Abstract
Liquid chromatography-tandem mass spectrometry (LC-MS/MS) for measurements of steroids in human saliva has garnered increased interest in the area of clinical psychoneuroendocrinological research. However, performance characteristics of LC-MS/MS methods for the analysis of steroids in saliva are limited. Human saliva samples were collected via passive drool. Cortisol and dehydroepiandrosterone sulfate (DHEA-S) in the samples were extracted together, resolved on a C18-A column, and analyzed using tandem mass spectrometry. The LC-MS/MS method had limits of quantitation of 0.03 and 0.06 ng/mL for DHEA-S and cortisol, respectively. Method evaluations showed coefficient variation (%CV) of inter-assay ranging 4.6–17.9% for DHEA-S and cortisol, recoveries of 102.4–109.5% for DHEA-S and 94.6–98.3% for cortisol, and assay linearity with R2 = 0.9964 for DHEA-S (1.0–25.0 ng/mL) and R2 = 0.997 (1.0–25.0 ng/mL) for cortisol. No cross contamination among samples was observed. Human saliva showed 20% and 18% ion enhancement effect for DHEA-S and cortisol assay, respectively. No interference by ten common steroids was detected. Regression analysis of method comparisons with laboratory-developed test (LDT) method revealed R2 = 0.9688 (LC-MS/MS = 0.9665 LDT-LC-MS/MS − 0.7355) for cortisol, and R2 = 0.9039 (LC-MS/MS = 1.0173 LDT-LC-MS/MS + 3.6797) for DHEA-S. Reference ranges for young adults were determined to be 0.3–5.9 ng/mL for females and 0.1–5.6 ng/mL for males for salivary cortisol, and 0.6–7.4 ng/mL for females and 0.6–10.1 ng/mL for males for salivary DHEA-S. An LC-MS/MS method for quantifying cortisol and DHEA-S in human saliva was developed and validated for clinical and psychoneuroendocrinological research that require noninvasive means of measuring these hormones.
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Abbreviations
- ACN:
-
Acetonitrile
- DHEA-S:
-
Dehydroepiandrosterone sulfate
- LC-MS/MS:
-
Liquid chromatography-tandem mass spectrometry
- LDT:
-
Laboratory-developed test
- LoD:
-
Limit of detection
- LoQ:
-
Limit of quantitation
- PT:
-
Proficiency test
References
Pfaffe T, Cooper-White J, Beyerlein P, Kostner K, Punyadeera C. Diagnostic potential of saliva: current state and future applications. Clin Chem. 2011;57:675–87.
Umeda T, Hiramatsu R, Iwaoka T, Shimada T, Miura F, Sato T. Use of saliva for monitoring unbound free cortisol levels in serum. Clin Chim Acta. 1981;110:245–53.
Mezzullo M, Fanelli F, Fazzini A, Gambineri A, Vicennati V, Di Dalmazi G, et al. Validation of an LC–MS/MS salivary assay for glucocorticoid status assessment: evaluation of the diurnal fluctuation of cortisol and cortisone and of their association within and between serum and saliva. J Steroid Biochem Mol Biol. 2016;163:103–12.
Dorn LD, Lucke JF, Loucks TL, Berga SL. Salivary cortisol reflects serum cortisol: analysis of circadian profiles. Ann Clin Biochem. 2007;44:281–4.
Foley P, Kirschbaum C. Human hypothalamus–pituitary–adrenal axis responses to acute psychosocial stress in laboratory settings. Neurosci Biobehav Rev. 2010;3:91–6.
Weckesser LJ, Plessow F, Pilhatsch M, Muehlhan M, Kirschbaum C, Miller R. Do venepuncture procedures induce cortisol responses? A review, study, and synthesis for stress research. Psychoneuroendocrinol. 2014;46:88–99.
Lovallo WR. Cortisol secretion patterns in addiction and addiction risk. Int J Psychophysiol. 2006;59:195–202.
Jacobs N, Nicolson NA, Derom C, Delespaul P, Van Os J, Myin-Germeys I. Electronic monitoring of salivary cortisol sampling compliance in daily life. Life Sci. 2005;76:2431–43.
Raff H, Raff JL, Findling JW. Late-night salivary cortisol as a screening test for Cushing’s syndrome. J Clin Endocrinol Metab. 1998;83:2681–6.
Luthold WW, Marcondes JA, Wajchenberg BL. Salivary cortisol for the evaluation of Cushing’s syndrome. Clin Chim Acta. 1985;151:33–9.
Castro M, Elias PC, Quidute AR, Halah FP, Moreira AC. Out-patient screening for Cushing’s syndrome: the sensitivity of the combination of circadian rhythm and overnight dexamethasone suppression salivary cortisol tests. J Clin Endocrinol Metab. 1999;84:878–82.
Davenport MD, Tiefenbacher S, Lutz CK, Novak MA, Meyer JS. Analysis of endogenous cortisol concentrations in the hair of rhesus macaques. Gen Comp Endocrinol. 2006;147:255–61.
Cruess DG, Antoni MH, Kumar M, Ironson G, McCabe P, Femadez JB, et al. Cognitive-behavioral stress management buffers decreases in dehydroepiandrosterone sulfate (DHEA-S) and increases in the cortisol:DHEA-S ratio and reduces mood disturbance and perceived stress among HIV-seropositive men. Psychoneuroendocrinology. 1999;24:537–49.
Maninger N, Capitanio JP, Mason WA, Ruys JD, Mendoza SP. Acute and chronic stress increase DHEA-S concentrations in rhesus monkeys. Psychoneuroendocrinology. 2010;35:1055–62.
Hamilton LD, Meston CM. The role of salivary cortisol and DHEA-S in response to sexual, humorous, and anxiety-inducing stimuli. Horm Behav. 2011;59:765–71.
Fabian TJ, Dew MA, Pollock BG, Reynolds CF 3rd, Mulsant BH, Butters MA, et al. Endogenous concentrations of DHEA and DHEA-S decrease with remission of depression in older adults. Biol Psychiatry. 2001;50:767–74.
Holst JP, Soldin OP, Guo T, Soldin SJ. Steroid hormones: relevance and measurement in the clinical laboratory. Clin Lab Med. 2004;24:105–18.
Holst JP, Soldin SJ, Tractenberg RE, Guo T, Kundra P, Verbalis JG. Use of steroid profiles in determining the cause of adrenal insufficiency. Steroids. 2007;72:71–84.
Inder WJ, Dimeski G, Russell A. Measurement of salivary cortisol in 2012–laboratory techniques and clinical indications. Clin Endocrinol. 2012;77:645–51.
Turpeinen U, Hämäläinen E. Determination of cortisol in serum, saliva and urine. Best Pract Res Clin Endocrinol Metab. 2013;27:795–801.
Miller R, Plessow F, Rauh M, Gröschl M, Kirschbaum C. Comparison of salivary cortisol as measured by different immunoassays and tandem mass spectrometry. Psychoneuroendocrinology. 2013;38:50–7.
Bae YJ, Gaudl A, Jaeger S, Stadelmann S, Hiemisch A, Kiess W, et al. Immunoassay or LC-MS/MS for the measurement of salivary cortisol in children? Clin Chem Lab Med. 2015;54:811–22.
Baecher S, Azad SC, Vogeser M. Inter-method comparison of salivary cortisol measurement. J Lab Med. 2013;37:269–73.
Handelsman DJ, Wartofsky L. Requirement for mass spectrometry sex steroid assays in the Journal of Clinical Endocrinology and Metabolism. J Clin Endocrinol Metab. 2013;98:3971–3.
Huang X, Spink DC, Schneider E, Ling H, Rai AJ, Rosano TG, Chen B, Cao Z(T). Measurement of unconjugated estriol in serum by liquid chromatography–tandem mass spectrometry and assessment of the accuracy of chemiluminescent immunoassays. Clin Chem 2014;60:260–268.
https://www.wadsworth.org/regulatory/clep/pt/summaries Accessed September 2018.
https://www.accessdata.fda.gov/scripts/cdrh/devicesatfda/index.cfm?db=pmn&id=K043175 Accessed September 2018.
Horowitz G, Jones RD. Establishment and use of reference intervals. In: Rifai N, Horvath AR, Wittwer CT, editors. Tietz textbook of clinical chemistry and molecular diagnostics. Sixth ed. St. Louis: Elsevier Inc; 2018. p. 170–94.
Clinical and Laboratory Standards Institute (CLSI). Defining, establishing and varifying reference intervals in the clincal laboratory; approved guideline- third edition (CLSI document C28-A3c). Wayne: Clinical and Laboratory Standards Institute; 2012.
Acknowledgements
We also thank the National Natural Science Foundation of China (Grant# 81572088 & 81601861) for the support of Liqiao Han in carrying out the study at Wadsworth Center, New York State Department of Health.
Funding
This project was supported in part by a grant (F31 DA038931) from the National Institute on Drug Abuse.
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The study protocol was approved by the Institutional Review Board (IRB) or Ethical Committee of the University at Albany, State University of New York. Consents were obtained from all individual participants, who voluntarily donated saliva samples.
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Cao, Z., Wemm, S.E., Han, L. et al. Noninvasive determination of human cortisol and dehydroepiandrosterone sulfate using liquid chromatography-tandem mass spectrometry. Anal Bioanal Chem 411, 1203–1210 (2019). https://doi.org/10.1007/s00216-018-1549-x
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DOI: https://doi.org/10.1007/s00216-018-1549-x