1
|
Jacobson TA, Rahbari KJ, Schwartz WA, Bae Y, Zhang R, Nunes DA, Huang C, Issa RP, Smilowitz K, Yan LD, Hirschhorn LR, Khan SS, Huffman MD, Miller GE, Feinglass JM, McDade TW, Funk WE. Dried Blood Spots to Assess Cardiovascular-Kidney-Metabolic Health. J Am Heart Assoc 2025; 14:e037454. [PMID: 40079345 DOI: 10.1161/jaha.124.037454] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/15/2025]
Abstract
Dried blood spot sampling offers a scalable strategy to close diagnostic gaps and improve global surveillance for cardiovascular-kidney-metabolic syndrome. However, assay performance and the extent of validity vary widely between biomarkers used in cardiovascular-kidney-metabolic health assessment under different settings and have not been well described. To fill this gap, we conducted a systematic search of the literature and a narrative synthesis through April 2024 and included reports with laboratory or field validation measuring biomarkers that can be used in cardiovascular-kidney-metabolic health assessment. We categorized assays into categories based on laboratory validation: excellent performance (r>0.95 with gold standard methods and coefficients of variation <5%), very good performance (r>0.90 and coefficients of variation <10%), reasonable performance (r>0.80 and coefficients of variation <15%), and poor performance (r<0.80 or coefficients of variation >15%). The extent of validation was determined by the total number of field validation studies with strong agreement. Hemoglobin A1c has strong laboratory and field validation and should be considered for expansion into clinical testing in low-resource settings. Traditional lipid biomarkers showed poor performance in field validation studies, but apoB (apolipoprotein B), creatinine, cystatin C, and NT-proBNP (N-terminal prohormone of brain natriuretic peptide) showed promising initial laboratory validation results and deserve greater attention in field validation studies. High-sensitivity C-reactive protein has strong laboratory and field validation but has limited clinical utility. Dried blood spot assays have been developed for biomarkers that offer mechanistic insights including inflammatory and vascular injury markers, fatty acids, malondialdehyde, asymmetric dimethylarginine, trimethylamine N-oxide, carnitines, and omics.
Collapse
Affiliation(s)
- Tyler A Jacobson
- Department of Preventive Medicine Northwestern University Feinberg School of Medicine Chicago IL USA
| | - Kian J Rahbari
- Department of Medicine Vanderbilt University Medical Center Nashville TN USA
| | - William A Schwartz
- Department of Preventive Medicine Northwestern University Feinberg School of Medicine Chicago IL USA
| | - Yeunook Bae
- Department of Health Sciences Illinois State University Normal IL USA
| | - Runze Zhang
- Department of Preventive Medicine Northwestern University Feinberg School of Medicine Chicago IL USA
| | - Denise A Nunes
- Galter Health Sciences Library Northwestern University Feinberg School of Medicine Chicago IL USA
| | - Cathelin Huang
- Department of Preventive Medicine Northwestern University Feinberg School of Medicine Chicago IL USA
| | - Ramzy P Issa
- Department of Preventive Medicine Northwestern University Feinberg School of Medicine Chicago IL USA
| | - Karen Smilowitz
- Department of Operations Kellogg School of Management, Northwestern University Evanston IL USA
- Department of Industrial Engineering and Management Sciences Northwestern University Evanston IL USA
| | - Lily D Yan
- Division of General Internal Medicine, Department of Medicine Weill Cornell Medicine New York NY USA
- Center for Global Health, Department of Medicine Weill Cornell Medicine New York NY USA
| | - Lisa R Hirschhorn
- Robert J Havey, Institute for Global Health Northwestern University Feinberg School of Medicine Chicago IL USA
- Department of Medical Social Sciences Northwestern University Feinberg School of Medicine Chicago IL USA
| | - Sadiya S Khan
- Department of Preventive Medicine Northwestern University Feinberg School of Medicine Chicago IL USA
- Department of Medicine (Cardiology) Northwestern University Feinberg School of Medicine Chicago IL USA
| | - Mark D Huffman
- Department of Preventive Medicine Northwestern University Feinberg School of Medicine Chicago IL USA
- Global Health Center and Department of Internal Medicine (Cardiology) Washington University in St. Louis St. Louis MO USA
- The George Institute for Global Health University of New South Wales Sydney Australia
| | - Gregory E Miller
- Department of Psychology Weinberg College of Arts and Sciences, Northwestern University Evanston IL USA
- Institute for Policy Research, Northwestern University Evanston IL USA
| | - Joseph M Feinglass
- Division of General Internal Medicine Northwestern University Feinberg School of Medicine Chicago IL USA
| | - Thomas W McDade
- Institute for Policy Research, Northwestern University Evanston IL USA
- Department of Anthropology Northwestern University Evanston IL USA
| | - William E Funk
- Department of Preventive Medicine Northwestern University Feinberg School of Medicine Chicago IL USA
| |
Collapse
|
2
|
Ott IR, Macali Oliveira DR, Grando AP, Frohlich KV, Perassolo MS, Linden R, Antunes MV. GC-NPD analysis of topiramate in capillary dried plasma: assessing chemical dependency pharmacotherapy. Bioanalysis 2024; 16:603-613. [PMID: 39185792 DOI: 10.1080/17576180.2024.2348938] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2024] [Accepted: 04/25/2024] [Indexed: 08/27/2024] Open
Abstract
Aim: This study aimed to develop and validate a GC-NPD method for quantifying topiramate (TPM) in capillary dried plasma spots (DPS).Materials & methods: Extraction involved three 6 mm DPS with albumin 0.1%, alkaline liquid extraction with tert-Butyl methyl ether and TMAH methylation. The method was validated and applied to 15 paired samples of capillary DPS and venous plasma from chemical dependency patients.Results: The method was linear from 1 to 50 μg/ml (r >0.99), precise (CV% 3.62-8.29%) accurate (98.1-107.7%). TPM stability was confirmed in DPS stored at 4, 23 and 45°C for 21 days. DPS TPM measurements were highly correlated plasma concentrations (rs = 0.96), representing on average 102% of the venous plasma measurements.Conclusion: The method was fully validated, demonstrating potential for clinical application.
Collapse
Affiliation(s)
- Isabela Ritter Ott
- Graduate Program on Toxicology & Analytical Toxicology, Feevale University, Novo Hamburgo, RS, 93525-075, Brazil
- Toxicological Analysis Laboratory, Institute of Health Sciences, Feevale University, Novo Hamburgo, RS, 93525-080,Brazil
| | - Debora Renata Macali Oliveira
- Graduate Program on Toxicology & Analytical Toxicology, Feevale University, Novo Hamburgo, RS, 93525-075, Brazil
- Toxicological Analysis Laboratory, Institute of Health Sciences, Feevale University, Novo Hamburgo, RS, 93525-080,Brazil
| | - Ana Paula Grando
- Toxicological Analysis Laboratory, Institute of Health Sciences, Feevale University, Novo Hamburgo, RS, 93525-080,Brazil
| | - Klaus Vogel Frohlich
- Toxicological Analysis Laboratory, Institute of Health Sciences, Feevale University, Novo Hamburgo, RS, 93525-080,Brazil
| | - Magda Susana Perassolo
- Graduate Program on Toxicology & Analytical Toxicology, Feevale University, Novo Hamburgo, RS, 93525-075, Brazil
- Toxicological Analysis Laboratory, Institute of Health Sciences, Feevale University, Novo Hamburgo, RS, 93525-080,Brazil
| | - Rafael Linden
- Graduate Program on Toxicology & Analytical Toxicology, Feevale University, Novo Hamburgo, RS, 93525-075, Brazil
- Toxicological Analysis Laboratory, Institute of Health Sciences, Feevale University, Novo Hamburgo, RS, 93525-080,Brazil
| | - Marina Venzon Antunes
- Graduate Program on Toxicology & Analytical Toxicology, Feevale University, Novo Hamburgo, RS, 93525-075, Brazil
- Toxicological Analysis Laboratory, Institute of Health Sciences, Feevale University, Novo Hamburgo, RS, 93525-080,Brazil
| |
Collapse
|
3
|
Deza S, Colina I, Beloqui O, Monreal JI, Martínez-Chávez E, Maroto-García J, Mugueta C, González A, Varo N. Evaluation of measured and calculated small dense low-density lipoprotein in capillary blood and association with the metabolic syndrome. Clin Chim Acta 2024; 557:117897. [PMID: 38570026 DOI: 10.1016/j.cca.2024.117897] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2024] [Revised: 03/31/2024] [Accepted: 03/31/2024] [Indexed: 04/05/2024]
Abstract
BACKGROUND AND AIMS Small-dense-low-density-lipoprotein cholesterol (sdLDL-C) is proatherogenic and not commonly measured. The aims were to evaluate capillary blood and its stability for sdLDL-C measurement and measure sdLDL-C in patients with metabolic syndrome (MS). METHODS 182 patients were studied (49 with MS). sdLDL-C was measured by electrophoresis (LipoPrint®), direct measurement (Roche Diagnostics) and Sampson equation. Intima-media thickness (IMT) and presence of atheroma was evaluated. sdLDL-C was compared in paired venous and capillary blood according to CLSI-EP09c (n = 40). sdLDL-C stability was studied after 24 h at room temperature (RT). RESULTS sdLDL-C in capillary blood and venous blood showed agreement with the direct measurement (bias: 4.17 mg/dL, LOA 95 %:-5.66; 13.99) and estimation (bias:8.12 mg/dL, LOA 95 %:-8.59; 24.82). sdLDL-C is stable in capillary blood for 24 h at RT. The electrophoretic method yielded lower (p < 0.05) sdLDL-C than the equation or direct measurement. Patients with MS had (p < 0.05) higher sdLDL-C (%) than patients without MS. Patients with atheroma plaques had higher sdLDL-C (p < 0.05). Estimated sdLDL-C correlated with IMT (r = 0.259, p < 0.001). CONCLUSIONS Capillary blood is an alternative to venous blood for sdLDL-C measurement and is stable for 24 h after collection. Estimated and directly measured sdLDL-C associate with the MS being accessible tools for cardiovascular risk assessment.
Collapse
Affiliation(s)
- Sara Deza
- Clinical Biochemistry Department, Clínica Universidad de Navarra, 31008 Pamplona, Spain
| | - Inmaculada Colina
- Internal Medicine Department, Clínica Universidad de Navarra, 31008 Pamplona, Spain
| | - Oscar Beloqui
- Internal Medicine Department, Clínica Universidad de Navarra, 31008 Pamplona, Spain
| | - José Ignacio Monreal
- Clinical Biochemistry Department, Clínica Universidad de Navarra, 31008 Pamplona, Spain
| | | | - Julia Maroto-García
- Clinical Biochemistry Department, Clínica Universidad de Navarra, 31008 Pamplona, Spain
| | - Carmen Mugueta
- Clinical Biochemistry Department, Clínica Universidad de Navarra, 31008 Pamplona, Spain
| | - Alvaro González
- Clinical Biochemistry Department, Clínica Universidad de Navarra, 31008 Pamplona, Spain
| | - Nerea Varo
- Clinical Biochemistry Department, Clínica Universidad de Navarra, 31008 Pamplona, Spain.
| |
Collapse
|