CORTISOL WITH CORTISONE FREE RANDOM URINE

General Information

HLAB/HOL Code: CCFRA
UPHSM LIS Test #: 024984
Schedule: Monday through Saturday
Testing Time: 2 days
Testing Lab: Mayo Labs

Specimen Info
Only 1 specimen type required, unless otherwise specified

Volume: 10mL (5.0 min)
Temperature: Frozen
Tube Type: Plastic, 10-mL urine tube or clean, plastic aliquot container with no metal cap or glued insert
Collection Info:
Collect a random urine specimen.

Specimen Acceptability

Specimen stability:
Frozen (preferred) 14 days; Refrigerated 14 days; Ambient 72 hours

Methods

METHOD DESCRIPTION
Cortisol and Cortisone:
Deuterated cortisol (d[3]-cortisol) is added to a 0.1-mL urine specimen as an internal standard. Cortisol, cortisone, and d3-cortisol are extracted from the specimens using online turbulent-flow high performance liquid chromatography and analyzed by liquid chromatography-tandem mass spectrometry using multiple-reaction monitoring in positive mode. The following ion pairs are used for analysis: cortisol (363.0/121.1); cortisone (361.0/163.0); d(3)-cortisol (366.0/121.2). A calibration curve, generated from stripped urine spiked standards, is included with each batch of patient specimens.(Taylor RL, Machacek DA, Singh RJ: Validation of a high-throughput liquid chromatography-tandem mass spectrometry method for urinary cortisol and cortisone. Clin Chem. 2002;48:1511-1519;Luo A, El Gierari ETM, Nally LM, et al: Clinical utility of an ultrasensitive urinary free cortisol assay by tandem mass spectrometry. Steroids. 2019 Jun;146:65-69. doi: 10.1016/j.steroids.2019.03.014)

Creatinine:
The enzymatic method is based on the determination of sarcosine from creatinine with the aid of creatininase, creatinase, and sarcosine oxidase. The liberated hydrogen peroxide is measured via a modified Trinder reaction using a colorimetric indicator. Optimization of the buffer system and the colorimetric indicator enables the creatinine concentration to be quantified both precisely and specifically.(Package insert: Creatinine plus ver 2. Roche Diagnostics; V15.0, 03/2019)

CPT Codes

82542
82530
82570

* The CPT codes provided are based on AMA guidelines and are for informational purposes only. CPT coding
is the sole responsibility of the billing party. Please direct any questions regarding coding to the payer being billed.

Reference Range

CORTISOL
Males
0-2 years: 3.0-120 mcg/g creatinine
3-8 years: 2.2-89 mcg/g creatinine
9-12 years: 1.4-56 mcg/g creatinine
13-17 years: 1.0-42 mcg/g creatinine
> or =18 years: 1.0-119 mcg/g creatinine
Females
0-2 years: 3.0-120 mcg/g creatinine
3-8 years: 2.2-89 mcg/g creatinine
9-12 years: 1.4-56 mcg/g creatinine
13-17 years: 1.0-42 mcg/g creatinine
> or =18 years: 0.7-85 mcg/g creatinine

CORTISONE
0-2 years: 25-477 mcg/g creatinine
3-8 years: 11-211 mcg/g creatinine
9-12 years: 5.8-109 mcg/g creatinine
13-17 years: 5.4-102 mcg/g creatinine
18-29 years: 5.7-153 mcg/g creatinine
30-39 years: 6.6-176 mcg/g creatinine
40-49 years: 7.6-203 mcg/g creatinine
50-59 years: 8.8-234 mcg/g creatinine
60-69 years: 10-270 mcg/g creatinine
> or =70 years: 12-311 mcg/g creatinine

Use the conversion factors below to convert each analyte from mcg/g creatinine to nmol/mol creatinine:
Conversion factors
Cortisol: mcg/g creatinine x 312=nmol/mol creatinine
Cortisone: mcg/g creatinine x 314=nmol/mol creatinine

Cortisol molecular weight=362.5
Cortisone molecular weight=360.41
Creatinine molecular weight=113.12