Introduction

Monitoring steroid hormone levels of patients with endocrine disorders, such as congenital adrenal hyperplasia (CAH) and disorders of sex development (DSD), can be challenging. Dried blood spot (DBS) sampling can be an outcome for these patients. DBS sampling is less invasive, DBS are easier to sample, and they are simpler to transport and store compared to venous blood sampling. Additionally, DBS sampling can be done at home, thus improving patient convenience. We have an in house developed LC-MS/MS method to measure steroid hormone concentrations in DBS. In order to sample at home and send the DBS to the laboratory, the effect of storage and temperature on the stability of steroid hormones in DBS samples needs to be established.

Methods

DBS from 10 healthy volunteers (5 males, 5 females) were collected and stored per different temperature (-20°C, 4°C, room temperature, 37°C) for 7- and 14-days, and 3- and 6-months (DBS stored at 37⁰C were kept for 7 weeks). Directly after sampling steroid hormone concentrations of cortisol, cortisone, corticosterone, testosterone, androstenedione, and 17-hydroxyprogesterone were assessed using our in-house LC-MS/MS method and were set at 100% (baseline).

Results

The median changes of the analyte concentrations compared to baseline up to 6 months (for 37⁰C up to 7 weeks) ranged from -8% to +12% for DBS stored at -20⁰C, -23% to +10% for DBS stored at 4⁰C, -44% to +23% for DBS stored at room temperature, and -51% to +15% for DBS stored at 37⁰C.

Conclusions

In general, steroids remain stable in DBS long enough to be send by regular mail to the diagnostic laboratory. Thus, self-sampling DBS at home could potentially be used for monitoring steroid hormone levels of patients with endocrine disorders such as CAH or DSD.