串联质谱法检测尿皮质醇和唾液皮质醇在库欣综合征诊断中的研究进展

Research progress in the detection of urinary cortisol and salivary cortisol by tandem mass spectrometry in the diagnosis of Cushing′s syndrome

尿游离皮质醇(UFC)和午夜唾液皮质醇(MSC)检测是诊断库欣综合征(CS)及其疗效监测的重要指标。串联质谱法检测类固醇激素的敏感性和特异性好,在国内外的应用越来越多。了解液相串联质谱法(LC-MS/MS)的优势和存在的问题,对CS的诊断具有重要意义。查阅相关文献,几个著名实验室用LC-MS/MS检测了UFC和MSC在健康人中的测定范围。近年来一些国内外文献也报道了LC-MS/MS检测UFC和MSC诊断CS的切点值,认为LC-MS/MS检测UFC诊断CS的切点为170 nmol/24 h。未来串联质谱法对糖皮质激素代谢组学的检测,有望对代谢综合征或CS的个性化诊断和治疗评估提供更全面、更有预测价值的信息。

Urinary free cortisol(UFC)and mid-night salivary cortisol(MSC)are important indicators for the diagnosis of Cushing′s syndrome(CS)and its efficacy monitoring.The measurement of steroid hormones by tandem mass spectrometry becomes more and more common nowadays worldwide because of its good sensitivity and specificity.Understanding the advantages and disadvantages of liquid chromatography-tandem mass spectrometry(LC-MS/MS)is of great significance for the diagnosis of CS.According to relevant literatures,LC-MS/MS was used by several famous laboratories to detect the range of UFC and MSC in healthy people.In recent years,some literatures have also reported the cut-off value of UFC and MSC detected by LC-MS/MS for the diagnosis of CS.It is generally believed that the cut-off value of UFC detected by LC-MS/MS is 170 nmol/24 h.In future,the determination of glucocorticoid metabolomics by tandem mass spectrometry is expected to provide more comprehensive and predictive information for the individualized diagnosis and treatment evaluation of metabolic syndrome or CS.