Comparisons of immunoassay and mass spectrometry measurements of serum estradiol levels and their influence on clinical association studies in men

Claes Ohlsson, Maria E. Nilsson, Åsa Tivesten, Henrik Ryberg, Dan Mellström, Magnus K. Karlsson, Östen Ljunggren, Fernand Labrie, Eric S. Orwoll, David M. Lee, Stephen R. Pye, Terence W. O'Neill, Joseph D. Finn, Judith E. Adams, Kate A. Ward, Steven Boonen, Gyorgy Bartfai, Felipe F. Casanueva, Gianni Forti, Aleksander GiwercmanThang S. Han, Ilpo T. Huhtaniemi, Krzysztof Kula, Michael E.J. Lean, Neil Pendleton, Margus Punab, Dirk Vanderschueren, Frederick C.W. Wu, Liesbeth Vandenput, Luisa Petrone, Giovanni Corona, Herman Borghs, Jolanta Slowikowska-Hilczer, Renata Walczak-Jedrzejowska, Alan Silman, Philip Steer, Mary Lage, Ana I. Castro, Imre Földesi, Imre Fejes, Paul Korrovitz, Min Jiang

Research output: Contribution to journalArticle

35 Scopus citations

Abstract

Context: Immunoassay-based techniques, routinely used to measure serum estradiol (E2), are known to have reduced specificity, especially at lower concentrations,whencompared with the gold standard technique of mass spectrometry (MS). Different measurement techniques may be responsible for the conflicting results of associations between serum E2 and clinical phenotypes in men. Objective: Our objective was to compare immunoassay and MS measurements of E2 levels in men and evaluate associations with clinical phenotypes. Design and Setting: Middle-aged and older male subjects participating in the population-based Osteoporotic Fractures in Men (MrOS) Sweden study (n = 2599), MrOS US (n = 688), and the European Male Aging Study (n = 2908) were included. Main Outcome Measures: Immunoassay and MS measurements of serum E2 were compared and related to bone mineral density (BMD; measured by dual energy x-ray absorptiometry) and ankle-brachial index. Results: Within each cohort, serum E2 levels obtained by immunoassay and MS correlated moderately (Spearman rank correlation coefficient rS 0.53-0.76). Serum C-reactive protein (CRP) levels associated significantly (albeit to a low extent, rS = 0.29) with immunoassay E2 but not with MS E2 levels. Similar associations of immunoassay E2 and MS E2 were seen with lumbar spine and total hip BMD, independent of serum CRP. However, immunoassay E2, but not MS E2, associated inversely with ankle-brachial index, and this correlation was lost after adjustment for CRP. Conclusions: Our findings suggest interference in the immunoassay E2 analyses, possibly by CRP or a CRP-associated factor. Although associations with BMD remain unaffected, this might imply for a reevaluation of previous association studies between immunoassay E2 levels and inflammation-related outcomes.

Original languageEnglish (US)
Pages (from-to)E1097-E1102
JournalJournal of Clinical Endocrinology and Metabolism
Volume98
Issue number6
DOIs
StatePublished - Jun 2013

ASJC Scopus subject areas

  • Endocrinology, Diabetes and Metabolism
  • Biochemistry
  • Endocrinology
  • Clinical Biochemistry
  • Biochemistry, medical

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    Ohlsson, C., Nilsson, M. E., Tivesten, Å., Ryberg, H., Mellström, D., Karlsson, M. K., Ljunggren, Ö., Labrie, F., Orwoll, E. S., Lee, D. M., Pye, S. R., O'Neill, T. W., Finn, J. D., Adams, J. E., Ward, K. A., Boonen, S., Bartfai, G., Casanueva, F. F., Forti, G., ... Jiang, M. (2013). Comparisons of immunoassay and mass spectrometry measurements of serum estradiol levels and their influence on clinical association studies in men. Journal of Clinical Endocrinology and Metabolism, 98(6), E1097-E1102. https://doi.org/10.1210/jc.2012-3861