Specificity and predictive value of circulating testosterone assessed by tandem mass spectrometry for the diagnosis of polycystic ovary syndrome by the National Institutes of Health 1990 criteria

Wael A. Salameh, Mildred M. Redor-Goldman, Nigel J. Clarke, Ruchi Mathur, Ricardo Azziz, Richard E. Reitz

Research output: Contribution to journalArticle

27 Citations (Scopus)

Abstract

Objective To determine whether liquid chromatography-tandem mass spectrometry (LC-MS/MS) determination of total (TT) and free (FT) testosterone is more specific than extraction chromatography-radioimmunoassay (RIA) for distinguishing women with polycystic ovary syndrome (PCOS) from controls and whether differing cutoff values should be used depending on the setting. Design Prospective case-control cohort study. Setting Tertiary care center and reference laboratory. Intervention(s) Blood sampling. Patient(s) One hundred patients with PCOS and 100 controls. Main Outcome Measure(s) Circulating TT measured by RIA and LC-MS/MS and FT measured by equilibrium dialysis using RIA or LC-MS/MS-generated TT values. Result(s) T measurement by RIA and LC-MS/MS similarly differentiated patients with PCOS from controls; detection of PCOS was higher for FT for both methods. TT values demonstrated greater overlap between patients with PCOS and controls than did FT for both RIA (80% vs. 42% overlap) and LC-MS/MS (52% vs. 67% overlap). A lower cutoff value by LC-MS/MS was better suited for the study of patients seen in the clinical (referred) setting (35 and 4.0 ng/dL for TT and FT, respectively) than in the screening of a general population (50 and 5.0 ng/dL for TT and FT, respectively). Conclusion(s) Extraction chromatography-RIA and LC-MS/MS measurements of T have similar performance for differentiating patients with PCOS from healthy controls; LC-MS/MS may be preferable given its relative ease of automation. Compared with FT, measurement of TT has relatively limited value for distinguishing PCOS from normal. Finally, different cutoff values should be considered depending on the clinical/investigative setting, with higher values being used in the study of biased (e.g., clinical or referred) populations.

Original languageEnglish (US)
JournalFertility and Sterility
Volume101
Issue number4
DOIs
StatePublished - Jan 1 2014

Fingerprint

Polycystic Ovary Syndrome
National Institutes of Health (U.S.)
Tandem Mass Spectrometry
Testosterone
Radioimmunoassay
Chromatography
Automation
Tertiary Care Centers
Liquid Chromatography
Population
Case-Control Studies
Dialysis
Cohort Studies
Outcome Assessment (Health Care)

Keywords

  • Polycystic ovary syndrome
  • androgens
  • mass spectrometry
  • radioimmunoassays
  • testosterone

ASJC Scopus subject areas

  • Reproductive Medicine
  • Obstetrics and Gynecology

Cite this

Specificity and predictive value of circulating testosterone assessed by tandem mass spectrometry for the diagnosis of polycystic ovary syndrome by the National Institutes of Health 1990 criteria. / Salameh, Wael A.; Redor-Goldman, Mildred M.; Clarke, Nigel J.; Mathur, Ruchi; Azziz, Ricardo; Reitz, Richard E.

In: Fertility and Sterility, Vol. 101, No. 4, 01.01.2014.

Research output: Contribution to journalArticle

Salameh, Wael A. ; Redor-Goldman, Mildred M. ; Clarke, Nigel J. ; Mathur, Ruchi ; Azziz, Ricardo ; Reitz, Richard E. / Specificity and predictive value of circulating testosterone assessed by tandem mass spectrometry for the diagnosis of polycystic ovary syndrome by the National Institutes of Health 1990 criteria. In: Fertility and Sterility. 2014 ; Vol. 101, No. 4.
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abstract = "Objective To determine whether liquid chromatography-tandem mass spectrometry (LC-MS/MS) determination of total (TT) and free (FT) testosterone is more specific than extraction chromatography-radioimmunoassay (RIA) for distinguishing women with polycystic ovary syndrome (PCOS) from controls and whether differing cutoff values should be used depending on the setting. Design Prospective case-control cohort study. Setting Tertiary care center and reference laboratory. Intervention(s) Blood sampling. Patient(s) One hundred patients with PCOS and 100 controls. Main Outcome Measure(s) Circulating TT measured by RIA and LC-MS/MS and FT measured by equilibrium dialysis using RIA or LC-MS/MS-generated TT values. Result(s) T measurement by RIA and LC-MS/MS similarly differentiated patients with PCOS from controls; detection of PCOS was higher for FT for both methods. TT values demonstrated greater overlap between patients with PCOS and controls than did FT for both RIA (80{\%} vs. 42{\%} overlap) and LC-MS/MS (52{\%} vs. 67{\%} overlap). A lower cutoff value by LC-MS/MS was better suited for the study of patients seen in the clinical (referred) setting (35 and 4.0 ng/dL for TT and FT, respectively) than in the screening of a general population (50 and 5.0 ng/dL for TT and FT, respectively). Conclusion(s) Extraction chromatography-RIA and LC-MS/MS measurements of T have similar performance for differentiating patients with PCOS from healthy controls; LC-MS/MS may be preferable given its relative ease of automation. Compared with FT, measurement of TT has relatively limited value for distinguishing PCOS from normal. Finally, different cutoff values should be considered depending on the clinical/investigative setting, with higher values being used in the study of biased (e.g., clinical or referred) populations.",
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AU - Salameh, Wael A.

AU - Redor-Goldman, Mildred M.

AU - Clarke, Nigel J.

AU - Mathur, Ruchi

AU - Azziz, Ricardo

AU - Reitz, Richard E.

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AB - Objective To determine whether liquid chromatography-tandem mass spectrometry (LC-MS/MS) determination of total (TT) and free (FT) testosterone is more specific than extraction chromatography-radioimmunoassay (RIA) for distinguishing women with polycystic ovary syndrome (PCOS) from controls and whether differing cutoff values should be used depending on the setting. Design Prospective case-control cohort study. Setting Tertiary care center and reference laboratory. Intervention(s) Blood sampling. Patient(s) One hundred patients with PCOS and 100 controls. Main Outcome Measure(s) Circulating TT measured by RIA and LC-MS/MS and FT measured by equilibrium dialysis using RIA or LC-MS/MS-generated TT values. Result(s) T measurement by RIA and LC-MS/MS similarly differentiated patients with PCOS from controls; detection of PCOS was higher for FT for both methods. TT values demonstrated greater overlap between patients with PCOS and controls than did FT for both RIA (80% vs. 42% overlap) and LC-MS/MS (52% vs. 67% overlap). A lower cutoff value by LC-MS/MS was better suited for the study of patients seen in the clinical (referred) setting (35 and 4.0 ng/dL for TT and FT, respectively) than in the screening of a general population (50 and 5.0 ng/dL for TT and FT, respectively). Conclusion(s) Extraction chromatography-RIA and LC-MS/MS measurements of T have similar performance for differentiating patients with PCOS from healthy controls; LC-MS/MS may be preferable given its relative ease of automation. Compared with FT, measurement of TT has relatively limited value for distinguishing PCOS from normal. Finally, different cutoff values should be considered depending on the clinical/investigative setting, with higher values being used in the study of biased (e.g., clinical or referred) populations.

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KW - radioimmunoassays

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