Poster Presentation ESA-SRB-APEG-NZSE 2022

Performance of total testosterone (tT) measured using immunoassay compared with total testosterone measured by LC-MS/MS (liquid chromatography/ mass spectrometry) in the identification of women with polycystic ovary syndrome (PCOS) (#310)

Udai Wijetunga 1 , Robin J Bell 2 , David J Handelsman 3 , Susan R Davis 2
  1. Department of Endocrinology, The Alfred Hospital, Melbourne, Victoria, Australia
  2. Women's Health Research Program, Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
  3. ANZAC Research Institute, University of Sydney, Sydney, NSW, Australia

Aims

To determine whether identification of women of PCOS differs between the use of tT measured by LC-MS/MS or a commercially available immunoassay.

Methods

A sub-group of participants in the Grollo-Ruzzene Study of Young Women’s Health were invited to a sub-study which involved a pelvic ultrasound, a blood sample for serum tT by both LC-MS/MS and immunoassay (Abbott Architect Gen II) and questions about their menstrual cycle. Participants were classified as having PCOS according to Rotterdam criteria, with the LC-MS/MS tT as the reference.

Results

Of 1121 potential participants, 240 wished to participate and met the inclusion criteria and 168 had a blood sample and ultrasound. None of the 15 women with tT above the LC-MS/MS reference range were also above the reference range of the immunoassay, and no women within the LC-MS/MS reference range had an elevated immunoassay tT.  Most participants with an LC-MS/MS tT just above the cut-off were considerably below the immunoassay cut off.

Replacing LC-MS/MS tT results with immunoassay tT, reduced the number of women classified as having PCOS from 31 to 26 due to 3 participants being reclassified as polycystic ovary morphology only and 2 to menstrual dysfunction only. In addition, 2 participants with all 3 criteria were reclassified as only having 2 criteria for PCOS. None of the 137 women not classified as having PCOS by LCMS were reclassified as having PCOS by the immunoassay.

Conclusion

With limited availability of LC-MS/MS, which is considered gold standard for measurement of tT, clinicians should be aware that measurement of tT by the Abbott Architect Gen II may under-identify women with PCOS.