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- Title
Comparison of Multiple Steroid Concentrations in Serum and Dried Blood Spots throughout the Day of Patients with Congenital Adrenal Hyperplasia.
- Authors
Sarafoglou, Kyriakie; Himes, John H.; Lacey, Jean M.; Netzel, Brian C.; Singh, Ravinder J.; Matern, Dietrich
- Abstract
Background/Aim: Periodic measurement of plasma concentrations of cortisol precursors on a clinic visit may be of limited value in patients with congenital adrenal hyperplasia because it does not reflect a patient's circadian patterns of adrenal steroid secretion. Steroid profiling in dried blood spots (DBS) may allow for more frequent and sensitive monitoring. Methods: We compared the agreement between 17α-hydroxyprogesterone (17-OHP) and androstenedione (D4A) levels determined from DBS samples and concurrently collected serum samples. Blood was drawn from 9 congenital adrenal hyperplasia patients every 4 h over a 24-hour period. Serum and DBS steroid levels were measured by liquid chromatography tandem mass spectrometry. Results: DBS determinations of 17-OHP overestimated corresponding serum levels (mean difference 1.67 ng/ml), and underestimated D4A serum levels (mean difference 0.84 ng/ml). However, the DBS assay yielded excellent agreement (97%) with serum 17-OHP, but did considerably poorer for D4A (31%). Conclusions: Our results indicate an excellent agreement between DBS and serum 17-OHP measurements to identify the peaks and troughs associated with an individual's circadian pattern. Larger-scale studies are required to evaluate the utility of DBS for home monitoring and to determine if more frequent monitoring leads to improved clinical outcomes. Copyright © 2010 S. Karger AG, Basel
- Subjects
ADRENOGENITAL syndrome; STEROIDS; SERUM; TANDEM mass spectrometry; CIRCADIAN rhythms; THERAPEUTIC use of glucocorticoids; HYDROXYPROGESTERONE; ANDROSTENEDIONE
- Publication
Hormone Research in Paediatrics, 2011, Vol 75, Issue 1, p19
- ISSN
1663-2818
- Publication type
Article
- DOI
10.1159/000315910