Ronda F Greaves1, Janne Pitkin, Chung Shun Ho, James Baglin, Rodney W Hunt, Margaret R Zacharin. 1. School of Medical Sciences (R.F.G.) and School of Mathematical and Geospatial Sciences (J.B.), RMIT University, Victoria 3000, Australia; Murdoch Children's Research Institute (R.F.G., J.P., R.W.H., M.R.Z.), Melbourne, Victoria 3052, Australia; Prince of Wales Hospital (C.S.H.), Shatin, New Territories, Hong Kong SAR; Department of Newborn Intensive Care (R.W.H.) and Department of Endocrinology and Diabetes (M.R.Z.), The Royal Children's Hospital, Parkville, Victoria 3052, Australia; and Department of Paediatrics (R.W.H., M.R.Z.), University of Melbourne, Parkville, Victoria 3010, Australia.
Abstract
CONTEXT: Reports suggest significant differences in serum levels of hormones in extremely preterm compared with late preterm and full-term infants. OBJECTIVES: The purpose of this study was to develop reference intervals (RIs) for 3 pituitary hormones and 5 steroid hormones in serum of preterm infants. DESIGN: Blood samples were collected from 248 (128 male and 120 female) preterm neonates born between 24 and 32 weeks' gestation. SETTING: PARTICIPANTS were recruited from 3 neonatal intensive care wards in Melbourne, Australia. PARTICIPANTS: No infant in this cohort had ambiguous genitalia or other endocrine abnormalities. All infants included in the RI determination survived beyond the equivalent of term. INTERVENTIONS: Serum was analyzed for prolactin, FSH, and LH by automated electrochemiluminescence immunoassay (Roche Cobas 8000-e601). Liquid chromatography coupled with tandem mass spectrometry was used for analysis of 17-hydroxyprogesterone, androstenedione, cortisol, cortisone, and testosterone. MAIN OUTCOME MEASURES: The robust method was applied to define the central 95% RI, after each hormone measure was transformed using a Box-Cox transformation to correct for asymmetry. RESULTS: RIs were established for 8 hormones. Gender-specific intervals were developed for FSH, LH, and testosterone. Cortisone and 17- hydroxyprogesterone required division based on gestational age, with neonates born at <30 weeks' gestation demonstrating higher levels than their older counterparts. Androstenedione, cortisol, and prolactin did not require any division within this cohort for RI assignment. CONCLUSIONS: This report provides the first characterization of serum steroids measured by mass spectrometry in preterm neonates, with the additional characterization of 3 pituitary hormones in infants born at ≤32 weeks' gestation. Use of these data allows for correct interpretation of results for very preterm neonates and reduces the risk of incorrect diagnosis due to misinterpretation of data.
CONTEXT: Reports suggest significant differences in serum levels of hormones in extremely preterm compared with late preterm and full-term infants. OBJECTIVES: The purpose of this study was to develop reference intervals (RIs) for 3 pituitary hormones and 5 steroid hormones in serum of preterm infants. DESIGN: Blood samples were collected from 248 (128 male and 120 female) preterm neonates born between 24 and 32 weeks' gestation. SETTING:PARTICIPANTS were recruited from 3 neonatal intensive care wards in Melbourne, Australia. PARTICIPANTS: No infant in this cohort had ambiguous genitalia or other endocrine abnormalities. All infants included in the RI determination survived beyond the equivalent of term. INTERVENTIONS: Serum was analyzed for prolactin, FSH, and LH by automated electrochemiluminescence immunoassay (Roche Cobas 8000-e601). Liquid chromatography coupled with tandem mass spectrometry was used for analysis of 17-hydroxyprogesterone, androstenedione, cortisol, cortisone, and testosterone. MAIN OUTCOME MEASURES: The robust method was applied to define the central 95% RI, after each hormone measure was transformed using a Box-Cox transformation to correct for asymmetry. RESULTS: RIs were established for 8 hormones. Gender-specific intervals were developed for FSH, LH, and testosterone. Cortisone and 17- hydroxyprogesterone required division based on gestational age, with neonates born at <30 weeks' gestation demonstrating higher levels than their older counterparts. Androstenedione, cortisol, and prolactin did not require any division within this cohort for RI assignment. CONCLUSIONS: This report provides the first characterization of serum steroids measured by mass spectrometry in preterm neonates, with the additional characterization of 3 pituitary hormones in infants born at ≤32 weeks' gestation. Use of these data allows for correct interpretation of results for very preterm neonates and reduces the risk of incorrect diagnosis due to misinterpretation of data.
Authors: Ronda F Greaves; Chung S Ho; Kirsten E Hoad; John Joseph; Brett McWhinney; Janice P Gill; Therese Koal; Chris Fouracre; Heidi P Iu; Brian R Cooke; Conchita Boyder; Hai T Pham; Lisa M Jolly Journal: Clin Biochem Rev Date: 2016-05
Authors: Graeme Eisenhofer; Mirko Peitzsch; Denise Kaden; Katharina Langton; Christina Pamporaki; Jimmy Masjkur; George Tsatsaronis; Anastasios Mangelis; Tracy A Williams; Martin Reincke; Jacques W M Lenders; Stefan R Bornstein Journal: Clin Chim Acta Date: 2017-05-04 Impact factor: 3.786