Department of Laboratory Medicine, Peking Union Medical College Hospital, Peking Union Medical College & Chinese Academy of Medical Sciences, Beijing 100730, China.
Waters Technologies (Shanghai) Co., Ltd., Shanghai, China.
J Chromatogr B Analyt Technol Biomed Life Sci. 2024 Jan 1;1232:123941. doi: 10.1016/j.jchromb.2023.123941. Epub 2023 Nov 28.
Steroids are essential in the differential diagnosis of congenital adrenal hyperplasia (CAH) subtypes; however, they may confuse physicians with multifarious results. In this study, we established a liquid chromatography tandem mass spectrometry (LC-MS/MS) method for the simultaneous measurement of 24 steroids and developed a steroid metabolite pathway-based report to aid physicians in understanding these results. Solid-phase extraction was used to concentrate and purify target plasma steroids. The linearity, precision, recovery, and matrix effects were thoroughly evaluated. PowerBuilder was used to transfer the results from LC-MS/MS to the graphic report in a laboratory information management system (LIS) and was applied to different subtypes of CAH. Twenty-four steroids were separated and analyzed in one sample preparation and two injections using LC-MS/MS. The linearity of the steroids was excellent, with coefficients of linear regression greater than 0.99. The relative recovery ranged from 90.0 to 107.1 %, whereas the intra- and total coefficient variations were 1.6 ∼ 8.7 % and 2.0 ∼ 9.9 %, respectively. Matrix effects were compensated after internal standard correction. A graphic combination report mode was established and used to effectively identify CAH subtypes. In conclusion, a useful LC-MS/MS method and graphic combination report of 24 steroids based on their metabolite pathways were established.
类固醇在先天性肾上腺皮质增生症（CAH）亚型的鉴别诊断中至关重要；然而，它们可能会因各种结果而使医生感到困惑。在这项研究中，我们建立了一种液相色谱串联质谱（LC-MS/MS）方法，用于同时测量 24 种类固醇，并开发了一种基于类固醇代谢物途径的报告，以帮助医生理解这些结果。固相萃取用于浓缩和纯化目标血浆类固醇。彻底评估了线性、精密度、回收率和基质效应。PowerBuilder 用于将 LC-MS/MS 的结果从实验室信息管理系统（LIS）转移到图形报告中，并应用于不同亚型的 CAH。在一次样品制备和两次注射中，使用 LC-MS/MS 分离和分析了 24 种类固醇。类固醇的线性度很好，线性回归系数大于 0.99。相对回收率在 90.0%至 107.1%之间，而内标和总变异系数分别为 1.6%∼8.7%和 2.0%∼9.9%。经过内标校正后，补偿了基质效应。建立了图形组合报告模式，用于有效识别 CAH 亚型。总之，建立了一种有用的基于代谢物途径的 24 种类固醇的 LC-MS/MS 方法和图形组合报告。
