Urine reference intervals for human chorionic gonadotropin (hCG) isoforms by immunoextraction–tandem mass spectrometry to detect hCG use. Issue 6 (27th November 2017)

• Record Type: Journal Article
• Authors: Butch, Anthony W.; Ahrens, Brian D.; Avliyakulov, Nuraly K.
• Is Part Of: Drug testing and analysis. Volume 10:Issue 6(2018)
• Page Start: 956
• Page End: 960
• Publication Date: 2017-11-27
• Subjects: doping -- human chorionic gonadotropin -- immunoextraction -- LC–MS/MS -- urine; Drugs -- Analysis -- Periodicals; Drug testing -- Periodicals; Chemistry, Forensic -- Periodicals; 615.1901
• DOI: 10.1002/dta.2333
• Languages: English
• ISSNs: 1942-7603

Abstract

Abstract: Human chorionic gonadotropin (hCG) stimulates testosterone production by the testicles and can normalize suppressed testosterone concentrations in males following prolonged anabolic steroid use. Because of the potential for abuse by males, hCG is on the World Anti‐Doping Agency (WADA) list of prohibited substances. The majority of WADA‐accredited laboratories measure urinary hCG using an automated immunoassay. Only immunoassays that recognize the intact alpha and beta heterodimer of hCG (intact hCG) should be used to measure urinary hCG for doping control purposes since intact hCG is the only biologically active molecule. WADA further requires that confirmation testing is performed using an intact hCG immunoassay that is different from the one used in the initial testing procedure or by liquid chromatography–tandem mass spectrometry (LC–MS/MS). In this study we measured the concentration of intact hCG, free β‐subunit (hCGβ) and β‐subunit core fragment (hCGβcf) in 570, 275, and 256 male urine samples, respectively, by an immunoextraction LC–MS/MS method. Mean concentrations of intact hCG, hCGβ and hCGβcf were 0.04 IU/L, 0.47 pmol/L and 0.16 pmol/L, respectively. The upper reference limits (97.5 th percentile) for intact hCG, hCGβ and hCGβcf were 0.21 IU/L, 0.40 pmol/L, and 1.86 pmol/L, respectively. Based on these data, we recommend a threshold of 1.0 IU/L for intact hCG (false positive rate of <1 in 10 000) for detecting male athletes that dope with hCG. Abstract : Concentrations of intact hCG, free β‐subunit (hCGβ) and β‐subunit core fragment (hCGβcf) were measured in 570, 275, and 256 male urine samples, respectively, by an immunoextraction‐LC‐MS/MS method. Mean concentrations of intact hCG, hCGβ and hCGβcf were 0.04 IU/L, 0.47 pmol/L and 0.16 pmol/L, respectively. The upper 97.5 th percentile for intact hCG, hCGβ and hCGβcf were 0.21 IU/L, 0.40 pmol/L, and 1.86 pmol/L, respectively. A threshold of 1.0 IU/L for intact hCG is recommended to detect doping with hCG.