone analysis by mass spectrometry in national health systems. International societies have recommended this methodology for a decade.
Collapse
Affiliation(s)
- Gregori Casals
- Servicio de Bioquímica y Genética Molecular, Hospital Clínic, IDIBAPS, CIBEREHD Universidad de Barcelona, Barcelona, Spain
| | - Roser Ferrer Costa
- Servicio de Bioquímica, Laboratoris Clínics, Hospital Universitari Vall d’Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Eulàlia Urgell Rull
- Servicio de Bioquímica, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
| | - Héctor F. Escobar-Morreale
- Servicio de Endocrinología y Nutrición, Hospital Ramón y Cajal, Universidad de Alcalá, Instituto Ramón y Cajal de Investigación Sanitaria IRYCIS y CIBER Diabetes y Enfermedades Metabólicas Asociadas CIBERDEM, Madrid, Spain
| | - Jesús Argente
- Departamento de Pediatría y Endocrinología Pediátrica, Hospital Infantil Universitario Niño Jesús, Universidad Autonoma de Madrid, CIBEROBN, Instituto de Salud Carlos III, Madrid, Spain
| | - Gemma Sesmilo
- Servicio de Endocrinología y Nutrición, Hospital Universitari Dexeus, Barcelona, Spain
| | - Betina Biagetti
- Servicio de Endocrinología y Nutrición, Hospital Universitari Vall d’Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain
| |
Collapse
|
10
|
Sait STL, Survilienė V, Jüssi M, Gonzalez SV, Ciesielski TM, Jenssen BM, Asimakopoulos AG. Determination of steroid hormones in grey seal (Halichoerus grypus) blood plasma using convergence chromatography tandem mass spectrometry. Talanta 2023; 254:124109. [PMID: 36535212 DOI: 10.1016/j.talanta.2022.124109] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2022] [Revised: 10/26/2022] [Accepted: 11/15/2022] [Indexed: 11/21/2022]
Abstract
A hybrid solid phase extraction (HybridSPE) protocol tailored to ultra-performance convergence chromatography tandem mass spectrometry (UPC2-MS/MS) was developed for the determination of 19 steroid hormones in grey seal (Halichoerus grypus) blood plasma. In this study, the protocol demonstrated acceptable absolute recoveries ranging from 33 to 90%. The chromatographic separation was carried out using a gradient elution program with a total run time of 5 min. For most target analytes, the method repeatability ranged from 1.9 to 24% and the method limits of quantification (mLOQs) ranged from 0.03 to 1.67 ng/mL. A total of 9 plasma samples were analysed to demonstrate the applicability of the developed method, and 13 steroid hormones were quantified in grey seal pup plasma. The most prevalent steroids: cortisol, cortisone, corticosterone, 11-deoxycortisol, progesterone and 17α-hydroxyprogesterone were detected at concentrations in the range of 12.6-40.1, 7.10-24.2, 0.74-10.7, 1.06-5.72, 0.38-4.38 and <mLOQ - 1.01 ng/mL, respectively. To our knowledge, this is the first study to determine steroid hormones in the plasma of pinnipeds using convergence chromatography.
Collapse
Affiliation(s)
- Shannen Thora Lea Sait
- Department of Chemistry, Norwegian University of Science and Technology (NTNU), 7491, Trondheim, Norway
| | - Vaida Survilienė
- Institute of Biosciences, Life Sciences Center, Vilnius University, Sauletekio Av. 7, Vilnius, Lithuania
| | - Mart Jüssi
- Pro Mare MTÜ, Saula, Kose, Harjumaa, 75101, Estonia
| | - Susana V Gonzalez
- Department of Chemistry, Norwegian University of Science and Technology (NTNU), 7491, Trondheim, Norway
| | - Tomasz Maciej Ciesielski
- Department of Biology, Norwegian University of Science and Technology (NTNU), 7491, Trondheim, Norway
| | - Bjørn Munro Jenssen
- Department of Biology, Norwegian University of Science and Technology (NTNU), 7491, Trondheim, Norway; Department of Arctic Technology, The University Centre in Svalbard (UNIS), P.O. Box 156, 9171, Longyearbyen, Norway; Department of Ecoscience, Aarhus University, P.O. Box 358, 4000, Roskilde, Denmark
| | - Alexandros G Asimakopoulos
- Department of Chemistry, Norwegian University of Science and Technology (NTNU), 7491, Trondheim, Norway.
| |
Collapse
|
11
|
Casals G, Ferrer Costa R, Urgell Rull E, Escobar-Morreale HF, Argente J, Sesmilo G, Biagetti B. Executive summary of the position statement of the Spanish Societies SEQC ML/SEEN/SEEP. Recommendations for the measurement of sex steroids in clinical practice. ENDOCRINOL DIAB NUTR 2023; 70 Suppl 1:103-109. [PMID: 36894451 DOI: 10.1016/j.endien.2023.03.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/15/2022] [Accepted: 11/15/2022] [Indexed: 03/09/2023]
Abstract
Accurate measurement of sex steroids, particularly testosterone and estradiol, is relevant for the diagnosis and treatment of a wide range of conditions. Unfortunately, current chemiluminescent immunoassays have analytical limitations with important clinical consequences. This document reviews the current state of clinical assays for estradiol and testosterone measurements and their potential impact in different clinical situations. It also includes a series of recommendations and necessary steps to introduce steroid analysis by mass spectrometry into national health systems, a methodology recommended for more than a decade by international societies.
Collapse
Affiliation(s)
- Gregori Casals
- Servicio de Bioquímica y Genética Molecular, Hospital Clínic, IDIBAPS, CIBERHD, Universitat de Barcelona, Barcelona, Spain.
| | - Roser Ferrer Costa
- Servicio de Bioquímica, Laboratoris Clínics, Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Eulàlia Urgell Rull
- Servicio de Bioquímica, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
| | - Héctor F Escobar-Morreale
- Servicio de Endocrinología y Nutrición, Hospital Ramón y Cajal, Universidad de Alcalá, Instituto Ramón y Cajal de Investigación Sanitaria IRYCIS, CIBER Diabetes y Enfermedades Metabólicas Asociadas CIBERDEM, Madrid, Spain
| | - Jesús Argente
- Departamento de Pediatría y Endocrinología Pediátrica, Hospital Infantil Universitario Niño Jesús, Universidad Autónoma de Madrid, CIBEROBN, Instituto de Salud Carlos III, Madrid, Spain
| | - Gemma Sesmilo
- Servicio de Endocrinología y Nutrición, Hospital Universitari Dexeus, Barcelona, Spain
| | - Betina Biagetti
- Servicio de Endocrinología y Nutrición, Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain.
| |
Collapse
|
12
|
Fleege NMG, Li Y, Kidwell KM, Henry NL. Ovarian Function Suppression in Premenopausal Women with Concurrent Endocrine Therapy Use. Clin Breast Cancer 2023; 23:454-460. [PMID: 37076363 DOI: 10.1016/j.clbc.2023.03.009] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2023] [Revised: 03/17/2023] [Accepted: 03/22/2023] [Indexed: 03/30/2023]
Abstract
INTRODUCTION Almost 20% of patients receiving ovarian function suppression (OFS) and endocrine therapy (ET) for breast cancer treatment had inadequate OFS within the first year of treatment. Few studies have explored the long-term effectiveness of OFS to maintain estrogen suppression. PATIENTS AND METHODS This retrospective, single institution study examined premenopausal women with early-stage breast cancer undergoing treatment with OFS and ET. The primary endpoint was the percentage of patients with inadequate ovarian suppression (estradiol ≥10 pg/mL) during OFS cycle 2 or later. The secondary endpoint was the percentage of patients with inadequate ovarian suppression within the first cycle after OFS initiation. Differences in age, body mass index (BMI), and previous chemotherapy use were summarized via multivariable logistic regression. RESULTS Of the 131 patients included in the analysis, 35 (26.7%) lacked adequate suppression during OFS cycle 2 or later cycles. Patients with adequate suppression throughout treatment were more likely to be older (odds ratio [OR] 1.12 [95% CI, 1.05-1.22], P = .02), have a lower BMI (OR 0.88 [95% CI, 0.82-0.94], P < .001), and have received chemotherapy (OR 6.30 [95% CI, 2.06-20.8], P = .002). A total of 20 of 83 patients (24.1%) had an inadequately suppressed estradiol level within 35 days of OFS initiation. CONCLUSION This "real world" cohort demonstrates that estradiol concentrations above the postmenopausal range of the assay are frequently detected, including more than 1 year after the start of OFS. Additional research is needed to establish estradiol monitoring guidelines and optimal degree of ovarian suppression.
Collapse
Affiliation(s)
- Nicole M Grogan Fleege
- Division of Hematology/Oncology, Department of Internal Medicine, University of Michigan Medical School, Ann Arbor, MI; Division of Hematology/Oncology, Department of Internal Medicine, University of Iowa Hospitals and Clinics, Iowa City, IA.
| | - Yajing Li
- Department of Biostatistics, University of Michigan School of Public Health, Ann Arbor, MI; Department of Biostatistics, Vanderbilt University Medical Center, Nashville, TN
| | - Kelley M Kidwell
- Department of Biostatistics, University of Michigan School of Public Health, Ann Arbor, MI
| | - N Lynn Henry
- Division of Hematology/Oncology, Department of Internal Medicine, University of Michigan Medical School, Ann Arbor, MI
| |
Collapse
|
13
|
Casals G, Ferrer Costa R, Urgell Rull E, Escobar-Morreale HF, Argente J, Sesmilo G, Biagetti B. Resumen ejecutivo del documento de posicionamiento SEQCML/SEEN/SEEP. Recomendaciones para la medición de esteroides sexuales en la práctica clínica. ENDOCRINOL DIAB NUTR 2022. [DOI: 10.1016/j.endinu.2022.11.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
|
14
|
Kehmeier MN, Bedell BR, Cullen AE, Khurana A, D'Amico HJ, Henson GD, Walker AE. In vivo arterial stiffness, but not isolated artery endothelial function, varies with the mouse estrous cycle. Am J Physiol Heart Circ Physiol 2022; 323:H1057-H1067. [PMID: 36240435 PMCID: PMC9678414 DOI: 10.1152/ajpheart.00369.2022] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/19/2022] [Revised: 10/12/2022] [Accepted: 10/12/2022] [Indexed: 12/14/2022]
Abstract
With the increasing appreciation for sex as a biological variable and the inclusion of female mice in research, it is important to understand the influence of the estrous cycle on physiological function. Sex hormones are known to modulate vascular function, but the effects of the mouse estrous cycle phase on arterial stiffness, endothelial function, and arterial estrogen receptor expression remain unknown. In 23 female C57BL/6 mice (6 mo of age), we determined the estrous cycle stage via vaginal cytology and plasma hormone concentrations. Aortic stiffness, assessed by pulse wave velocity, was lower during the estrus phase compared with diestrus. In ex vivo assessment of isolated pressurized mesenteric and posterior cerebral arteries, the responses to acetylcholine, insulin, and sodium nitroprusside, as well as nitric oxide-mediated dilation, were not different between estrous cycle phases. In the aorta, expression of phosphorylated estrogen receptor-α was higher for mice in estrus compared with mice in proestrus. In the cerebral arteries, gene expression for estrogen receptor-β (Esr2) was lowest for mice in estrus compared with diestrus and proestrus. These results demonstrate that the estrus phase is associated with lower in vivo large artery stiffness in mice. In contrast, ex vivo resistance artery endothelial function is not different between estrous cycle phases. Estrogen receptor expression is modulated by the estrus cycle in an artery-dependent manner. These results suggest that the estrous cycle phase should be considered when measuring in vivo arterial stiffness in young female mice.NEW & NOTEWORTHY To design rigorous vascular research studies using young female rodents, the influence of the estrous cycle on vascular function must be known. We found that in vivo aortic stiffness was lower during estrus compared with the diestrus phase in female mice. In contrast, ex vivo mesenteric and cerebral artery endothelial function did not differ between estrous cycle stages. These results suggest that the estrous cycle stage should be accounted for when measuring in vivo arterial stiffness.
Collapse
Affiliation(s)
| | - Bradley R Bedell
- Department of Human Physiology, University of Oregon, Eugene, Oregon
| | - Abigail E Cullen
- Department of Human Physiology, University of Oregon, Eugene, Oregon
| | - Aleena Khurana
- Department of Human Physiology, University of Oregon, Eugene, Oregon
| | - Holly J D'Amico
- Department of Human Physiology, University of Oregon, Eugene, Oregon
| | - Grant D Henson
- Department of Human Physiology, University of Oregon, Eugene, Oregon
| | - Ashley E Walker
- Department of Human Physiology, University of Oregon, Eugene, Oregon
| |
Collapse
|
15
|
Aribas E, Roeters van Lennep JE, De Rijke YB, Laven JSE, Ikram MA, Peeters RP, Kavousi M. Sex steroids and sex steroid-binding globulin levels amongst middle-aged and elderly men and women from general population. Eur J Clin Invest 2022; 52:e13866. [PMID: 36038500 PMCID: PMC9787498 DOI: 10.1111/eci.13866] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/20/2022] [Revised: 07/20/2022] [Accepted: 08/06/2022] [Indexed: 12/30/2022]
Abstract
BACKGROUND AND AIMS Availability of age- and sex-specific reference values for sex steroids and sex steroid-binding globulin (SHBG) levels allows for appropriate interpretation of research findings and their clinical applications. We report the sex-specific distribution and reference levels of sex steroids, including total estradiol, total testosterone and (calculated) free androgen index (cFAI), SHBG and other androgens dehydroepiandrosterone (DHEA), dehydroepiandrosterone sulphate (DHEAS) and androstenedione across age. METHODS Using data from 3291 participants from the prospective population-based Rotterdam Study (2006-2008), we visualised the distribution of sex steroids and SHBG levels by calculating and depicting the 5th, 25th, 50th, 75th and 95th percentiles per year and per age-year across 5-year age bands to provide reference value ranges in men and women. Total estradiol and SHBG were measured using automated immunoassay and androgens using liquid chromatography-mass spectrometry (LC-MS/MS). RESULT Mean age was 56.8 (range 45.6-79.9) years in men and 56.9 (range 45.7-79.9) years in women. Amongst men, total estradiol and SHBG showed an increasing trend from 45 years onwards. In women, total estradiol and SHBG showed a decreasing trend from 45 years until the age of 60. From 60 years onwards, SHBG showed an increasing trend. For total testosterone, a clear declining trend was observed amongst men but not women. Other androgens showed a similar decreasing trend in both sexes from 45 years onwards. DISCUSSION AND CONCLUSION Our study underlines sex-specific trends in sex steroids and SHBG levels with ageing. This warrants taking into account sex- and age-specific reference values for sex steroids and SHBG when investigating their impact on health outcomes to prevent controversial results and allow for their appropriate clinical application.
Collapse
Affiliation(s)
- Elif Aribas
- Department of Epidemiology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands
| | | | - Yolanda B De Rijke
- Department of Clinical Chemistry, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands
| | - Joop S E Laven
- Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands
| | - Mohammad Arfan Ikram
- Department of Epidemiology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands
| | - Robin P Peeters
- Department of Internal Medicine, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands
| | - Maryam Kavousi
- Department of Epidemiology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands
| |
Collapse
|
16
|
Bick AJ, Skosana SB, Avenant C, Hapgood JP. Variability and quantification of serum medroxyprogesterone acetate levels. Steroids 2022; 187:109100. [PMID: 35964796 PMCID: PMC9884996 DOI: 10.1016/j.steroids.2022.109100] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/30/2022] [Revised: 07/27/2022] [Accepted: 08/09/2022] [Indexed: 02/01/2023]
Abstract
Quantification of serum progestin levels in clinical contraceptive studies is now routinely performed to understand progestin pharmacokinetics and to correct for unreliable self-reporting of contraceptive use by study participants. Many such studies are focussed on the three-monthly progestin-only intramuscular (IM) injectable contraceptive depot medroxyprogesterone acetate (DMPA-IM). Methods commonly used to measure serum MPA levels include liquid chromatography coupled to mass spectrometry (LC/MS) and radioimmunoassay (RIA); however, RIA methods have not been used in recent years. We review the available literature and find that these methods vary widely in terms of use of organic solvent extraction, use of derivitization and choice of organic solvent and chromatography columns. There is a lack of standardization of LC/MS methodology, including a lack of detailed extraction protocols. Limited evidence suggests that RIA, without organic solvent extraction, likely over-estimates progestin levels. Maximum MPA concentrations in the first two weeks post-injection show wide inter-individual and inter-study variation, regardless of quantification method used. Standardization of quantification methods and sampling time post-injection is required to improve interpretation of clinical data, in particular the side effects arising at different times depending on the pharmacokinetic profile unique to injectable contraceptives.
Collapse
Affiliation(s)
- Alexis J Bick
- Department of Molecular and Cell Biology, University of Cape, Cape Town, South Africa
| | - Salndave B Skosana
- Department of Molecular and Cell Biology, University of Cape, Cape Town, South Africa
| | - Chanel Avenant
- Department of Molecular and Cell Biology, University of Cape, Cape Town, South Africa
| | - Janet P Hapgood
- Department of Molecular and Cell Biology, University of Cape, Cape Town, South Africa; Institute of Infectious Disease and Molecular Medicine, University of Cape Town, South Africa.
| |
Collapse
|
17
|
Rappold BA. Review of the Use of Liquid Chromatography-Tandem Mass Spectrometry in Clinical Laboratories: Part II-Operations. Ann Lab Med 2022; 42:531-557. [PMID: 35470272 PMCID: PMC9057814 DOI: 10.3343/alm.2022.42.5.531] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2021] [Revised: 02/08/2022] [Accepted: 04/13/2022] [Indexed: 11/19/2022] Open
Abstract
Liquid chromatography-tandem mass spectrometry (LC-MS/MS) is increasingly utilized in clinical laboratories because it has advantages in terms of specificity and sensitivity over other analytical technologies. These advantages come with additional responsibilities and challenges given that many assays and platforms are not provided to laboratories as a single kit or device. The skills, staff, and assays used in LC-MS/MS are internally developed by the laboratory, with relatively few exceptions. Hence, a laboratory that deploys LC-MS/MS assays must be conscientious of the practices and procedures adopted to overcome the challenges associated with the technology. This review discusses the post-development landscape of LC-MS/MS assays, including validation, quality assurance, operations, and troubleshooting. The content knowledge of LC-MS/MS users is quite broad and deep and spans multiple scientific fields, including biology, clinical chemistry, chromatography, engineering, and MS. However, there are no formal academic programs or specific literature to train laboratory staff on the fundamentals of LC-MS/MS beyond the reports on method development. Therefore, depending on their experience level, some readers may be familiar with aspects of the laboratory practices described herein, while others may be not. This review endeavors to assemble aspects of LC-MS/MS operations in the clinical laboratory to provide a framework for the thoughtful development and execution of LC-MS/MS applications.
Collapse
Affiliation(s)
- Brian A Rappold
- Laboratory Corporation of America Holdings, Research Triangle Park, NC, USA
| |
Collapse
|
18
|
Spritzer PM, Marchesan LB, Santos BR, Fighera TM. Hirsutism, Normal Androgens and Diagnosis of PCOS. Diagnostics (Basel) 2022; 12:1922. [PMID: 36010272 PMCID: PMC9406611 DOI: 10.3390/diagnostics12081922] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2022] [Revised: 08/01/2022] [Accepted: 08/02/2022] [Indexed: 11/17/2022] Open
Abstract
Hirsutism is defined as the presence of terminal hair with male pattern distribution in women. While in the general population, hirsutism affects around 4-11% of women, it is the main manifestation of hyperandrogenism in women with polycystic ovary syndrome (PCOS), with a prevalence estimated at 65-75%. Hirsutism in PCOS is associated with both androgen excess and individual response of the pilosebaceous unit to androgens. The modified Ferriman-Gallwey (mFG) scoring system has been widely used in clinical practice to visually score excessive terminal hair, thus standardizing hirsutism evaluation and facilitating data comparison. Although a universal mFG score cutoff would be useful for comparisons, ethnic variations, as well as skin type and other factors, should be considered when evaluating hirsutism in distinct populations. In turn, androgen levels, measured by conventional techniques, have been shown to correlate poorly with the severity of hirsutism. Indeed, while most women with PCOS and hirsutism also have higher than reference values for serum androgen levels, some of them may not present with biochemical hyperandrogenism, representing a challenge to the diagnosis of PCOS. In this article, we critically review this not uncommon condition in women with PCOS presenting with hirsutism but normal androgen levels.
Collapse
Affiliation(s)
- Poli Mara Spritzer
- Gynecological Endocrinology Unit, Division of Endocrinology, Hospital de Clínicas de Porto Alegre, Porto Alegre 90035-903, RS, Brazil
- Post-Graduate Program in Endocrinology, Medicine School, Universidade Federal do Rio Grande do Sul, Porto Alegre 90035-003, RS, Brazil
- Department and Post-Graduate Program in Physiology, Universidade Federal do Rio Grande do Sul, Porto Alegre 90035-003, RS, Brazil
| | - Lucas Bandeira Marchesan
- Gynecological Endocrinology Unit, Division of Endocrinology, Hospital de Clínicas de Porto Alegre, Porto Alegre 90035-903, RS, Brazil
- Post-Graduate Program in Endocrinology, Medicine School, Universidade Federal do Rio Grande do Sul, Porto Alegre 90035-003, RS, Brazil
| | - Betânia Rodrigues Santos
- Gynecological Endocrinology Unit, Division of Endocrinology, Hospital de Clínicas de Porto Alegre, Porto Alegre 90035-903, RS, Brazil
- Department and Post-Graduate Program in Physiology, Universidade Federal do Rio Grande do Sul, Porto Alegre 90035-003, RS, Brazil
| | - Tayane Muniz Fighera
- Gynecological Endocrinology Unit, Division of Endocrinology, Hospital de Clínicas de Porto Alegre, Porto Alegre 90035-903, RS, Brazil
- Post-Graduate Program in Endocrinology, Medicine School, Universidade Federal do Rio Grande do Sul, Porto Alegre 90035-003, RS, Brazil
- Department of Internal Medicine, Universidade Federal do Rio Grande do Sul, Porto Alegre 90035-003, RS, Brazil
| |
Collapse
|
19
|
Yadav A, Dabur R. Rapid Identification of 44 Steroids in Human Urine Samples using HPLCESI-
QTOF-MS. CURR PHARM ANAL 2022. [DOI: 10.2174/1573412917666210309145639] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Objective:
Detailed analysis of un-processed and un-derivatized free and conjugated
urinary steroids is useful to avoid miscalculations and to diagnose sports doping and adrenal
problems, including abnormal steroidogenesis, congenital deficiency of related enzymes, cancer,
and other disease conditions. Hence, the present study was conducted to develop a soft ionization
method to identify the maximum number of urinary steroids using ultra-performance liquid
chromatography coupled with quadrupole time of flight mass spectrometer (HPLC–Q-TOF-MS).
Material and Methods:
HPLC–Q-TOF-MS was carried out for the qualitative detection of steroids
and their conjugates in urine samples. The method provides high sensitivity and fast analysis
of steroids and their glucuronides without hydrolysis or sample preparation or extraction of steroids.
Results:
Using the method, 44 steroids belonging to C-18, C-19, and C-21 classes and their conjugates
were resolved and identified using positive and negative modes of ionizations by their
characteristic ionization and collision energy induced dissociation behaviors.
Conclusion:
The method is time-saving and good to compare samples from different peoples
with control or healthy ones as it does not require any kind of pre-treatment or sample processing.
It provides a complete picture of steroids metabolism and catabolism. It can be good for doping
control or to explore the effects of other drugs. However, in qualitative analysis, one may miss
the significant information unless direct methods of steroids analysis to be employed.
Collapse
Affiliation(s)
- Aarti Yadav
- Clinical Research Laboratory, Department of Biochemistry, Maharshi Dayanand University, Rohtak, 124001,
Haryana, India
| | - Rajesh Dabur
- Clinical Research Laboratory, Department of Biochemistry, Maharshi Dayanand University, Rohtak, 124001,
Haryana, India
| |
Collapse
|
20
|
Afrouziyeh M, Zuidhof MJ. Impact of broiler breeder growth trajectory on plasma corticosterone concentration: a comparison of analytical methods. Poult Sci 2022; 101:101792. [PMID: 35325835 PMCID: PMC8942834 DOI: 10.1016/j.psj.2022.101792] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2021] [Revised: 02/04/2022] [Accepted: 02/13/2022] [Indexed: 11/25/2022] Open
Abstract
Blood concentration of corticosterone (CORT) is a measure of welfare in feed restricted broiler breeders. The RIA and ELISA have been routinely used for measuring CORT in blood, excreta, and feather. Due to the presence of some confounding factors in the aforementioned colorimetric enzyme reaction methods, some methodological difficulties have been attributed to those assays. The correlation between broiler breeder plasma CORT concentrations, measured using ELISA and a novel liquid chromatography-tandem mass spectrometry (LC-MS/MS) method, was the focus of the current study. A total of 36 broiler breeder pullets were used, of which 30 were randomly assigned to one of 10 unique growth trajectories, and 6 were assigned to an unrestricted group. We designed the growth trajectories using a 3-phase Gompertz growth model with 10 levels of BW gain in the prepubertal and pubertal growth phases, ranging from the breeder-recommended target BW (CON) to 22.5% higher (CON+22.5%), in 2.5% increments. The BW trajectories were applied to each individual bird using a precision feeding (PF) system, which collected BW and feed intake data. The birds were classified based on age at first egg (AFE), and 12 birds each having the highest and lowest AFE was selected for the CORT study. Then median photostimulation BW of the candidate birds was used to define the upper (heavy BW) and lower (standard BW) extremes, and plasma CORT levels were evaluated by ELISA and LC-MS/MS methods from their blood collected at 18, 20, 22, 24, and 26 wk of age. Concentrations of plasma CORT measured using ELISA method were highly correlated (r = 0.95; P < 0.001) with values measured using LC-MS/MS method, validating interchangeably usage of both methods to measure plasma CORT in broiler breeders. Plasma CORT levels were not affected by photostimulation BW or breeders' age, indicating same welfare status between the precision fed high and low BW groups.
Collapse
Affiliation(s)
- Mohammad Afrouziyeh
- Department of Agricultural, Food and Nutritional Science, University of Alberta, Edmonton, AB, Canada T6G 2P5
| | - Martin J Zuidhof
- Department of Agricultural, Food and Nutritional Science, University of Alberta, Edmonton, AB, Canada T6G 2P5.
| |
Collapse
|
21
|
Cirrincione LR, Crews BO, Dickerson JA, Krasowski MD, Rongitsch J, Imborek KL, Goldstein Z, Greene DN. Oral estrogen leads to falsely low concentrations of estradiol in a common immunoassay. Endocr Connect 2022; 11:e210550. [PMID: 35015702 PMCID: PMC8859944 DOI: 10.1530/ec-21-0550] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/23/2021] [Accepted: 01/11/2022] [Indexed: 11/30/2022]
Abstract
OBJECTIVES Recently, an estradiol immunoassay manufacturer (Beckman Coulter, USA) issued an 'important product notice' alerting clinical laboratories that their assay (Access Sensitive Estradiol) was not indicated for patients undergoing exogenous estradiol treatment. The objective of this analysis was to evaluate immunoassay bias relative to liquid chromatography tandem mass spectrometry (LC-MS/MS) in transgender women and to examine the influence of unconjugated estrone on measurements. DESIGN Cross-sectional secondary analysis. METHODS Estradiol concentrations from 89 transgender women were determined by 3 immunoassays (Access Sensitive Estradiol ('New BC') and Access Estradiol assays ('Old BC'), Beckman Coulter; Estradiol III assay ('Roche'), Roche Diagnostics) and LC-MS/MS. Bias was evaluated with and without adjustment for estrone concentrations. The number of participants who shifted between three estradiol concentration ranges for each immunoassay vs LC-MS/MS (>300 pg/mL, 70-300 pg/mL, and <70 pg/mL) was calculated. RESULTS The New BC assay had the largest magnitude overall bias (median: -34%) and was -40%, -22%, and -10%, among participants receiving tablet, patch, or injection preparations, respectively. Overall bias was -12% and +17% for the Roche and Old BC assays, respectively. When measured with the New BC assay, 18 participants shifted to a lower estradiol concentration range (vs 9 and 10 participants based on Roche or Old BC assays, respectively). Adjustment for estrone did not minimize bias. CONCLUSIONS Immunoassay measurement of estradiol in transgender women may lead to falsely decreased concentrations that have the potential to affect management. A multidisciplinary health care approach is needed to ensure if appropriate analytical methods are available.
Collapse
Affiliation(s)
| | - Bridgit O Crews
- Department of Pathology and Laboratory Medicine, University of California Irvine, Orange, California, USA
| | - Jane A Dickerson
- Department of Laboratories, Seattle Children's Hospital, Seattle, Washington, USA
| | - Matthew D Krasowski
- Department of Pathology, University of Iowa Hospitals and Clinics, Iowa City, Iowa, USA
| | | | - Katherine L Imborek
- Department of Family Medicine, University of Iowa Hospitals and Clinics, Iowa City, Iowa, USA
| | - Zil Goldstein
- Department of Medicine, Callen-Lorde Community Health Center, New York, New York, USA
- CUNY Graduate School of Public Health and Health Policy, New York, New York, USA
| | - Dina N Greene
- Washington Kaiser Permanente, Renton, Washington, USA
- Department of Laboratory Medicine and Pathology, University of Washington, Seattle, Washington, USA
- Correspondence should be addressed to D N Greene:
| |
Collapse
|
22
|
Potential Pitfalls of Reproductive Direct-to-Consumer Testing. F S Rep 2022; 3:3-7. [PMID: 35386504 PMCID: PMC8978065 DOI: 10.1016/j.xfre.2022.01.007] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2021] [Revised: 01/25/2022] [Accepted: 01/26/2022] [Indexed: 11/22/2022] Open
Abstract
The availability of direct-to-consumer (DTC) testing has dramatically increased over the past 2 decades, particularly those targeted at reproduction and fertility. Several ethical concerns exist with regard to DTC tests, including the lack of governmental regulation and consumer protection, standardized laboratory methodology, and clinical validity and actionability. Physicians must familiarize themselves with the pitfalls of DTC tests to best aid patients in interpreting DTC test results and guide them toward evidence-based treatment plans.
Collapse
|
23
|
Drummond AE, Swain CTV, Brown KA, Dixon-Suen SC, Boing L, van Roekel EH, Moore MM, Gaunt TR, Milne RL, English DR, Martin RM, Lewis SJ, Lynch BM. Linking Physical Activity to Breast Cancer via Sex Steroid Hormones, Part 2: The Effect of Sex Steroid Hormones on Breast Cancer Risk. Cancer Epidemiol Biomarkers Prev 2022; 31:28-37. [PMID: 34670801 PMCID: PMC7612577 DOI: 10.1158/1055-9965.epi-21-0438] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2021] [Revised: 08/10/2021] [Accepted: 10/07/2021] [Indexed: 11/25/2022] Open
Abstract
We undertook a systematic review and appraised the evidence for an effect of circulating sex steroid hormones and sex hormone-binding globulin (SHBG) on breast cancer risk in pre- and postmenopausal women. Systematic searches identified prospective studies relevant to this review. Meta-analyses estimated breast cancer risk for women with the highest compared with the lowest level of sex hormones, and the DRMETA Stata package was used to graphically represent the shape of these associations. The ROBINS-E tool assessed risk of bias, and the GRADE system appraised the strength of evidence. In premenopausal women, there was little evidence that estrogens, progesterone, or SHBG were associated with breast cancer risk, whereas androgens showed a positive association. In postmenopausal women, higher estrogens and androgens were associated with an increase in breast cancer risk, whereas higher SHBG was inversely associated with risk. The strength of the evidence quality ranged from low to high for each hormone. Dose-response relationships between sex steroid hormone concentrations and breast cancer risk were most notable for postmenopausal women. These data support the plausibility of a role for sex steroid hormones in mediating the causal relationship between physical activity and the risk of breast cancer.See related reviews by Lynch et al., p. 11 and Swain et al., p. 16.
Collapse
Affiliation(s)
- Ann E Drummond
- Cancer Epidemiology Division, Cancer Council Victoria, Victoria, Australia
| | | | - Kristy A Brown
- Department of Medicine, Weill Cornell Medicine, New York, New York
| | - Suzanne C Dixon-Suen
- Cancer Epidemiology Division, Cancer Council Victoria, Victoria, Australia
- Institute for Physical Activity and Nutrition, Deakin University, Geelong, Victoria, Australia
| | - Leonessa Boing
- Laboratory of Research in Leisure and Physical Activity, Santa Catarina State University, Florianópolis, Brazil
| | - Eline H van Roekel
- Department of Epidemiology, GROW School for Oncology and Developmental Biology, Maastricht University, Maastricht, the Netherlands
| | - Melissa M Moore
- Medical Oncology, St Vincent's Hospital, Melbourne, Victoria, Australia
| | - Tom R Gaunt
- Bristol Medical School, University of Bristol, Bristol, United Kingdom
| | - Roger L Milne
- Cancer Epidemiology Division, Cancer Council Victoria, Victoria, Australia
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Victoria, Australia
- Precision Medicine, School of Clinical Sciences at Monash Health, Monash University, Melbourne, Victoria, Australia
| | - Dallas R English
- Cancer Epidemiology Division, Cancer Council Victoria, Victoria, Australia
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Victoria, Australia
| | - Richard M Martin
- Bristol Medical School, University of Bristol, Bristol, United Kingdom
- NIHR Biomedical Research Centre at University Hospitals Bristol and Weston NHS Foundation Trust and the University of Bristol, Bristol, United Kingdom
| | - Sarah J Lewis
- Bristol Medical School, University of Bristol, Bristol, United Kingdom
| | - Brigid M Lynch
- Cancer Epidemiology Division, Cancer Council Victoria, Victoria, Australia.
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Victoria, Australia
| |
Collapse
|
24
|
Malviya R, Fuloria S, Verma S, Subramaniyan V, Sathasivam KV, Kumarasamy V, Hari Kumar D, Vellasamy S, Meenakshi DU, Yadav S, Sharma A, Fuloria NK. Commercial utilities and future perspective of nanomedicines. PeerJ 2021; 9:e12392. [PMID: 34820175 PMCID: PMC8607930 DOI: 10.7717/peerj.12392] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2021] [Accepted: 10/05/2021] [Indexed: 11/20/2022] Open
Abstract
The present review aims to describe the commercial utilities and future perspectives of nanomedicines. Nanomedicines are intended to increase precision medicine and decrease the adverse effects on the patient. Nanomedicines are produced, engineered, and industrialized at the cellular, chemical, and macromolecular levels. This study describes the various aspects of nanomedicine such as governing outlooks over high use of nanomedicine, regulatory advancements for nanomedicines, standards, and guidelines for nanomedicines as per Therapeutic Goods Administration (TGA). This review also focuses on the patents and clinical trials based on nanoformulation, along with nanomedicines utilization as drug therapy and their market value. The present study concludes that nanomedicines are of high importance in biomedical and pharmaceutical production and offer better therapeutic effects especially in the case of drugs that possess low aqueous solubility. The factual data presented in this study will assist the researchers and health care professionals in understanding the applications of nanomedicine for better diagnosis and effective treatment of a disease.
Collapse
Affiliation(s)
- Rishabha Malviya
- Department of Pharmacy, SMAS, Galgotias University, Greater Noida, Uttar Pradesh, India
| | - Shivkanya Fuloria
- Faculty of Pharmacy & Centre of Excellence for Biomaterials Engineering, AIMST University, Bedong, Kedah, Malaysia
| | - Swati Verma
- Department of Pharmacy, SMAS, Galgotias University, Greater Noida, Uttar Pradesh, India
| | - Vetriselvan Subramaniyan
- Faculty of Medicine, Bioscience and Nursing, MAHSA University, Bandar Saujana Putra, Selangor, Malaysia
| | - Kathiresan V Sathasivam
- Faculty of Applied Science & Centre of Excellence for Biomaterials Engineering, AIMST University, Bedong, Kedah, Malaysia
| | - Vinoth Kumarasamy
- Faculty of Medicine, Bioscience and Nursing, MAHSA University, Bandar Saujana Putra, Selangor, Malaysia
| | - Darnal Hari Kumar
- Jeffrey Cheah Cheshire School of Medicine & Health Sciences, Monash University, Selangor, Malaysia
| | - Shalini Vellasamy
- Faculty of Medicine, Bioscience and Nursing, MAHSA University, Bandar Saujana Putra, Selangor, Malaysia
| | | | - Shikha Yadav
- Department of Pharmacy, SMAS, Galgotias University, Greater Noida, Uttar Pradesh, India
| | - Akanksha Sharma
- Department of Pharmacy, SMAS, Galgotias University, Greater Noida, Uttar Pradesh, India
| | - Neeraj Kumar Fuloria
- Faculty of Pharmacy & Centre of Excellence for Biomaterials Engineering, AIMST University, Bedong, Kedah, Malaysia
| |
Collapse
|
25
|
|
26
|
Connan-Perrot S, Léger T, Lelandais P, Desdoits-Lethimonier C, David A, Fowler PA, Mazaud-Guittot S. Six Decades of Research on Human Fetal Gonadal Steroids. Int J Mol Sci 2021; 22:ijms22136681. [PMID: 34206462 PMCID: PMC8268622 DOI: 10.3390/ijms22136681] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2021] [Revised: 06/14/2021] [Accepted: 06/18/2021] [Indexed: 11/16/2022] Open
Abstract
Human fetal gonads acquire endocrine steroidogenic capabilities early during their differentiation. Genetic studies show that this endocrine function plays a central role in the sexually dimorphic development of the external genitalia during fetal development. When this endocrine function is dysregulated, congenital malformations and pathologies are the result. In this review, we explain how the current knowledge of steroidogenesis in human fetal gonads has benefited from both the technological advances in steroid measurements and the assembly of detailed knowledge of steroidogenesis machinery and its expression in human fetal gonads. We summarise how the conversion of radiolabelled steroid precursors, antibody-based assays, mass spectrometry, ultrastructural studies, and the in situ labelling of proteins and mRNA have all provided complementary information. In this review, our discussion goes beyond the debate on recommendations concerning the best choice between the different available technologies, and their degrees of reproducibility and sensitivity. The available technologies and techniques can be used for different purposes and, as long as all quality controls are rigorously employed, the question is how to maximise the generation of robust, reproducible data on steroid hormones and their crucial roles in human fetal development and subsequent functions.
Collapse
Affiliation(s)
- Stéphane Connan-Perrot
- Univ Rennes, Inserm, EHESP, Irset (Institut de Recherche en Santé, Environnement et Travail), UMR_S 1085, 35000 Rennes, France; (S.C.-P.); (P.L.); (C.D.-L.); (A.D.)
| | - Thibaut Léger
- Fougères Laboratory, French Agency for Food, Environmental and Occupational Health & Safety (ANSES), CEDEX, 35306 Fougères, France;
| | - Pauline Lelandais
- Univ Rennes, Inserm, EHESP, Irset (Institut de Recherche en Santé, Environnement et Travail), UMR_S 1085, 35000 Rennes, France; (S.C.-P.); (P.L.); (C.D.-L.); (A.D.)
| | - Christèle Desdoits-Lethimonier
- Univ Rennes, Inserm, EHESP, Irset (Institut de Recherche en Santé, Environnement et Travail), UMR_S 1085, 35000 Rennes, France; (S.C.-P.); (P.L.); (C.D.-L.); (A.D.)
| | - Arthur David
- Univ Rennes, Inserm, EHESP, Irset (Institut de Recherche en Santé, Environnement et Travail), UMR_S 1085, 35000 Rennes, France; (S.C.-P.); (P.L.); (C.D.-L.); (A.D.)
| | - Paul A. Fowler
- Institute of Medical Sciences, University of Aberdeen, Foresterhill, Aberdeen AB25 2ZD, UK;
| | - Séverine Mazaud-Guittot
- Univ Rennes, Inserm, EHESP, Irset (Institut de Recherche en Santé, Environnement et Travail), UMR_S 1085, 35000 Rennes, France; (S.C.-P.); (P.L.); (C.D.-L.); (A.D.)
- Correspondence: ; Tel.: +33-2-23-23-58-86
| |
Collapse
|
27
|
Bick AJ, Louw-du Toit R, Skosana SB, Africander D, Hapgood JP. Pharmacokinetics, metabolism and serum concentrations of progestins used in contraception. Pharmacol Ther 2021; 222:107789. [PMID: 33316287 PMCID: PMC8122039 DOI: 10.1016/j.pharmthera.2020.107789] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2019] [Accepted: 11/24/2020] [Indexed: 02/07/2023]
Abstract
Many different forms of hormonal contraception are used by millions of women worldwide. These contraceptives differ in the dose and type of synthetic progestogenic compound (progestin) used, as well as the route of administration and whether or not they contain estrogenic compounds. There is an increasing awareness that different forms of contraception and different progestins have different side-effect profiles, in particular their cardiovascular effects, effects on reproductive cancers and susceptibility to infectious diseases. There is a need to develop new methods to suit different needs and with minimal risks, especially in under-resourced areas. This requires a better understanding of the pharmacokinetics, metabolism, serum and tissue concentrations of progestins used in contraception as well as the biological activities of progestins and their metabolites via steroid receptors. Here we review the current knowledge on these topics and identify the research gaps. We show that there is a paucity of research on most of these topics for most progestins. We find that major impediments to clear conclusions on these topics include a lack of standardized methodologies, comparisons between non-parallel clinical studies and variability of data on serum concentrations between and within studies. The latter is most likely due, at least in part, to differences in intrinsic characteristics of participants. The review highlights the importance of insight on these topics in order to provide the best contraceptive options to women with minimal risks.
Collapse
Affiliation(s)
- Alexis J Bick
- Department of Molecular and Cell Biology, University of Cape Town, Private Bag X3, Rondebosch 7700, South Africa
| | - Renate Louw-du Toit
- Department of Biochemistry, Stellenbosch University, Stellenbosch 7602, South Africa
| | - Salndave B Skosana
- Department of Molecular and Cell Biology, University of Cape Town, Private Bag X3, Rondebosch 7700, South Africa
| | - Donita Africander
- Department of Biochemistry, Stellenbosch University, Stellenbosch 7602, South Africa
| | - Janet P Hapgood
- Department of Molecular and Cell Biology, University of Cape Town, Private Bag X3, Rondebosch 7700, South Africa; Institute of Infectious Disease and Molecular Medicine, University of Cape Town, Cape Town, South Africa.
| |
Collapse
|
28
|
Zhu Z, Chen Y, Ren J, Dawsey SM, Yin J, Freedman ND, Fan JH, Taylor PR, Liu Y, Qiao YL, Abnet CC. Serum Levels of Androgens, Estrogens, and Sex Hormone Binding Globulin and Risk of Primary Gastric Cancer in Chinese Men: A Nested Case-Control Study. Cancer Prev Res (Phila) 2021; 14:659-666. [PMID: 33766833 PMCID: PMC8225565 DOI: 10.1158/1940-6207.capr-20-0497] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2020] [Revised: 02/20/2021] [Accepted: 03/22/2021] [Indexed: 12/24/2022]
Abstract
Gastric cancer shows a strong male predominance, and sex steroid hormones have been hypothesized to explain this sex disparity. Previous studies examining the associations between sex hormones and sex hormone binding globulin (SHBG) and risk of gastric cancer come primarily from western populations and additional studies in diverse populations will help us better understand the association. We performed a nested case-control study in Linxian Nutrition Intervention Trials cohorts to evaluate the associations among Chinese men, where we had sufficient cases to perform a well-powered study. Using radioimmunoassays and immunoassays, we quantitated androgens, estrogens, and SHBG in baseline serum from 328 men that developed noncardia gastric cancer and matched controls. We used multivariable unconditional logistic regression to calculate ORs and 95% confidence intervals (CI) and explored interactions with body mass index (BMI), age, alcohol drinking, smoking, and follow-up time. Subjects with SHBG in the highest quartile, as compared with those in the lowest quartile, had a significantly increased risk of gastric cancer (OR = 1.87; 95% CI, 1.01-3.44). We found some evidence for associations of sex steroid hormones in men with lower BMI. Our study found a novel association suggesting that higher serum concentrations of SHBG may be associated with risk of gastric cancer in men. We found no overall associations with sex hormones themselves, but future studies should expand the scope of these studies to include women and further explore whether BMI modifies a potential association. PREVENTION RELEVANCE: It was the first study to investigate the association of gastric cancer with prediagnostic sex steroid hormones and SHBG in an Asian male population. Although there were no overall associations for sex steroid hormone concentrations, higher concentrations of SHBG was associated with increased risk of noncardia gastric cancer.
Collapse
Affiliation(s)
- Zhikai Zhu
- Department of Cancer Epidemiology, National Cancer Center/Cancer Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
- School of Health Policy and Management, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Yingxi Chen
- Metabolic Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, Maryland
| | - Jiansong Ren
- Office of Cancer Screening, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Sanford M Dawsey
- Metabolic Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, Maryland
| | - Jian Yin
- Department of Cancer Epidemiology, National Cancer Center/Cancer Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Neal D Freedman
- Metabolic Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, Maryland
| | - Jin-Hu Fan
- Department of Cancer Epidemiology, National Cancer Center/Cancer Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Philip R Taylor
- Metabolic Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, Maryland
| | - Yuanli Liu
- School of Health Policy and Management, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China.
| | - You-Lin Qiao
- Department of Cancer Epidemiology, National Cancer Center/Cancer Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China.
| | - Christian C Abnet
- Metabolic Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, Maryland
| |
Collapse
|
29
|
Zuercher J, Boes KM, Balogh O, Helms AB, Cecere JT. Comparison of a Point-of-Care Analyzer With a Chemiluminescent Immunoassay for Serum Progesterone Measurement in Breeding Management of the Bitch. Front Vet Sci 2021; 8:660923. [PMID: 34055950 PMCID: PMC8155301 DOI: 10.3389/fvets.2021.660923] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2021] [Accepted: 04/12/2021] [Indexed: 11/13/2022] Open
Abstract
Accurate serum progesterone measurements for timing bitches during breeding management is critical for reproductive practice, especially as artificial insemination has become routine to facilitate breeding of animals that are geographically or temporally separated. To measure serum progesterone, chemiluminescent immunoassay (CLIA) has replaced radioimmunoassay as the current standard in the bitch due to its high correlation and increased practicality. In January 2019, a colorimetric point-of-care (POC) immunoassay for quantitative in-clinic canine serum progesterone measurements in <30 min was released. This study provides an independent comparison of the POC (Catalyst One, IDEXX) to the current industry standard, CLIA (Immulite-2000, Siemens). To assess inter-assay imprecision of POC and agreement of the POC and CLIA results, 100 canine serum samples were analyzed on three analyzers (POC-1, POC-2, and CLIA), of which, 74 (POC-1) and 75 (POC-2) results were within POCs' reportable range of 0.2–20 ng/mL and included in the study. To assess intra-assay imprecision, pooled canine serum samples at low (L1), intermediate (L2), and high (L3) progesterone concentrations were analyzed ten times each on POC-1 and CLIA. Relative to CLIA, POC values showed good correlation (POC-1, r2 = 0.9366; POC-2, r2 = 0.9438, P < 0.0001) and significant positive proportional bias at values >2 ng/mL. The POC inter-assay coefficients of variation (CVs) were 13.2% (0.2–2.9 ng/mL, 0.6–9.2 nmol/L, L1), 10.0% (3.0–9.9 ng/mL, 9.5–31.5 nmol/L, L2), 7.1% (10.0–20.0 ng/mL, 31.8–63.6 nmol/L, L3), and 11.2% (all samples). The intra-assay CVs for POC (L1, 15.3%; L2, 7.0%; L3, 4.7%) were higher than those for CLIA (L1, 5.89%; L2, 4.89%; L3, 3.44%). Based on the more rapid increase in serial serum progesterone concentrations in ovulating bitches and the greater imprecision of the POC, the clinical interpretations of serum progesterone measurements as they relate to canine breeding management should be made with caution.
Collapse
Affiliation(s)
- Julia Zuercher
- Virginia-Maryland College of Veterinary Medicine, Blacksburg, VA, United States
| | - Katie M Boes
- Department of Biomedical Sciences and Pathobiology, Virginia-Maryland College of Veterinary Medicine, Blacksburg, VA, United States
| | - Orsolya Balogh
- Department of Small Animal Clinical Sciences, Virginia-Maryland College of Veterinary Medicine, Blacksburg, VA, United States
| | - Alyssa B Helms
- Department of Small Animal Clinical Sciences, Virginia-Maryland College of Veterinary Medicine, Blacksburg, VA, United States
| | - Julie T Cecere
- Department of Small Animal Clinical Sciences, Virginia-Maryland College of Veterinary Medicine, Blacksburg, VA, United States
| |
Collapse
|
30
|
The 2020 genitourinary syndrome of menopause position statement of The North American Menopause Society. ACTA ACUST UNITED AC 2021; 27:976-992. [PMID: 32852449 DOI: 10.1097/gme.0000000000001609] [Citation(s) in RCA: 190] [Impact Index Per Article: 63.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
OBJECTIVE To update and expand the 2013 position statement of The North American Menopause Society (NAMS) on the management of the genitourinary syndrome of menopause (GSM), of which symptomatic vulvovaginal atrophy (VVA) is a component. METHODS A Panel of acknowledged experts in the field of genitourinary health reviewed the literature to evaluate new evidence on vaginal hormone therapies as well as on other management options available or in development for GSM. A search of PubMed was conducted identifying medical literature on VVA and GSM published since the 2013 position statement on the role of pharmacologic and nonpharmacologic treatments for VVA in postmenopausal women. The Panel revised and added recommendations on the basis of current evidence. The Panel's conclusions and recommendations were reviewed and approved by the NAMS Board of Trustees. RESULTS Genitourinary syndrome of menopause affects approximately 27% to 84% of postmenopausal women and can significantly impair health, sexual function, and quality of life. Genitourinary syndrome of menopause is likely underdiagnosed and undertreated. In most cases, symptoms can be effectively managed. A number of over-the-counter and government-approved prescription therapies available in the United States and Canada demonstrate effectiveness, depending on the severity of symptoms. These include vaginal lubricants and moisturizers, vaginal estrogens and dehydroepiandrosterone (DHEA), systemic hormone therapy, and the estrogen agonist/antagonist ospemifene. Long-term studies on the endometrial safety of vaginal estrogen, vaginal DHEA, and ospemifene are lacking. There are insufficient placebo-controlled trials of energy-based therapies, including laser, to draw conclusions on efficacy and safety or to make treatment recommendations. CONCLUSIONS Clinicians can resolve many distressing genitourinary symptoms and improve sexual health and the quality of life of postmenopausal women by educating women about, diagnosing, and appropriately managing GSM. Choice of therapy depends on the severity of symptoms, the effectiveness and safety of treatments for the individual patient, and patient preference. Nonhormone therapies available without a prescription provide sufficient relief for most women with mild symptoms. Low-dose vaginal estrogens, vaginal DHEA, systemic estrogen therapy, and ospemifene are effective treatments for moderate to severe GSM. When low-dose vaginal estrogen or DHEA or ospemifene is administered, a progestogen is not indicated; however, endometrial safety has not been studied in clinical trials beyond 1 year. There are insufficient data at present to confirm the safety of vaginal estrogen or DHEA or ospemifene in women with breast cancer; management of GSM should consider the woman's needs and the recommendations of her oncologist.
Collapse
|
31
|
Bouras E, Papandreou C, Tzoulaki I, Tsilidis KK. Endogenous sex steroid hormones and colorectal cancer risk: a systematic review and meta-analysis. Discov Oncol 2021; 12:8. [PMID: 35201467 PMCID: PMC8777537 DOI: 10.1007/s12672-021-00402-z] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2021] [Accepted: 03/02/2021] [Indexed: 12/24/2022] Open
Abstract
Preclinical data suggest that endogenous sex steroid hormones may be implicated in colorectal cancer (CRC) development, however, findings from epidemiological studies are conflicting. The aim of this systematic review and meta-analysis was to investigate the associations between endogenous concentrations of sex hormones and CRC risk. PubMed and Scopus were searched until June 2020 for prospective studies evaluating the association between pre-diagnostic plasma/serum concentrations of estradiol, testosterone and sex-hormone binding globulin (SHBG) and CRC risk. Summary relative risks (RRs) and 95% confidence intervals (CIs) were estimated using the inverse-variance weighted random-effects model based on the DerSimonian-Laird estimator. Eight studies were included in the meta-analysis after evaluating 3,859 non-duplicate records. Four of the eight studies had a nested case-control design, one study was a case-cohort and the rest three studies were cohort studies, and they included on average 295 cases (range:48-732) and 2,105 controls. No associations were found for endogenous sex steroid hormones in men or post-menopausal women with CRC risk, with evidence for substantial heterogeneity observed among women. Findings from this meta-analysis do not support presence of associations between pre-diagnostic concentrations of testosterone, estradiol and SHBG with incident CRC risk in men and post-menopausal women.
Collapse
Affiliation(s)
- Emmanouil Bouras
- Department of Hygiene and Epidemiology, University of Ioannina Medical School, Ioannina, Greece
| | | | - Ioanna Tzoulaki
- Department of Hygiene and Epidemiology, University of Ioannina Medical School, Ioannina, Greece
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, St Mary's Campus, London, W2 1PG, UK
| | - Konstantinos K Tsilidis
- Department of Hygiene and Epidemiology, University of Ioannina Medical School, Ioannina, Greece.
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, St Mary's Campus, London, W2 1PG, UK.
| |
Collapse
|
32
|
Athimulam S, Grebe S, Bancos I. Steroid profiling in the diagnosis of mild and overt Cushing's syndrome. Best Pract Res Clin Endocrinol Metab 2021; 35:101488. [PMID: 33589355 PMCID: PMC8164982 DOI: 10.1016/j.beem.2021.101488] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
In this review, we provide a comprehensive overview of the utility of steroid profiling for diagnosis of management of overt Cushing syndrome and mild autonomous cortisol secretion. A diagnosis of Cushing syndrome is made through a multistep process that includes confirmation of endogenous hypercortisolism, followed by determination of its cause. Steroid metabolomic testing applied to serum or urine steroids and their metabolites can provide additional and novel insights into alterations of steroid biosynthesis and metabolism and its causes. In particular, increased availability and advances in mass spectrometry-based steroid analysis, coupled with machine learning-based algorithms, have facilitated the development of tailored diagnostic and subtyping approaches for autonomous cortisol secretion and might be useful for detecting low grade autonomous glucocorticoid secretion and in predicting and monitoring of disease severity and associated comorbidities.
Collapse
Affiliation(s)
- Shobana Athimulam
- Department of Medicine, Division of Endocrinology, Diabetes, Bone and Mineral Disorders, Henry Ford Health System, Detroit, MI, USA.
| | - Stefan Grebe
- Department of Laboratory Medicine and Pathology, Division of Clinical Biochemistry and Immunology, Mayo Clinic, Rochester, MN, USA; Department of Medicine, Division of Endocrinology, Diabetes, Metabolism and Nutrition, Mayo Clinic, Rochester, MN, USA.
| | - Irina Bancos
- Department of Medicine, Division of Endocrinology, Diabetes, Metabolism and Nutrition, Mayo Clinic, Rochester, MN, USA.
| |
Collapse
|
33
|
Hayashi K, Gonzales TK, Kapoor A, Ziegler TE, Meethal SV, Atwood CS. Development of Classification Models for the Prediction of Alzheimer's Disease Utilizing Circulating Sex Hormone Ratios. J Alzheimers Dis 2020; 76:1029-1046. [PMID: 32623397 DOI: 10.3233/jad-200418] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND While sex hormones are essential for normal cognitive health, those individuals with greater endocrine dyscrasia around menopause and with andropause are more likely to develop cognitive loss and Alzheimer's disease (AD). OBJECTIVE To assess whether circulating sex hormones may provide an etiologically significant, surrogate biomarker, for cognitive decline. METHODS Plasma (n = 152) and serum (n = 107) samples from age- and gender-matched AD and control subjects from the Wisconsin Alzheimer's Disease Research Center (ADRC) were analyzed for 11 steroids and follicle-stimulating hormone. Logistic regression (LR), correlation analyses, and recursive partitioning (RP) were used to examine the interactions of hormones and hormone ratios and their association with AD. Models generated were then tested on an additional 43 ADRC samples. RESULTS The wide variation and substantial overlap in the concentrations of all circulating sex steroids across control and AD groups precluded their use for predicting AD. Classification tree analyses (RP) revealed interactions among single hormones and hormone ratios that associated with AD status, the most predictive including only the hormone ratios identified by LR. The strongest associations were observed between cortisol, cortisone, and androstenedione with AD, with contributions from progesterone and 17β-estradiol. Utilizing this model, we correctly predicted 81% of AD test cases and 64% of control test cases. CONCLUSION We have developed a diagnostic model for AD, the Wisconsin Hormone Algorithm Test for Cognition (WHAT-Cog), that utilizes classification tree analyses of hormone ratios. Further refinement of this technology could provide a quick and cheap diagnostic method for screening those with AD.
Collapse
Affiliation(s)
- Kentaro Hayashi
- Division of Geriatrics and Gerontology, Department of Medicine, University of Wisconsin-Madison School of Medicine and Public Health, Madison, WI, USA
| | - Tina K Gonzales
- Division of Geriatrics and Gerontology, Department of Medicine, University of Wisconsin-Madison School of Medicine and Public Health, Madison, WI, USA.,Geriatric Research, Education and Clinical Center, Veterans Administration Hospital, Madison, WI, USA
| | - Amita Kapoor
- Assay Services Unit and Institute for Clinical and Translational Research Core Laboratory, National Primate Research Center, University of Wisconsin-Madison, Madison, WI, USA
| | - Toni E Ziegler
- Assay Services Unit and Institute for Clinical and Translational Research Core Laboratory, National Primate Research Center, University of Wisconsin-Madison, Madison, WI, USA
| | - Sivan Vadakkadath Meethal
- Division of Geriatrics and Gerontology, Department of Medicine, University of Wisconsin-Madison School of Medicine and Public Health, Madison, WI, USA
| | - Craig S Atwood
- Division of Geriatrics and Gerontology, Department of Medicine, University of Wisconsin-Madison School of Medicine and Public Health, Madison, WI, USA.,Geriatric Research, Education and Clinical Center, Veterans Administration Hospital, Madison, WI, USA.,School of Exercise, Biomedical and Health Sciences, Edith Cowan University, Joondalup, WA, Australia
| |
Collapse
|
34
|
Development of a total serum testosterone, androstenedione, 17-hydroxyprogesterone, 11β-hydroxyandrostenedione and 11-ketotestosterone LC-MS/MS assay and its application to evaluate pre-analytical sample stability. ACTA ACUST UNITED AC 2020; 58:741-752. [DOI: 10.1515/cclm-2019-0959] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2019] [Accepted: 11/15/2019] [Indexed: 11/15/2022]
Abstract
AbstractBackgroundClassically, serum testosterone (T) and androstenedione (A4) have been the mainstay for the biochemical assessment of hyperandrogenism. However, recent evidence suggests 11β-hydroxyandrostenedione (11OHA4) and 11-ketotestosterone (11KT) may also be important. Here, we describe the development of a liquid chromatography-tandem mass spectrometry (LC-MS/MS) assay for quantitation of total serum T, A4, 17-hydroxyprogesterone (17OHP), 11OHA4 and 11KT. In addition, we applied the method to assess pre-analytical stability.MethodsAn isotopically labelled internal standard was added to samples prior to supported liquid extraction (SLE). Extracts were analysed using LC-MS/MS to detect T/A4/17OHP/11OHA4 and 11KT along with their corresponding internal standards. Samples (n = 7) were collected from healthy volunteers (n = 14) and left incubated at 20 °C for up to 72 h. Tubes were retrieved at select time points, centrifuged, separated and frozen prior to analysis.ResultsThe total run time was 4 min. For all analytes, intra- and inter-assay imprecision did not exceed 7.9% and 5.3%, respectively; matrix effects were negligible and mean recoveries ranged from 95.3 to 111.6%. The limits of quantitation (LOQs) were 0.25 nmol/L for T, A4 and 11OHA4, 0.50 nmol/L for 17OHP, and 0.24 nmol/L for 11KT. No significant change was observed in pre-centrifugation A4 or female T concentrations over 72 h. Significant increases (p < 0.01) in concentrations of 11KT, 17OHP, 11OHA4 and male T were observed after 2, 8, 12 and 24 h, respectively.ConclusionsWe developed a robust LC-MS/MS assay for the quantitation of total serum T/A4/17OHP/11OHA4 and 11KT. Applying the method to determine pre-analytical stability suggests samples requiring 11KT need separating from the cells within 2 h.
Collapse
|
35
|
Gradl K, Taibon J, Singh N, Albrecht E, Geistanger A, Pongratz S, Hutzler S, Mayer M, Kleinschmidt C, Geletneky C, Hofmann V, Köppl D, Rauh M, Kobold U. An isotope dilution LC–MS/MS-based candidate reference method for the quantification of androstenedione in human serum and plasma. CLINICAL MASS SPECTROMETRY 2020; 16:1-10. [PMID: 34820514 PMCID: PMC8600989 DOI: 10.1016/j.clinms.2020.01.003] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/14/2019] [Revised: 01/15/2020] [Accepted: 01/20/2020] [Indexed: 11/18/2022]
Abstract
LC-MS/MS-based candidate reference method for the quantification of androstenedione. Certified reference material from NMIA with additional qNMR characterization. Uncertainty evaluation according to the GUM 1995. Inter laboratory comparison study and comparison to a routine LC-MS/MS assay.
The accurate measurement of androstenedione in human serum and plasma is required for steroid profiling to assure the appropriate diagnosis and differential diagnosis of hyperandrogenism. In this work, we introduce an isotope dilution liquid chromatography–tandem mass spectrometry (LC–MS/MS) candidate reference measurement procedure for the quantification of androstenedione in human serum and plasma. The performance of the procedure enables its use in the evaluation and standardization of routine assays and for the evaluation of patient samples to ensure the traceability of individual patient results. As the primary standard, a certified reference material from NMIA (National Measurement Institute, Australia) was used. Additionally, a quantitative nuclear magnetic resonance (qNMR) method was developed for the value assignment of the primary reference material, which ensures the direct traceability to SI units, as well as the independence from the availability of reference materials. 13C3-labeled androstenedione was used as the internal standard. The introduced method allows the measurement of androstenedione in the range of 0.05–12 ng/mL, and the assay imprecision was found to be <2% between 5 and 12 ng/mL, 3.5% at 1.5 ng/mL, and 5.2% at 0.05 ng/mL, with an accuracy of 95–105% for the serum and 91–103% for the plasma matrix. The transferability to a second laboratory was validated by method comparison based on 112 patient samples. The comparison of the results obtained from the presented method and an LC–MS/MS routine assay, using 150 native patient samples, showed a good correlation with a bias of the routine method of ≤4.0%.
Collapse
Affiliation(s)
- Katrin Gradl
- Roche Diagnostics GmbH, Nonnenwald 2, 82377 Penzberg, Germany
| | - Judith Taibon
- Roche Diagnostics GmbH, Nonnenwald 2, 82377 Penzberg, Germany
- Corresponding author.
| | - Neeraj Singh
- Roche Diagnostics GmbH, Nonnenwald 2, 82377 Penzberg, Germany
| | - Eva Albrecht
- Roche Diagnostics GmbH, Nonnenwald 2, 82377 Penzberg, Germany
| | | | | | - Stefan Hutzler
- Roche Diagnostics GmbH, Nonnenwald 2, 82377 Penzberg, Germany
| | - Magdalena Mayer
- Roche Diagnostics GmbH, Nonnenwald 2, 82377 Penzberg, Germany
| | | | | | - Verena Hofmann
- Roche Diagnostics GmbH, Nonnenwald 2, 82377 Penzberg, Germany
| | - Daniel Köppl
- Klinik für Kinder und Jugendliche, Universitätsklinikum Erlangen, Loschgestr. 15, 91054 Erlangen, Germany
| | - Manfred Rauh
- Klinik für Kinder und Jugendliche, Universitätsklinikum Erlangen, Loschgestr. 15, 91054 Erlangen, Germany
| | - Uwe Kobold
- Roche Diagnostics GmbH, Nonnenwald 2, 82377 Penzberg, Germany
| |
Collapse
|
36
|
Macias-Muñoz L, Filella X, Augé JM, Hanzu FA, Morales-Ruiz M, Bedini JL, Jiménez W, Casals G. Performance evaluation of Siemens Atellica enhanced estradiol assay. ADVANCES IN LABORATORY MEDICINE 2020; 1:20190009. [PMID: 37362558 PMCID: PMC10197438 DOI: 10.1515/almed-2019-0009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/28/2019] [Accepted: 10/24/2019] [Indexed: 06/28/2023]
Abstract
Background Serum estradiol (E2) levels may be used in the diagnostic and/or monitoring of a broad variety of clinical conditions. The aims of this study were to evaluate the Siemens enhanced estradiol assay (eE2) on Atellica IM 1600 (Siemens Healthineers) and to perform a sample comparison with the Siemens ADVIA Centaur XP (Siemens Healthineers). Methods Within-day and between-day coefficient of variation (CV) were determined using serum sample pools and quality control materials. Six serum samples with decreasing concentrations of E2 were used to assess the limit of quantification. Linearity was evaluated using two different serum samples. Accuracy was evaluated by measuring three certified reference materials. Passing-Bablok regression and Bland-Altman plot were used for comparing Atellica and Centaur XP in 119 serum samples ranging from 45 to 10,059 pmol/L. Results Within-day and between-day imprecision was <6.6%. Accuracy was <6.0% for all values except for 114 pmol/L (22%). The study of limit of quantification resulted in an interday imprecision <20%. High correlation between measured and expected estradiol dilution results was observed (R = 0.99), with recoveries ranging from 77 to 93%. Comparison study showed good agreement and no significant bias. Conclusions The study shows that Atellica eE2 assay presents acceptable imprecision and accuracy and correlates well with Centaur XP.
Collapse
Affiliation(s)
- Laura Macias-Muñoz
- Department of Biochemistry and Molecular Genetics, Hospital Clínic, IDIBAPS, Barcelona, Spain
| | - Xavier Filella
- Department of Biochemistry and Molecular Genetics, Hospital Clínic, IDIBAPS, Barcelona, Spain
| | - Josep Maria Augé
- Department of Biochemistry and Molecular Genetics, Hospital Clínic, IDIBAPS, Barcelona, Spain
| | - Felicia A. Hanzu
- Department of Endocrinology, Hospital Clínic, IDIBAPS, Barcelona, Spain
- University of Barcelona, Barcelona, Spain
| | - Manuel Morales-Ruiz
- Department of Biochemistry and Molecular Genetics, Hospital Clínic, IDIBAPS, Barcelona, Spain
- University of Barcelona, Barcelona, Spain
| | - Josep Lluis Bedini
- Department of Biochemistry and Molecular Genetics, Hospital Clínic, IDIBAPS, Barcelona, Spain
| | - Wladimiro Jiménez
- Department of Biochemistry and Molecular Genetics, Hospital Clínic, IDIBAPS, Barcelona, Spain
- University of Barcelona, Barcelona, Spain
| | - Gregori Casals
- Department of Biochemistry and Molecular Genetics, Hospital Clinic Universitari, Villarroel 170, Barcelona 08036, Spain
| |
Collapse
|
37
|
Hu J, Lin JH, Jiménez MC, Manson JE, Hankinson SE, Rexrode KM. Plasma Estradiol and Testosterone Levels and Ischemic Stroke in Postmenopausal Women. Stroke 2020; 51:1297-1300. [PMID: 32078496 DOI: 10.1161/strokeaha.119.028588] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Background and Purpose- Although exogenous hormone therapy (HT) use has been associated with increased risk of ischemic stroke in postmenopausal women, it remains unknown whether sex hormone levels contribute to ischemic stroke risk. We aimed to estimate associations between plasma sex hormone levels and ischemic stroke risk, by HT status, in a nested case-control study of postmenopausal women from the NHS (Nurses' Health Study). Methods- Women with confirmed incident ischemic stroke (n=419) were matched with controls (n=419) by age, HT use, and other factors. Plasma estradiol and testosterone levels were measured using liquid chromatography tandem mass spectrometry; SHBG (sex hormone-binding globulin) was assayed by electrochemiluminescence immunoassay. Associations of total and free estradiol and testosterone, the estradiol/testosterone ratio, and SHBG with ischemic stroke were estimated using conditional logistic regressions stratified by HT status with adjustment for matching and cardiovascular risk factors. Results- Current HT users had different hormone profiles from never/past users. No clear linear trends were observed between estradiol (total or free) levels or the estradiol/testosterone ratio and ischemic stroke risk among either current users (Ptrend>0.1) or never/past users (Ptrend>0.6). For both current and never/past users, the associations between some of the sex hormones and ischemic stroke differed by body mass index categories (Pinteraction≤0.04). For women with a body mass index <25 kg/m2, a higher estradiol/testosterone ratio was associated with significantly elevated ischemic stroke risk among current users (Ptrend=0.01), and higher levels of total and free estradiol were significantly associated with higher ischemic stroke risk among never/past users (Ptrend≤0.04). Testosterone and SHBG were not associated with ischemic stroke in either current or never/past users. Conclusions- Our findings do not support a role of sex hormone levels in mediating ischemic stroke risk among postmenopausal women. Replications in additional larger studies are required.
Collapse
Affiliation(s)
- Jie Hu
- From the Division of Women's Health (J.H., M.C.J., K.M.R.), Department of Medicine, Brigham and Women's Hospital, Boston, MA
| | - Jennifer H Lin
- Division of Preventive Medicine (J.H.L., M.C.J., J.E.M., K.M.R.), Department of Medicine, Brigham and Women's Hospital, Boston, MA
| | - Monik C Jiménez
- From the Division of Women's Health (J.H., M.C.J., K.M.R.), Department of Medicine, Brigham and Women's Hospital, Boston, MA.,Division of Preventive Medicine (J.H.L., M.C.J., J.E.M., K.M.R.), Department of Medicine, Brigham and Women's Hospital, Boston, MA
| | - JoAnn E Manson
- Division of Preventive Medicine (J.H.L., M.C.J., J.E.M., K.M.R.), Department of Medicine, Brigham and Women's Hospital, Boston, MA.,Channing Division of Network Medicine (J.E.M., S.E.H.), Department of Medicine, Brigham and Women's Hospital, Boston, MA.,Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA (J.E.M., S.E.H.)
| | - Susan E Hankinson
- Channing Division of Network Medicine (J.E.M., S.E.H.), Department of Medicine, Brigham and Women's Hospital, Boston, MA.,Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA (J.E.M., S.E.H.).,Department of Biostatistics and Epidemiology, School of Public Health and Health Science, University of Massachusetts Amherst (S.E.H.)
| | - Kathryn M Rexrode
- From the Division of Women's Health (J.H., M.C.J., K.M.R.), Department of Medicine, Brigham and Women's Hospital, Boston, MA.,Division of Preventive Medicine (J.H.L., M.C.J., J.E.M., K.M.R.), Department of Medicine, Brigham and Women's Hospital, Boston, MA
| |
Collapse
|
38
|
Moyano HB, Santos RLSR, Pinilla MPR. Validation of an enzyme immunoassay for the quantification of testosterone in green iguana males (Iguana iguana). Gen Comp Endocrinol 2020; 287:113343. [PMID: 31809722 DOI: 10.1016/j.ygcen.2019.113343] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/09/2019] [Revised: 11/24/2019] [Accepted: 11/25/2019] [Indexed: 11/22/2022]
Abstract
The endocrinological study by immunological methods allows elucidating mechanisms of response to environmental challenges and reproductive regulatory mechanisms in animals. However, it is often overlooked that immunological assays for the detection and quantification of steroid hormones require prior validation tests. In this study, the efficacy of a commercial enzyme immunoassays (EIA) was evaluated for the quantification of plasma testosterone (T) in males from a population of green iguanas (Iguana iguana) in semi-captivity. The enzyme immunoassay was validated for specificity, accuracy and precision. Testosterone concentrations obtained by EIA were compared to estimates obtained on the same samples by high-performance liquid chromatography (HPLC). The proposed protocol has shown linearity and parallelism, T recovery was found to be within 80-110% accuracy, and precision variation was <10%. The EIA method allowed the differentiation of the plasma T concentration of male iguanas during the reproductive season (29.7 ± 14.4 ng mL-1, n = 4) and outside the reproductive season (6.8 ± 2.0 ng mL-1, n = 4). The HPLC method has been able to detect concentrations of T only for those individuals during the reproductive season. The T concentrations obtained by the two methods were not statistically different (p > 0.05) indicating that the commercial EIA kit analyzed can be employed in the laboratory routine to quantify plasma T concentration and consequently differentiate the reproductive status of green iguana males.
Collapse
Affiliation(s)
- Heriberto Barbosa Moyano
- Laboratorio de Biología Reproductiva de Vertebrados, Escuela de Biología, Universidad Industrial de Santander (UIS), Bucaramanga, Colombia.
| | | | - Martha Patricia Ramírez Pinilla
- Laboratorio de Biología Reproductiva de Vertebrados, Escuela de Biología, Universidad Industrial de Santander (UIS), Bucaramanga, Colombia
| |
Collapse
|
39
|
Weiss RV, Hohl A, Athayde A, Pardini D, Gomes L, de Oliveira M, Meirelles R, Clapauch R, Spritzer PM. Testosterone therapy for women with low sexual desire: a position statement from the Brazilian Society of Endocrinology and Metabolism. ARCHIVES OF ENDOCRINOLOGY AND METABOLISM 2019; 63:190-198. [PMID: 31340240 PMCID: PMC10522198 DOI: 10.20945/2359-3997000000152] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/02/2019] [Accepted: 04/22/2019] [Indexed: 11/23/2022]
Abstract
OBJECTIVE To summarize current evidence regarding testosterone treatment for women with low sexual desire. MATERIALS AND METHODS The Female Endocrinology and Andrology Department of the Brazilian Society of Endocrinology and Metabolism invited nine experts to review the physiology of testosterone secretion and the use, misuse, and side effects of exogenous testosterone therapy in women, based on the available literature and guidelines and statements from international societies. RESULTS Low sexual desire is a common complaint in clinical practice, especially in postmenopausal women, and may negatively interfere with quality of life. Testosterone seems to exert a positive effect on sexual desire in women with sexual dysfunction, despite a small magnitude of effect, a lack of long-term safety data, and insufficient evidence to make a broad recommendation for testosterone therapy. Furthermore, there are currently no testosterone formulations approved for women by the relevant regulatory agencies in the United States, Brazil, and most other countries, and testosterone formulations approved for men are not recommended for use by women. CONCLUSION Therefore, testosterone therapy might be considered if other strategies fail, but the risks and benefits must be discussed with the patient before prescription. Arch Endocrinol Metab. 2019;63(3):190-8.
Collapse
Affiliation(s)
- Rita V. Weiss
- Pontifícia Universidade Católica do Rio de JaneiroInstituto Estadual de Diabetes e Endocrinologia Luiz CapriglionePontifícia Universidade Católica do Rio de JaneiroEscola Médica de Pós-Graduação em EndocrinologiaRio de JaneiroRJBrasilInstituto Estadual de Diabetes e Endocrinologia Luiz Capriglione, Pontifícia Universidade Católica do Rio de Janeiro, Escola Médica de Pós-Graduação em Endocrinologia (IEDE-PUC/RJ), Rio de Janeiro, RJ, Brasil
| | - Alexandre Hohl
- Universidade Federal de Santa CatarinaDepartamento de Medicina InternaHospital UniversitárioUniversidade Federal de Santa CatarinaFlorianópolisSCBrasilServiço de Endocrinologia e Metabolismo, Departamento de Medicina Interna, Hospital Universitário (HU), Universidade Federal de Santa Catarina (UFSC), Florianópolis, SC, Brasil
| | - Amanda Athayde
- Pontifícia Universidade Católica do Rio de JaneiroInstituto Estadual de Diabetes e Endocrinologia Luiz CapriglionePontifícia Universidade Católica do Rio de JaneiroEscola Médica de Pós-Graduação em EndocrinologiaRio de JaneiroRJBrasilInstituto Estadual de Diabetes e Endocrinologia Luiz Capriglione, Pontifícia Universidade Católica do Rio de Janeiro, Escola Médica de Pós-Graduação em Endocrinologia (IEDE-PUC/RJ), Rio de Janeiro, RJ, Brasil
- Universidade Federal do Rio de JaneiroUniversidade Federal do Rio de JaneiroRio de JaneiroRJBrasilUniversidade Federal do Rio de Janeiro (UFRJ), Rio de Janeiro, RJ, Brasil
| | - Dolores Pardini
- Universidade Federal de São PauloUniversidade Federal de São PauloSão PauloSPBrasilDisciplina de Endocrinologia, Universidade Federal de São Paulo (UNIFESP), São Paulo, SP, Brasil
| | - Larissa Gomes
- Universidade de São PauloFaculdade de MedicinaHospital de ClínicasUniversidade de São PauloSão PauloSPBrasilDisciplina de Endocrinologia, Faculdade de Medicina, Hospital de Clínicas, Universidade de São Paulo (USP), São Paulo, SP, Brasil
| | - Monica de Oliveira
- Instituto de Medicina Integral Professor Fernando FigueiraInstituto de Medicina Integral Professor Fernando FigueiraRecifePEBrasilInstituto de Medicina Integral Professor Fernando Figueira, Recife, PE, Brasil
| | - Ricardo Meirelles
- Pontifícia Universidade Católica do Rio de JaneiroInstituto Estadual de Diabetes e Endocrinologia Luiz CapriglionePontifícia Universidade Católica do Rio de JaneiroEscola Médica de Pós-Graduação em EndocrinologiaRio de JaneiroRJBrasilInstituto Estadual de Diabetes e Endocrinologia Luiz Capriglione, Pontifícia Universidade Católica do Rio de Janeiro, Escola Médica de Pós-Graduação em Endocrinologia (IEDE-PUC/RJ), Rio de Janeiro, RJ, Brasil
| | - Ruth Clapauch
- Departamento de Fisiologia Endócrina e FisiologiaLaboratório de Pesquisas Clínicas e Experimentais em Biologia VascularRio de JaneiroRJBrasilDepartamento de Fisiologia Endócrina e Fisiologia e Laboratório de Pesquisas Clínicas e Experimentais em Biologia Vascular (BIOVASC), Rio de Janeiro, RJ, Brasil
| | - Poli Mara Spritzer
- Universidade Federal do Rio Grande do SulHospital de Clínicas de Porto AlegreDepartamento de FisiologiaUniversidade Federal do Rio Grande do SulPorto AlegreRSBrasilUnidade de Endocrinologia Ginecológica, Serviço de Endocrinologia, Hospital de Clínicas de Porto Alegre e Departamento de Fisiologia, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brasil
| |
Collapse
|
40
|
Mohr MA, Wong AM, Tomm RJ, Soma KK, Micevych PE. Pubertal development of estradiol-induced hypothalamic progesterone synthesis. Horm Behav 2019; 111:110-113. [PMID: 30552874 PMCID: PMC6527482 DOI: 10.1016/j.yhbeh.2018.12.007] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/15/2018] [Revised: 11/20/2018] [Accepted: 12/11/2018] [Indexed: 12/28/2022]
Abstract
In females, a hallmark of puberty is the luteinizing hormone (LH) surge that triggers ovulation. Puberty initiates estrogen positive feedback onto hypothalamic circuits, which underlie the stimulation of gonadotropin releasing hormone (GnRH) neurons. In reproductively mature female rodents, both estradiol (E2) and progesterone (P4) signaling are necessary to stimulate the surge release of GnRH and LH. Estradiol membrane-initiated signaling facilitates progesterone (neuroP) synthesis in hypothalamic astrocytes, which act on E2-induced progesterone receptors (PGR) to stimulate kisspeptin release, thereby activating GnRH release. How the brain changes during puberty to allow estrogen positive feedback remains unknown. In the current study, we hypothesized that a critical step in estrogen positive feedback was the ability for estradiol-induced neuroP synthesis. To test this idea, hypothalamic neuroP levels were measured in groups of prepubertal, pubertal and young adult female Long Evans rats. Steroids were measured with liquid chromatography tandem mass spectrometry (LC-MS/MS). Hypothalamic neuroP increases from pre-puberty to young adulthood in both gonad-intact females and ovariectomized rats treated with E2. The pubertal development of hypothalamic E2-facilitated progesterone synthesis appears to be one of the neural switches facilitating reproductive maturation.
Collapse
Affiliation(s)
- M A Mohr
- UCLA DGSOM Dept of Neurobiology, 650 Charles E Young Dr. S, Los Angeles, CA 90095, Laboratory of Neuroendocrinology of the Brain Research Institute, United States of America.
| | - A M Wong
- UCLA DGSOM Dept of Neurobiology, 650 Charles E Young Dr. S, Los Angeles, CA 90095, Laboratory of Neuroendocrinology of the Brain Research Institute, United States of America
| | - R J Tomm
- UBC Dept of Psychology and Centre for Brain Health, Vancouver, BC V6T 1Z4, Canada
| | - K K Soma
- UBC Dept of Psychology and Centre for Brain Health, Vancouver, BC V6T 1Z4, Canada
| | - P E Micevych
- UCLA DGSOM Dept of Neurobiology, 650 Charles E Young Dr. S, Los Angeles, CA 90095, Laboratory of Neuroendocrinology of the Brain Research Institute, United States of America
| |
Collapse
|
41
|
Estradiol reference intervals in women during the menstrual cycle, postmenopausal women and men using an LC-MS/MS method. Clin Chim Acta 2019; 495:198-204. [PMID: 30981845 DOI: 10.1016/j.cca.2019.04.062] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2018] [Revised: 04/09/2019] [Accepted: 04/10/2019] [Indexed: 11/20/2022]
Abstract
BACKGROUND For optimal medical decision-making, harmonized reference intervals for estradiol for different ages and both sexes are needed. Our aim was to establish reference intervals using a highly accurate and traceable LC-MS/MS method and to compare these with reference intervals in literature. METHODS Estradiol was measured in serum obtained daily during the menstrual cycle of 30 healthy premenopausal women and in serum of 64 men and 33 postmenopausal women. The accuracy of our LC-MS/MS method was demonstrated by a method comparison with the CDC reference method. RESULTS Our LC-MS/MS method was traceable to the reference method. Estradiol reference interval during the early follicular phase (days -15 to -6) was 31-771 pmol/L; during the late follicular phase (days -5 to -1) 104-1742 pmol/L; during the LH peak (day 0) 275-2864 pmol/L; during the early luteal phase (days +1 to +4) 95-1188 pmol/L; during mid luteal phase (days +5 to +9) 151-1941 pmol/L; during late luteal phase (days +10 to +14) 39-1769 pmol/L. The reference interval for men was 12-136 pmol/L and for postmenopausal women <26 pmol/L. CONCLUSIONS The established estradiol reference intervals can be used for all traceable LC-MS/MS methods for medical-decision making.
Collapse
|
42
|
Ofori EK, Conde Alonso S, Correas-Gomez L, Carnero EA, Zwygart K, Hugues H, Bardy D, Hans D, Dwyer AA, Amati F. Thigh and abdominal adipose tissue depot associations with testosterone levels in postmenopausal females. Clin Endocrinol (Oxf) 2019; 90:433-439. [PMID: 30575083 DOI: 10.1111/cen.13921] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/02/2018] [Revised: 12/15/2018] [Accepted: 12/17/2018] [Indexed: 11/27/2022]
Abstract
OBJECTIVE Research findings on the relationship between serum androgens and adipose tissue in older females are inconsistent. We aimed to clarify the relationship using state-of-the-art techniques to evaluate associations between body fat distribution and plasma testosterone (T) levels in older postmenopausal women. DESIGN Observational, cross-sectional study of healthy, community dwelling postmenopausal women. PATIENTS AND MEASUREMENTS Postmenopausal women (60-80 years old) were included in this study. Overall body composition was evaluated by dual-energy X-ray absorptiometry. Abdominal and thigh fat depots were measured by magnetic resonance imaging. Circulating T concentrations were analysed by liquid chromatography-tandem mass spectrometry. RESULTS Thirty-five women (66.6 ± 0.8 years) participated in this study. T levels were positively associated with clinical proxy measures of adiposity including weight (ρ = 0.39), BMI (ρ = 0.43) and waist circumference (ρ = 0.39) (all P < 0.05). Fat mass and % body fat were correlated with T levels (ρ = 0.42 and 0.38 respectively, both P < 0.05). T correlated with overall and superficial abdominal fat (ρ = 0.34 and 0.37 respectively, both P < 0.05) but not with visceral adipose tissue. T increased with greater thigh fat (ρ = 0.49, P < 0.05) in both superficial and deep depots (ρ = 0.50 and 0.35 respectively, both P < 0.05). CONCLUSION Our results suggest that postmenopausal women with higher circulating T levels have both higher regional and overall body adiposity. These findings underscore the sexual dimorphism in the relationship between serum androgen levels and adiposity.
Collapse
Affiliation(s)
- Emmanuel K Ofori
- Aging and Muscle Metabolism Laboratory, Department of Physiology, School of Biology and Medicine, University of Lausanne, Lausanne, Switzerland
| | - Sonia Conde Alonso
- Aging and Muscle Metabolism Laboratory, Department of Physiology, School of Biology and Medicine, University of Lausanne, Lausanne, Switzerland
| | - Lorena Correas-Gomez
- Aging and Muscle Metabolism Laboratory, Department of Physiology, School of Biology and Medicine, University of Lausanne, Lausanne, Switzerland
| | - Elvis A Carnero
- Aging and Muscle Metabolism Laboratory, Department of Physiology, School of Biology and Medicine, University of Lausanne, Lausanne, Switzerland
| | - Karin Zwygart
- Magnetic Resonance Spectroscopy and Methodology, Department of Clinical Research, University of Bern, Bern, Switzerland
| | - Henry Hugues
- Clinical Chemistry Laboratory, University Hospital (CHUV), Lausanne, Switzerland
| | - Daniel Bardy
- Clinical Chemistry Laboratory, University Hospital (CHUV), Lausanne, Switzerland
| | - Didier Hans
- Center for Bone Diseases, University Hospital (CHUV), Lausanne, Switzerland
| | - Andrew A Dwyer
- Service of Endocrinology, Diabetology and Metabolism, University Hospital (CHUV), Lausanne, Switzerland
- William F. Connell School of Nursing, Boston College, Boston, Massachusetts
| | - Francesca Amati
- Aging and Muscle Metabolism Laboratory, Department of Physiology, School of Biology and Medicine, University of Lausanne, Lausanne, Switzerland
- Service of Endocrinology, Diabetology and Metabolism, University Hospital (CHUV), Lausanne, Switzerland
- Institute of Sport Sciences (ISSUL), University of Lausanne, Lausanne, Switzerland
| |
Collapse
|
43
|
Zhang W, Zhang Y, Xie E, Ma J, Xu HG, Pan SY. False high testosterone of unknown reason in a clinically inconspicuous female. J LAB MED 2019. [DOI: 10.1515/labmed-2018-0327] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Abstract
Background
This report investigates an unusual total testosterone result in a middle-aged female.
Case presentation
A 40-year-old female patient was found to have high serum total testosterone of 30.82 nmol/L on a Beckman Coulter UniCel® DxI800 automatic chemiluminescence immunoanalyzer without appropriate clinical appearance. Heterophile antibody interference was considered for elevated testosterone and investigated; reanalysis of the original serum sample and liquid chromatography with tandem mass spectrometry (LC-MS/MS) were performed. Reanalysis of the original serum sample using Roche® and Siemens® immunoassays both gave a normal total testosterone level. Beckman Coulter® also excluded the possibility of interference by heterophile antibodies. Finally, LC-MS/MS showed that the total testosterone level was in the normal range.
Conclusions
This report highlights the importance of ruling out the interfering factors for false high values of the analyte in laboratories.
Collapse
|
44
|
Zhang J, Tang C, Oberly PJ, Minnigh MB, Achilles SL, Poloyac SM. A sensitive and robust UPLC-MS/MS method for quantitation of estrogens and progestogens in human serum. Contraception 2019; 99:244-250. [PMID: 30685285 DOI: 10.1016/j.contraception.2018.12.010] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2018] [Revised: 12/13/2018] [Accepted: 12/28/2018] [Indexed: 12/21/2022]
Abstract
OBJECTIVE With the widespread use of sex-steroid hormones in contraceptives and hormone replacement therapy, there is an increasing need for reliable analytical methods. We report the development of a sensitive and robust UPLC-MS/MS method for quantitation of both endogenous and synthetic sex-steroid hormones in human serum. STUDY DESIGN We developed and validated a UPLC-MS/MS method to quantify progestogens (etonogestrel, levonorgestrel, medroxyprogesterone acetate, norethindrone, progesterone) and estrogens (estradiol and ethinyl estradiol) with good accuracy, high sensitivity, and excellent robustness. We then applied the method to the analysis of sex-steroid hormones in serum from 451 clinical research participants. RESULTS Each UPLC-MS/MS analysis was 6.5 min. The lower limits of quantitation (LLOQs) were 25 pg/ml for the progestogens, and 2.5 and 5.0 pg/ml for estradiol and ethinyl estradiol, respectively. When estradiol was analyzed without assessment of progestogens, the LLOQ was reduced to 1 pg/ml. The calibration curves were linear from 25-50,000, 2.5-2000 (1-2000 for estrogens-only analysis) and 5-2000 pg/ml, respectively. Both the accuracy and precision were below±15% not only for routine validation (intraday and interday), but for long-term (>2 years) assay robustness with external controls, thereby, demonstrating the utility of this method for multi-year clinical trial assessments of progestogens and estrogens. We applied the method to quantify sex-steroid levels in 1804 clinical samples. CONCLUSIONS We successfully developed a UPLC-MS/MS method, and overcame the matrix suppression to allow sensitive quantitation of both synthetic and endogenous sex-steroid hormones in human serum. IMPLICATIONS We developed a sensitive and robust UPLC-MS/MS method to accurately measure the levels of sex-steroid hormones in serum. The method overcame matrix interference barriers and achieved excellent long-term stability and reproducibility (≥96.9% accuracy; ≤13.0% relative variability measured with external controls over 2 years), demonstrating its utility in clinical sample analysis.
Collapse
Affiliation(s)
- Junmei Zhang
- Department of Pharmaceutical Sciences, School of Pharmacy, University of Pittsburgh, Pittsburgh, PA
| | - Chenxiao Tang
- Department of Pharmaceutical Sciences, School of Pharmacy, University of Pittsburgh, Pittsburgh, PA
| | - Patrick J Oberly
- Department of Pharmaceutical Sciences, School of Pharmacy, University of Pittsburgh, Pittsburgh, PA
| | - Margaret B Minnigh
- Department of Pharmaceutical Sciences, School of Pharmacy, University of Pittsburgh, Pittsburgh, PA
| | - Sharon L Achilles
- Department of Obstetrics, Gynecology, and Reproductive Sciences and Center for Family Planning Research, School of Medicine, University of Pittsburgh, Pittsburgh, PA; Magee-Womens Research Institute, Pittsburgh, PA
| | - Samuel M Poloyac
- Department of Pharmaceutical Sciences, School of Pharmacy, University of Pittsburgh, Pittsburgh, PA.
| |
Collapse
|
45
|
Yang Y, Ding M, Di N, Azziz R, Yang D, Zhao X. Close correlation between hyperandrogenism and insulin resistance in women with polycystic ovary syndrome-Based on liquid chromatography with tandem mass spectrometry measurements. J Clin Lab Anal 2018; 33:e22699. [PMID: 30350882 DOI: 10.1002/jcla.22699] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2018] [Revised: 09/27/2018] [Accepted: 09/29/2018] [Indexed: 11/07/2022] Open
Abstract
BACKGROUND To investigate the correlation between hyperandrogenism (HA) and insulin resistance (IR) in women with polycystic ovary syndrome (PCOS) by measuring serum total testosterone (TT) using a liquid chromatography and tandem mass spectrometry assay (LC-MS/MS). METHODS This cohort study included 332 patients with PCOS, 63 patients with IR and 276 with controls. TT levels were measured by LC-MS/MS and chemiluminescent immunoassay (CLIA); glucose and insulin levels were determined by an oral glucose tolerance test (OGTT). RESULTS Compared with CLIA, LC-MS/MS differentiated more cases with high TT levels among the non-PCOS subjects with IR In patients with PCOS, LC-MS/MS-based TT levels or a combination with the mFG score detected a significantly higher incidence of HA in subjects with IR identified by hyperinsulinemia (HIN), HOMA-IR or impaired fasting glucose (IFG) than in those without IR Conversely, the IR rates demonstrated by HIN, HOMA-IR, or IFG were remarkably higher in the LC-MS/MS-defined high TT subgroup than in the normal TT subgroup. However, the CLIA platform could not discern a difference in HA incidence between IR and non-IR subgroups or in IR rate between high and normal TT populations. ROC curves also proved that HIN, HOMA-IR, and IFG were positive contributors to HA as measured by LC-MS/MS CONCLUSIONS: The correlation between HA and IR has always been underestimated, partly owing to the less accurate methods previously used to measure TT. HIN, HOMA-IR, and IFG are likely to contribute to the development of HA from a clinical perspective.
Collapse
Affiliation(s)
- Yabo Yang
- Guangdong Provincial Key Laboratory of Malignant Tumor Epigenetics and Gene Regulation, Sun Yat-Sen Memorial Hospital of Sun Yat-Sen University, Guangzhou, China
- Department of Obstetrics and Gynecology, Sun Yat-sen Memorial Hospital of Sun Yat-sen University, Guangzhou, China
| | - Miao Ding
- Guangdong Provincial Key Laboratory of Malignant Tumor Epigenetics and Gene Regulation, Sun Yat-Sen Memorial Hospital of Sun Yat-Sen University, Guangzhou, China
- Department of Obstetrics and Gynecology, Sun Yat-sen Memorial Hospital of Sun Yat-sen University, Guangzhou, China
| | - Na Di
- Guangdong Provincial Key Laboratory of Malignant Tumor Epigenetics and Gene Regulation, Sun Yat-Sen Memorial Hospital of Sun Yat-Sen University, Guangzhou, China
- Department of Obstetrics and Gynecology, Sun Yat-sen Memorial Hospital of Sun Yat-sen University, Guangzhou, China
| | - Ricardo Azziz
- Academic Health and Hospital Affairs, State University of New York (SUNY) System Administration, New York, New York
| | - Dongzi Yang
- Guangdong Provincial Key Laboratory of Malignant Tumor Epigenetics and Gene Regulation, Sun Yat-Sen Memorial Hospital of Sun Yat-Sen University, Guangzhou, China
- Department of Obstetrics and Gynecology, Sun Yat-sen Memorial Hospital of Sun Yat-sen University, Guangzhou, China
| | - Xiaomiao Zhao
- Guangdong Provincial Key Laboratory of Malignant Tumor Epigenetics and Gene Regulation, Sun Yat-Sen Memorial Hospital of Sun Yat-Sen University, Guangzhou, China
- Department of Obstetrics and Gynecology, Sun Yat-sen Memorial Hospital of Sun Yat-sen University, Guangzhou, China
| |
Collapse
|
46
|
van Helden J, Weiskirchen R. Cross-method comparison of serum androstenedione measurement with respect to the validation of a new fully automated chemiluminescence immunoassay. Clin Biochem 2018; 62:32-38. [PMID: 30261182 DOI: 10.1016/j.clinbiochem.2018.09.009] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2018] [Revised: 08/28/2018] [Accepted: 09/23/2018] [Indexed: 01/15/2023]
Abstract
OBJECTIVES Androstenedione is an androgen produced as an intermediate product of the biosynthesis of testosterone and estradiol in testicles, ovaries and also in the adrenal cortex. Measurement is used for diagnosing and differentiating hirsutism and virilisation, enzyme deficiencies of the steroid hormone biosynthesis, and in suspicion of androgen-producing tumors. METHODS Specimens included de-identified residual serum specimens submitted for routine testing and banked adult and pediatric sera. Samples were measured with tandem mass spectrometry, two automated immunoassays, the newly developed DiaSorin LIAISON androstenedione assay, the Immulite assay, and a radioimmunoassay (Beckman Coulter) according to manufacturer's protocols. All methods were correlated, and the analytical sensitivity, linearity and imprecision of each assay determined. Diagnostic accuracy with respect to detection of PCOS in women was evaluated by verifying the respective reference ranges of the different assays and receiver operating characteristic (ROC) curve analysis. RESULTS Due to the methodology, LC-MS/MS demonstrated the highest analytical specificity, good performance and excellent diagnostic accuracy. The best agreement was found with the LIAISON chemiluminescent immunoassay method. Due to its lower analytical sensitivity, the measured values in children were often outside the measuring range. Although, the coefficient of correlation between LC-MS/MS and the Beckman Coulter radioimmunoassay was lower, the assay demonstrated the best analytical sensitivity and a similar diagnostic accuracy in adults. The Immulite androstenedione chemiluminescent immunoassay showed the poorest performance and was not interchangeable with the other assays. CONCLUSIONS These data suggest the LIAISON androstenedione assay may be a suitable alternative for the measurement of androstenedione in serum of adult patients with all advantages of a fully automated assay.
Collapse
Affiliation(s)
- Josef van Helden
- Laboratory Diagnostic Center, University Hospital RWTH, Aachen, Germany.
| | - Ralf Weiskirchen
- Institute of Molecular Pathobiochemistry, Experimental Gene Therapy and Clinical Chemistry (IFMPEGKC), University Hospital RWTH, Aachen, Germany
| |
Collapse
|
47
|
Stanczyk FZ, Xu X, Sluss PM, Brinton LA, McGlynn KA. Do metabolites account for higher serum steroid hormone levels measured by RIA compared to mass spectrometry? Clin Chim Acta 2018; 484:223-225. [DOI: 10.1016/j.cca.2018.05.054] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2018] [Accepted: 05/27/2018] [Indexed: 11/15/2022]
|
48
|
Drotleff B, Hallschmid M, Lämmerhofer M. Quantification of steroid hormones in plasma using a surrogate calibrant approach and UHPLC-ESI-QTOF-MS/MS with SWATH-acquisition combined with untargeted profiling. Anal Chim Acta 2018; 1022:70-80. [DOI: 10.1016/j.aca.2018.03.040] [Citation(s) in RCA: 33] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2017] [Revised: 03/16/2018] [Accepted: 03/20/2018] [Indexed: 11/16/2022]
|
49
|
Measurement of human serum unconjugated estriol without derivatization using liquid chromatography-tandem mass spectrometry candidate reference method and compared with two immunoassays. Anal Bioanal Chem 2018; 410:6257-6267. [DOI: 10.1007/s00216-018-1236-y] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2018] [Revised: 06/20/2018] [Accepted: 06/28/2018] [Indexed: 10/28/2022]
|
50
|
LC-MS/MS based profiling and dynamic modelling of the steroidogenesis pathway in adrenocarcinoma H295R cells. Toxicol In Vitro 2018; 52:332-341. [PMID: 30017865 DOI: 10.1016/j.tiv.2018.07.002] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2017] [Revised: 05/22/2018] [Accepted: 07/06/2018] [Indexed: 12/17/2022]
Abstract
Endocrine disrupting chemicals have been reported to exert effects directly on enzymes involved in steroid biosynthesis. Here, we present a new liquid chromatography-tandem mass spectrometry (LC-MS/MS) method for profiling the steroid metabolome of H295R human adrenocarcinoma cells. Our method can simultaneously analyse 19 precursors, intermediates and end-products, representing the adrenal steroid biosynthesis pathway. In order to obtain better insights into the processes of steroidogenesis, we investigated the dose-response relationship of forskolin, an activator of adenylate cyclase, on steroid production in H295R cells. We observed that 1.5 μM forskolin stimulated steroid production at approximately 50% of the maximum rate for most steroids. Hence, we studied the time course for steroid synthesis over 72 h in H295R cells that were stimulated with forskolin. At 24 h, we observed a peak in steroid levels for the intermediate metabolites, such as progesterone and pregnenolone, while end-products such as testosterone and cortisol continued to increase until 72 h. Finally, we show how global data provide a unique basis to develop a comprehensive, dynamic model for steroidogenesis using first order kinetics. The timeline data made it possible to estimate all reaction rate constants of the network. We propose this method as a unique and sensitive screening tool to identify effects on adrenal steroidogenesis by endocrine disrupting compounds.
Collapse
|