Serum cortisol assay performance following the 1 mg overnight dexamethasone suppression test.

IF 2.1 4区医学 Q3 MEDICAL LABORATORY TECHNOLOGY

Annals of Clinical Biochemistry Pub Date : 2023-11-01 Epub Date: 2023-06-30 DOI:10.1177/00045632231179560

Jonathan S Atkins, James M Hawley, Laura J Owen, Jonathan Clayton, Jonathan Scargill, Brian G Keevil

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引用次数: 2

Abstract

Background: The 1 mg overnight dexamethasone suppression test (ONDST) is recommended for the differential diagnosis of Cushing's syndrome and the investigation of adrenal incidentalomas. Despite documented variation in serum cortisol immunoassay performance, little has been published regarding its effect on the ONDST.

Aims: Assess the performance of three immunoassay platforms (Roche Elecsys II, Abbott Alinity & Siemens Centaur) when compared to a liquid chromatography tandem mass spectrometry (LC-MS/MS) method.

Methods: Samples (n = 77) sent to the laboratory as part of an ONDST were retrieved prior to disposal, anonymized, and analysed on all platforms. Samples with factors impacting immunoassay analysis quality were excluded. Results were statistically compared to an LC-MS/MS method that previously demonstrated excellent comparability to a candidate reference method.

Results: The Roche gen II showed a mean bias of -2.4 nmol/L and a Passing-Bablok fit of y = -0.9 + 0.97x. This was not affected by sex. The Abbott showed a mean bias -18.8 nmol/L, and a fit of y = -11.3 + 0.88x. This bias was -20.7 nmol/L in females versus -17.2 nmol/L in males. The Siemens had a mean bias of 2.3 nmol/L and a fit of y = 1.4 + 1.07x. This bias was 5.7 nmol/L in males versus -1.0 nmol/L in females.

Conclusions: Clinicians should be aware of the method-dependent variation that exists within serum cortisol analysis during the ONDSTs. Roche and Siemens aligned more closely with LC-MS/MS while the Abbot may cause a reduction in ONDST sensitivity. This data supports assay-specific cut-offs for the ONDST.

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1 mg地塞米松夜间抑制试验后血清皮质醇测定性能。

背景:1mg地塞米松抑制试验(ONDST)被推荐用于库欣综合征的鉴别诊断和肾上腺偶发瘤的调查。尽管记录了血清皮质醇免疫测定性能的变化，但很少有关于其对ONDST的影响的报道。目的:与液相色谱串联质谱(LC-MS/MS)方法相比，评估三种免疫分析平台(罗氏Elecsys II，雅培Alinity和西门子Centaur)的性能。方法:作为ONDST的一部分送到实验室的样本(n = 77)在处理前回收，匿名并在所有平台上进行分析。排除影响免疫分析质量的因素。结果与LC-MS/MS方法进行了统计比较，LC-MS/MS方法先前与候选参考方法具有良好的可比性。结果:Roche gen II的平均偏倚为-2.4 nmol/L, pass - bablok拟合为y = -0.9 + 0.97x。这并不受性别的影响。Abbott的平均偏差为-18.8 nmol/L，拟合y = -11.3 + 0.88x。女性的偏倚为-20.7 nmol/L，男性为-17.2 nmol/L。西门子的平均偏差为2.3 nmol/L，拟合为y = 1.4 + 1.07x。男性的偏倚为5.7 nmol/L，而女性为-1.0 nmol/L。结论:临床医生应该意识到在ondst期间血清皮质醇分析中存在的方法依赖性差异。罗氏和西门子更紧密地与LC-MS/MS结合，而Abbot可能会导致ONDST敏感性降低。该数据支持ONDST的特定检测截止值。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Annals of Clinical Biochemistry Biochemistry, Genetics and Molecular Biology-Clinical Biochemistry

CiteScore

5.20

自引率

4.50%

发文量

期刊介绍： Annals of Clinical Biochemistry is the fully peer reviewed international journal of the Association for Clinical Biochemistry and Laboratory Medicine. Annals of Clinical Biochemistry accepts papers that contribute to knowledge in all fields of laboratory medicine, especially those pertaining to the understanding, diagnosis and treatment of human disease. It publishes papers on clinical biochemistry, clinical audit, metabolic medicine, immunology, genetics, biotechnology, haematology, microbiology, computing and management where they have both biochemical and clinical relevance. Papers describing evaluation or implementation of commercial reagent kits or the performance of new analysers require substantial original information. Unless of exceptional interest and novelty, studies dealing with the redox status in various diseases are not generally considered within the journal''s scope. Studies documenting the association of single nucleotide polymorphisms (SNPs) with particular phenotypes will not normally be considered, given the greater strength of genome wide association studies (GWAS). Research undertaken in non-human animals will not be considered for publication in the Annals. Annals of Clinical Biochemistry is also the official journal of NVKC (de Nederlandse Vereniging voor Klinische Chemie) and JSCC (Japan Society of Clinical Chemistry).