Age- and sex-adjusted reference intervals for steroid hormones measured by liquid chromatography‑tandem mass spectrometry (LC-MS/MS) using a widely available kit.

OBJECTIVE: Measurements utilizing commercially available sets of reagents for determination of steroid hormone profiles by liquid chromatography-tandem-mass-spectrometry (LC MS/MS) become increasingly important for routine laboratories. However, method specific publications of reference intervals obtained from sufficiently large studies are often missing.

METHODS: After validation of performance characteristics, a widely available kit for steroid analysis by LC MS/MS was used to measure concentrations of 15 endogenous steroids (aldosterone, cortisol, cortisone, corticosterone, 11 deoxycortisol, 21 deoxycortisol, dehydroepiandrosterone sulfate, estradiol, testosterone, androstenedione, dihydrotestosterone, dehydroepiandrosterone, 17 hydroxyprogesterone, 11 deoxycorticosterone, progesterone) in more than 500 blood samples from a population based study. While randomly selected from a larger cohort, the samples equally represented both sexes, and covered a wide range of adult age groups. Age- and sex-specific reference intervals were calculated, and correlation with body mass index (BMI) was assessed.

RESULTS: Performance characteristics of the assay matched expectations for 9 of 15 steroids. For most of them, reference intervals obtained from our study population were comparable to those reported by others, with age and sex being the major determinants. A sex-specific correlation with BMI was found for seven steroids. We identified limitations regarding sensitivity of the method for quantification of progesterone in males and postmenopausal females. Concentrations of aldosterone, 21-deoxycortisol, estradiol, 11 deoxycorticosterone and dihydrotestosterone could not be quantified in a large percentage of samples.

CONCLUSIONS: The reference intervals for 9 steroids will support meaningful interpretation for steroid profiles as measured by a widely used kit for LC MS/MS based quantification. Laboratories using such kits must be aware of potential limitations in sensitivity for some steroids included in the profile.