Endogenous glucocorticoid analysis by liquid chromatography–tandem mass spectrometry in routine clinical laboratories

•A review of the clinical applications of LC–MS/MS glucocorticoid analysis.•The major endogenous glucocorticoids are discussed.•Serum, urine and salivary cortisol are comprehensively covered. Liquid chromatography-tandem mass spectrometry (LC–MS/MS) is a powerful analytical technique that offers exc...

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Bibliographic Details
Published in:The Journal of steroid biochemistry and molecular biology 2016-09, Vol.162, p.27-40
Main Authors: Hawley, James M., Keevil, Brian G.
Format: Article
Language:English
Subjects:
Animals
Chromatography, Liquid - methods
Cortisol
Cortisone
Glucocorticoids
Glucocorticoids - analysis
Glucocorticoids - blood
Glucocorticoids - metabolism
Glucocorticoids - urine
Humans
Hydrocortisone - analysis
Hydrocortisone - blood
Hydrocortisone - metabolism
Hydrocortisone - urine
Liquid chromatography–tandem mass spectrometry
Saliva - chemistry
Tandem Mass Spectrometry - methods
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Summary:•A review of the clinical applications of LC–MS/MS glucocorticoid analysis.•The major endogenous glucocorticoids are discussed.•Serum, urine and salivary cortisol are comprehensively covered. Liquid chromatography-tandem mass spectrometry (LC–MS/MS) is a powerful analytical technique that offers exceptional selectivity and sensitivity. Used optimally, LC–MS/MS provides accurate and precise results for a wide range of analytes at concentrations that are difficult to quantitate with other methodologies. Its implementation into routine clinical biochemistry laboratories has revolutionised our ability to analyse small molecules such as glucocorticoids. Whereas immunoassays can suffer from matrix effects and cross-reactivity due to interactions with structural analogues, the selectivity offered by LC–MS/MS has largely overcome these limitations. As many clinical guidelines are now beginning to acknowledge the importance of the methodology used to provide results, the advantages associated with LC–MS/MS are gaining wider recognition. With their integral role in both the diagnosis and management of hypo- and hyperadrenal disorders, coupled with their widespread pharmacological use, the accurate measurement of glucocorticoids is fundamental to effective patient care. Here, we provide an up-to-date review of the LC–MS/MS techniques used to successfully measure endogenous glucocorticoids, particular reference is made to serum, urine and salivary cortisol.
ISSN:0960-0760
1879-1220
DOI:10.1016/j.jsbmb.2016.05.014