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Hyperandrogenism by Liquid Chromatography Tandem Mass Spectrometry in PCOS: Focus on Testosterone and Androstenedione

The identification of hyperandrogenism in polycystic ovary syndrome (PCOS) is concerning because of the poor accuracy of the androgen immunoassays (IA) and controversies regarding which androgens should be measured. The aim of our study was to evaluate the impact of the assessment of testosterone (T...

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Autores principales: Grassi, Giorgia, Polledri, Elisa, Fustinoni, Silvia, Chiodini, Iacopo, Ceriotti, Ferruccio, D’Agostino, Simona, Filippi, Francesca, Somigliana, Edgardo, Mantovani, Giovanna, Arosio, Maura, Morelli, Valentina
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7795755/
https://www.ncbi.nlm.nih.gov/pubmed/33396396
http://dx.doi.org/10.3390/jcm10010119
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author Grassi, Giorgia
Polledri, Elisa
Fustinoni, Silvia
Chiodini, Iacopo
Ceriotti, Ferruccio
D’Agostino, Simona
Filippi, Francesca
Somigliana, Edgardo
Mantovani, Giovanna
Arosio, Maura
Morelli, Valentina
author_facet Grassi, Giorgia
Polledri, Elisa
Fustinoni, Silvia
Chiodini, Iacopo
Ceriotti, Ferruccio
D’Agostino, Simona
Filippi, Francesca
Somigliana, Edgardo
Mantovani, Giovanna
Arosio, Maura
Morelli, Valentina
author_sort Grassi, Giorgia
collection PubMed
description The identification of hyperandrogenism in polycystic ovary syndrome (PCOS) is concerning because of the poor accuracy of the androgen immunoassays (IA) and controversies regarding which androgens should be measured. The aim of our study was to evaluate the impact of the assessment of testosterone (T) and androstenedione (A) by liquid chromatography in tandem with mass spectrometry (LC/MS-MS), in the diagnosis of PCOS. We evaluated 131 patients referred for suspected PCOS. Fourteen patients in total were excluded, some because of other diagnosis (n = 7) or incomplete diagnostic workup (n = 7). We measured T and A both by IA and LC-MS/MS in the 117 subjects included. We calculated free T (fT) by the Vermeulen formula and recorded clinical and metabolic data. 73 healthy females served as controls to derive immunoassays (IA) and LC-MS/MS reference intervals for T, fT and A. PCOS was confirmed in 90 subjects by IA and in 93 (+3.3%) by LC-MS/MS. The prevalence of biochemical hyperandrogenism in PCOS by LC-MS/MS increased from 81.7% to 89.2% if A was also considered. The most frequently elevated androgens were fT (73.1%) and A (64.5%) and they had similar levels of accuracy in differentiating PCOS and controls (0.34 ng/dL, Sn 91% Sp 89%; 1.16 ng/mL, Sn 91% Sp 88%, respectively). Free testosterone correlated with body mass index (BMI), homeostatic model assessment (HOMA)-index, glycated hemoglobin (HbA1c), and sex-binding globulin (SHBG). The results confirm that LC-MS/MS is slightly more sensitive than IA in the diagnosis of PCOS with LC-MS/MS detecting higher levels of fT and A. Moreover, assessment of fT and A by LC-MS/MS had a similar level of accuracy in discriminating between PCOs and control subjects. Lastly, fT by LC-MS/MS correlates with adverse metabolic parameters.
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spelling pubmed-77957552021-01-10 Hyperandrogenism by Liquid Chromatography Tandem Mass Spectrometry in PCOS: Focus on Testosterone and Androstenedione Grassi, Giorgia Polledri, Elisa Fustinoni, Silvia Chiodini, Iacopo Ceriotti, Ferruccio D’Agostino, Simona Filippi, Francesca Somigliana, Edgardo Mantovani, Giovanna Arosio, Maura Morelli, Valentina J Clin Med Article The identification of hyperandrogenism in polycystic ovary syndrome (PCOS) is concerning because of the poor accuracy of the androgen immunoassays (IA) and controversies regarding which androgens should be measured. The aim of our study was to evaluate the impact of the assessment of testosterone (T) and androstenedione (A) by liquid chromatography in tandem with mass spectrometry (LC/MS-MS), in the diagnosis of PCOS. We evaluated 131 patients referred for suspected PCOS. Fourteen patients in total were excluded, some because of other diagnosis (n = 7) or incomplete diagnostic workup (n = 7). We measured T and A both by IA and LC-MS/MS in the 117 subjects included. We calculated free T (fT) by the Vermeulen formula and recorded clinical and metabolic data. 73 healthy females served as controls to derive immunoassays (IA) and LC-MS/MS reference intervals for T, fT and A. PCOS was confirmed in 90 subjects by IA and in 93 (+3.3%) by LC-MS/MS. The prevalence of biochemical hyperandrogenism in PCOS by LC-MS/MS increased from 81.7% to 89.2% if A was also considered. The most frequently elevated androgens were fT (73.1%) and A (64.5%) and they had similar levels of accuracy in differentiating PCOS and controls (0.34 ng/dL, Sn 91% Sp 89%; 1.16 ng/mL, Sn 91% Sp 88%, respectively). Free testosterone correlated with body mass index (BMI), homeostatic model assessment (HOMA)-index, glycated hemoglobin (HbA1c), and sex-binding globulin (SHBG). The results confirm that LC-MS/MS is slightly more sensitive than IA in the diagnosis of PCOS with LC-MS/MS detecting higher levels of fT and A. Moreover, assessment of fT and A by LC-MS/MS had a similar level of accuracy in discriminating between PCOs and control subjects. Lastly, fT by LC-MS/MS correlates with adverse metabolic parameters. MDPI 2020-12-31 /pmc/articles/PMC7795755/ /pubmed/33396396 http://dx.doi.org/10.3390/jcm10010119 Text en © 2020 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Grassi, Giorgia
Polledri, Elisa
Fustinoni, Silvia
Chiodini, Iacopo
Ceriotti, Ferruccio
D’Agostino, Simona
Filippi, Francesca
Somigliana, Edgardo
Mantovani, Giovanna
Arosio, Maura
Morelli, Valentina
Hyperandrogenism by Liquid Chromatography Tandem Mass Spectrometry in PCOS: Focus on Testosterone and Androstenedione
title Hyperandrogenism by Liquid Chromatography Tandem Mass Spectrometry in PCOS: Focus on Testosterone and Androstenedione
title_full Hyperandrogenism by Liquid Chromatography Tandem Mass Spectrometry in PCOS: Focus on Testosterone and Androstenedione
title_fullStr Hyperandrogenism by Liquid Chromatography Tandem Mass Spectrometry in PCOS: Focus on Testosterone and Androstenedione
title_full_unstemmed Hyperandrogenism by Liquid Chromatography Tandem Mass Spectrometry in PCOS: Focus on Testosterone and Androstenedione
title_short Hyperandrogenism by Liquid Chromatography Tandem Mass Spectrometry in PCOS: Focus on Testosterone and Androstenedione
title_sort hyperandrogenism by liquid chromatography tandem mass spectrometry in pcos: focus on testosterone and androstenedione
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7795755/
https://www.ncbi.nlm.nih.gov/pubmed/33396396
http://dx.doi.org/10.3390/jcm10010119
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