Systematic Review of Serum Steroid Reference Intervals Developed Using MS

Michael Scally MD

Doctor of Medicine
10+ Year Member
Tavita N, Greaves RF. Systematic review of serum steroid reference intervals developed using mass spectrometry. Clin Biochem. http://www.sciencedirect.com/science/article/pii/S0009912017305829

Highlights
· A systematic review of the English language literature looked for mass spectrometry based serum steroid reference intervals.
· Sixteen peer reviewed publications have developed reference intervals in healthy cohorts.
· Published reference intervals for 17 serum/plasma steroids were identified.
· Reporting units, age stratification and reference intervals are inconsistent between publications for individual steroids.
· The task of applying universally applicable reference intervals is challenging.

The aim of this study was to perform a systematic review of the published literature to determine the available serum/plasma steroid reference intervals generated by mass spectrometry (MS) methods across all age groups in healthy subjects and to suggest recommendations to achieve common MS based reference intervals for serum steroids.

MEDLINE, EMBASE and PubMed databases were used to conduct a comprehensive search for English language, MS-based reference interval studies for serum/plasma steroids. Selection of steroids to include was based on those listed in the Royal College of Pathologists of Australasia Quality Assurance Programs, Chemical Pathology, Endocrine Program. This methodology has been registered onto the PROSPERO International prospective register of systematic reviews (ID number: CRD42015029637).

After accounting for duplicates, a total of 60 manuscripts were identified through the search strategy. Following critical evaluation, a total of 16 studies were selected. Of the 16 studies, 12 reported reference intervals for testosterone, 11 for 17 hydroxy-progesterone, nine for androstenedione, six for cortisol, three for progesterone, two for dihydrotestosterone and only one for aldosterone and dehydroepiandrosterone sulphate. No studies established MS-based reference intervals for oestradiol.

As far as we are aware, this report provides the first comparison of the peer reviewed literature for serum/plasma steroid reference intervals generated by MS-based methods. The reference intervals based on these published studies can be used to inform the process to develop common reference intervals, and agreed reporting units for mass spectrometry based steroid methods.


 

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