Martínez Brito Dayamin, Leogrande Patrizia, de la Torre Xavier, Romanelli Francesco, Botrè Francesco
Laboratorio Antidoping FMSI, Federazione Medico Sportiva Italiana, Rome, Italy.
"La Sapienza" University, Rome, Italy.
Drug Test Anal. 2025 Jun;17(6):868-881. doi: 10.1002/dta.3788. Epub 2024 Aug 24.
This paper aims to study the metabolism of thyroid hormones (TH) in urine by liquid chromatography-tandem mass spectrometry (LC-MS/MS). The method was applied to samples collected before and after the administration of sodium triiodothyronine (T3) and sodium levothyroxine (T4) to a euthyroid volunteer and to samples of athletes declaring and not declaring thyroid supplementation. Samples were analyzed by LC-MS/MS after enzymatic hydrolysis, liquid-liquid, and solid-phase extractions. Ratios between T3/thyronine and T4/3,3'-T2 may be used for the detection of the administration of exogenous T3 in urine. Meanwhile, 3-T1 concentrations may be used to detect exogenous T4 administration. Nevertheless, these markers may not work properly in hypothyroid population, as athletes seem to be. The levels of T3 and T4 of athletes were lower than those of a euthyroid state even when they are under administration of TH supplements. The HTP axis high efficiency does not allow observing differences between athletes who do not declare and those who declare having used TH supplementation by direct measurements of T3 and T4 in urine. The detection of TH administration in urine (triiodothyronine and levothyroxine) may work when dealing with euthyroid individuals. Nevertheless, in individuals with hypothyroidism where the tendency is toward the maintenance of homeostasis, and it may be not possible to detect their consumption by applying cut-off values.
本文旨在通过液相色谱-串联质谱法(LC-MS/MS)研究尿液中甲状腺激素(TH)的代谢情况。该方法应用于向一名甲状腺功能正常的志愿者施用三碘甲状腺原氨酸(T3)和左甲状腺素钠(T4)前后采集的样本,以及申报和未申报补充甲状腺激素的运动员的样本。样本经酶水解、液-液萃取和固相萃取后,采用LC-MS/MS进行分析。T3/甲状腺素和T4/3,3'-二碘甲状腺原氨酸之间的比值可用于检测尿液中外源性T3的施用情况。同时,3-T1浓度可用于检测外源性T4的施用情况。然而,这些标志物在甲状腺功能减退人群(如运动员)中可能无法正常发挥作用。即使运动员正在服用甲状腺激素补充剂,其T3和T4水平仍低于甲状腺功能正常状态下的水平。下丘脑-垂体-甲状腺(HTP)轴的高效性使得无法通过直接测量尿液中的T3和T4来观察未申报和申报使用过甲状腺激素补充剂的运动员之间的差异。在处理甲状腺功能正常的个体时,检测尿液中甲状腺激素(三碘甲状腺原氨酸和左甲状腺素)的施用情况可能有效。然而,在甲状腺功能减退的个体中,其倾向于维持体内平衡,通过应用临界值可能无法检测到他们是否服用了甲状腺激素。