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Clinical Utility and Analytical Aspects of Direct Measurements of Free Hormones Using Mass Spectrometry-Based Methods.

Authors
  • Kushnir, Mark M1, 2
  • Nelson, Heather A2
  • Doyle, Kelly1, 2
  • 1 ARUP Institute for Clinical and Experimental Pathology, Salt Lake City, UT.
  • 2 Department of Pathology, University of Utah Health Sciences Center, Salt Lake City, UT.
Type
Published Article
Journal
The journal of applied laboratory medicine
Publication Date
Jun 30, 2022
Volume
7
Issue
4
Pages
945–970
Identifiers
DOI: 10.1093/jalm/jfac010
PMID: 35296890
Source
Medline
Keywords
Language
English
License
Unknown

Abstract

The free hormone (FH) hypothesis states that hormone action and the corresponding biological effects are mediated by the unbound (free) fraction of hormone in circulation. The in vivo relationship between protein-bound and FH is complex and dynamic. In most individuals, measurement of total hormone (TH) is usually adequate to reflect the hormone status; however, certain physiological conditions and/or medications can affect protein binding and alter FH concentration. In these cases, measurement of FH will provide a better measure of the bioactive hormone status than measurement of the TH. Measurement of FH presents many challenges, as the concentrations are very low and there are number of pitfalls, which may affect the measured concentrations. In this review, we discuss techniques used in the separation and direct quantitation of FH concentrations in biological samples using mass spectrometry for analysis. We also highlight clinical situations in which FH analysis is warranted and when mass spectrometry should be the preferred methodology over immunoassays. Equilibrium dialysis, ultrafiltration, or size-exclusion separation coupled with liquid chromatography-tandem mass spectrometry provides a sensitive and specific method to measure FH concentrations. These direct methods are useful in iatrogenic or physiological states that alter hormone binding or metabolism. © American Association for Clinical Chemistry 2022. All rights reserved. For permissions, please email: [email protected]

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