同位素稀释超高效液相色谱串联质谱法检测血浆18-羟皮质酮方法的建立及初步临床应用

Quantification of Human Plasma 18-Hydroxycorticosterone by Isotope Dilution Ultra Performance Liquid Chromatography Tandem Mass Spectrometry

  • 摘要:
      目的  建立一种同位素稀释超高效液相色谱串联质谱法(isotope dilution ultra performance liquid chromatography tandem mass spectrometry, ID-UPLC-MS/MS)检测血浆18-羟皮质酮(18-Hydroxycorticosterone,18-OHB)的方法。
      方法  取血浆标本或标准溶液200 μL置于离心管中,然后加入同位素氚标记的18-OHB为内标,用甲醇沉淀血浆蛋白,离心后取上清液,用Prime HLB Elution 96孔SPE板进行萃取,收集洗脱液,在正离子电喷雾离子化的多离子反应监测模式下检测18-OHB。评价该方法的精密度、加标回收率、定量检测下限、线性和基质效应。2019年11月起招募表观健康志愿者,采用ID-UPLC-MS/MS检测其血浆18-OHB水平,并验证梅奥医学实验中心提供的18-OHB参考区间。
      结果  该方法检测血浆18-OHB的分析时间约为3.0 min,检测低、中、高3个水平18-OHB的重复性变异系数和实验室内不精密度分别为2.2%~3.5%和3.7%~5.0%,平均加标回收率为98.1%~101.7%,定量检测下限为0.01 μg/L,在0.1~10 μg/L范围内线性良好(r>0.990),血浆基质效应为86.83%~119.00%。基于本研究建立的ID-UPLC-MS/MS方法,73名表观健康人群血浆18-OHB第2.5、97.5百分位数分别为0.01、0.60 μg/L,其中66%(48/73)血浆18-OHB水平处于梅奥医学实验中心提供的参考范围外。
      结论  本研究建立了一种ID-UPLC-MS/MS测定血浆18-OHB的方法,该方法检测快速、结果准确可靠,性能满足临床需求。

     

    Abstract:
      Objective  To establish a method for quantification of 18-Hydroxycorticosterone (18-OHB) in plasma by isotope dilution ultra performance liquid chromatography tandem mass spectrometry (ID-UPLC-MS/MS).
      Methods  This study was a methodology-validation on the evaluation of plasma 18-OHB with LC-MS/MS. Two hundreds microliter(μL) of serum samples or standard solution were mixed with 18-OHB-d4 (internal standard) and treated with methanol solution to precipitate protein and anion-exchange solID-phase extraction(SPE). After SPE, the eluates were detected in the positive electro-spray ionization mode and multiple reaction-monitor mode. The precision, recovery, lower limits of quantification, linearity and the matrix-effect of LC-MS/MS have been evaluated. Since November 2019, healthy participants were recruited continuously to the study to validate the reference intervals of Mayo Clinical Laboratory.
      Results  The analyzing time was 3.0 min. The repeatability coefficient of variation and laboratory imprecision for detecting low, medium and high levels of 18-OHB were 2.2%-3.5% and 3.7%-5.0%, respectively. The average recovery of 18-OHB ranged between 98.1% and 101.7%.The lower limit of quantification was 0.1 μg/L. The matrix of plasma had no significant effect on the measurement of 18-OHB. The 2.5th to 97.5th percentiles of 18-OHB measured by ID-UPLC-MS/MS in apparently healthy population was 0.01 and 0.60 μg/L, The plasma level of 18-OHB is outside the reference range provided by the Mayo Medical Laboratory Center in 66%(48/73) of the population.
      Conclusions  A reliable and specific LC-MS/MS method for evaluating plasma 18-OHB was established in the clinical laboratory. The method was simple, rapid and suitable for the diagnosis and classification of primary aldosteronism.

     

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