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  • Author: B Stolze x
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T P Parikh Program in Reproductive and Adult Endocrinology, National Institute of Child Health and Human Development, National Institutes of Health (NIH), Bethesda, Maryland, USA

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B Stolze Department of Laboratory Medicine, Clinical Center, NIH, Bethesda, Maryland, USA

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Y Ozarda Department of Medical Biochemistry, Faculty of Medicine, Uludag University, Bursa, Turkey

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J Jonklaas Division of Endocrinology and Metabolism, Department of Medicine, Georgetown University, Washington, District of Columbia, USA

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K Welsh Department of Laboratory Medicine, Clinical Center, NIH, Bethesda, Maryland, USA

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L Masika Department of Laboratory Medicine and Pathology/National Health Laboratory Service Walter Sisulu University, Mthatha, South Africa

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M Hill Program in Reproductive and Adult Endocrinology, National Institute of Child Health and Human Development, National Institutes of Health (NIH), Bethesda, Maryland, USA

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A DeCherney Program in Reproductive and Adult Endocrinology, National Institute of Child Health and Human Development, National Institutes of Health (NIH), Bethesda, Maryland, USA

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S J Soldin Department of Laboratory Medicine, Clinical Center, NIH, Bethesda, Maryland, USA
Division of Endocrinology and Metabolism, Department of Medicine, Georgetown University, Washington, District of Columbia, USA

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Objective

Accurate measurement of steroid hormones remains challenging. Mass spectrometry affords a reliable means for quantitating steroid profiles accurately. Our objective was to establish and define (1) the extent of diurnal fluctuations in steroid concentrations that potentially necessitate strict adherence to time of sample acquisition and (2) time-dependent steroid reference intervals.

Design

Nine steroid markers were examined in couplets in males and females.

Methods

Using isotope dilution high-performance liquid chromatography–tandem mass spectrometric (LC–MS/MS) analysis, we developed a multi-steroid profile requiring only a minimal volume of serum (0.1 mL). Couplet (AM and PM) measurements of steroid hormones for 120 healthy females (F) and 62 healthy males (M) were obtained. Patients were recruited from several participating centers.

Results

The following diurnal values were noted to be significantly different in both females and males: cortisone, cortisol, corticosterone, 11 deoxycortisol (11 DOC), androstenedione, 17a-hydroxyprogesterone (17 OHP) and dehydroepiandrosterone (DHEA). Testosterone was only found to have significant diurnal variance in males. Progesterone showed no significant difference in AM and PM values for either groups and thus may provide an internal control.

Conclusions

When diagnosing endocrine disorders, it is imperative to acknowledge the 24-h diurnal variation of the biochemical steroid markers. We highlight the importance of standardization of collection times and appropriate implementation of reference intervals.

Precis

We identify diurnal fluctuations in steroid concentrations with time of day and emphasize the importance of adhering to firm time of sample acquisition.

Article Type:
Research Article
DOI:
https://doi.org/10.1530/EC-18-0417
Volume/Issue:
Volume 7: Issue 12
Open access