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Clinical Chemistry and Laboratory Medicine (CCLM)

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Volume 54, Issue 5

Issues

Immunoassay or LC-MS/MS for the measurement of salivary cortisol in children?

Yoon Ju Bae
  • Institute of Laboratory Medicine, Clinical Chemistry and Molecular Diagnostics, University of Leipzig, Leipzig, Germany
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/ Alexander Gaudl
  • Institute of Laboratory Medicine, Clinical Chemistry and Molecular Diagnostics, University of Leipzig, Leipzig, Germany
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/ Sonia Jaeger
  • LIFE – Leipzig Research Center for Civilization Diseases, University of Leipzig, Leipzig, Germany
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/ Stephanie Stadelmann
  • LIFE – Leipzig Research Center for Civilization Diseases, University of Leipzig, Leipzig, Germany
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/ Andreas Hiemisch
  • Hospital for Children and Adolescents and Center for Pediatric Research, University of Leipzig, Leipzig, Germany
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/ Wieland Kiess
  • Hospital for Children and Adolescents and Center for Pediatric Research, University of Leipzig, Leipzig, Germany
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/ Anja Willenberg
  • Institute of Laboratory Medicine, Clinical Chemistry and Molecular Diagnostics, University of Leipzig, Leipzig, Germany
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/ Michael Schaab
  • Institute of Laboratory Medicine, Clinical Chemistry and Molecular Diagnostics, University of Leipzig, Leipzig, Germany
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/ Kai von Klitzing
  • Department of Child and Adolescent Psychiatry, Psychotherapy and Psychosomatics, University of Leipzig, Leipzig, Germany
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/ Joachim Thiery
  • Institute of Laboratory Medicine, Clinical Chemistry and Molecular Diagnostics, University of Leipzig, Leipzig, Germany
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/ Uta Ceglarek
  • Institute of Laboratory Medicine, Clinical Chemistry and Molecular Diagnostics, University of Leipzig, Leipzig, Germany
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/ Mirko Döhnert
  • Department of Child and Adolescent Psychiatry, Psychotherapy and Psychosomatics, University of Leipzig, Leipzig, Germany
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/ Juergen Kratzsch
  • Corresponding author
  • Institute of Laboratory Medicine, Clinical Chemistry and Molecular Diagnostics, University of Leipzig, Leipzig, Germany
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Published Online: 2015-11-12 | DOI: https://doi.org/10.1515/cclm-2015-0412

Abstract

Background:

Dysregulation of the adrenal cortex has been assessed with measurement of salivary cortisol. So far salivary cortisol is routinely measured with immunoassay (IA). However, liquid chromatography-tandem mass spectrometry (MS) is known to offer better specificity. We compared the concentrations of salivary cortisol measured by MS and IA at basal and stress induced conditions and evaluated reasons for the difference in method-dependent cortisol results.

Methods:

Saliva samples (n=2703) were collected from 169 children (age range: 8–14 years; 81 healthy children; 55 with internalizing and 33 with externalizing disorders) under circadian conditions and during the Trier Social Stress Test for Children (TSST-C). Biochemical analyses were performed with MS for cortisol and cortisone, IA (IBL, RE62011) for cortisol, and enzyme kinetic assay for α-amylase.

Results:

MS and IA showed mostly comparable results for circadian activity and TSST-C response with similar statistical power. However, IA measured cortisol concentrations about 2.39-fold higher than MS. We found that this difference in measured values between MS and IA was mainly due to different standardization of IA compared to MS. In addition, at cortisol IA concentration below 5 nmol/L, cross-reactivity with cortisone was found to contribute to the lower concordance between MS and IA.

Conclusions:

Immunoassay and LC-MS/MS were largely comparable in the interpretation of salivary cortisol dynamics in stress research. But the IA method revealed a restricted accuracy in the measuring range below 5 nmol/L.

This article offers supplementary material which is provided at the end of the article.

Keywords: α-amylase interference; cortisone cross-reactivity; immunoassay; liquid chromatography tandem mass spectrometry; salivary cortisol; standardization; Trier Social Stress Test for Children

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About the article

Corresponding author: Prof. Dr. Juergen Kratzsch, Institute of Laboratory Medicine, Clinical Chemistry and Molecular Diagnostics, University of Leipzig, Paul-List Str. 13-15, 04103 Leipzig, Germany, Phone: +49 341 97 22241, Fax: +49 341 97 22249

aYoon Ju Bae and Alexander Gaudl contributed equally as first authors.

bMirko Döhnert and Juergen Kratzsch contributed equally as senior authors.


Received: 2015-04-30

Accepted: 2015-10-10

Published Online: 2015-11-12

Published in Print: 2016-05-01


Author contributions: All the authors have accepted responsibility for the entire content of this submitted manuscript and approved submission.

Research funding: This project was funded by LIFE (the Leipzig Research Centre for Civilization Diseases). LIFE is funded by means of the European Union, by the European Regional Development Fund (ERDF) and by means of the Free State of Saxony within the framework of the excellence initiative.

Employment or leadership: None declared.

Honorarium: None declared.

Competing interests: The funding organization(s) played no role in the study design; in the collection, analysis, and interpretation of data; in the writing of the report; or in the decision to submit the report for publication.


Citation Information: Clinical Chemistry and Laboratory Medicine (CCLM), Volume 54, Issue 5, Pages 811–822, ISSN (Online) 1437-4331, ISSN (Print) 1434-6621, DOI: https://doi.org/10.1515/cclm-2015-0412.

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