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Arnaud J, Weykamp C, Wenzel R, Patriarca M, González-Estecha M, Janssen L, Fofou-Caillierez MB, Alemany MV, Patriarca V, de Graaf I, Persoons R, Panadès M, China B, Winkel MT, van der Vuurst H, Thelen M. Analytical performance specifications for trace elements in biological fluids derived from six countries federated external quality assessment schemes over 10 years. Clin Chem Lab Med 2024; 0:cclm-2024-0551. [PMID: 39027966 DOI: 10.1515/cclm-2024-0551] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2024] [Accepted: 07/07/2024] [Indexed: 07/20/2024]
Abstract
OBJECTIVES This article defines analytical performance specifications (APS) for evaluating laboratory proficiency through an external quality assessment scheme. METHODS Standard deviations for proficiency assessment were derived from Thompson's characteristic function applied to robust data calculated from participants' submissions in the Occupational and Environmental Laboratory Medicine (OELM) external quality assurance scheme for trace elements in serum, whole blood and urine. Characteristic function was based on two parameters: (1) β - the average coefficient of variation (CV) at high sample concentrations; (2) α - the average standard deviation (SD) at low sample concentrations. APSs were defined as 1.65 standard deviations calculated by Thompson's approach. Comparison between OELM robust data and characteristic function were used to validate the model. RESULTS Application of the characteristic function allowed calculated APS for 18 elements across three matrices. Some limitations were noted, particularly for elements (1) with no sample concentrations near analytical technique limit of detection; (2) exhibiting high robust CV at high concentration; (3) exhibiting high analytical variability such as whole blood Tl and urine Pb; (4) with an unbalanced number of robust SD above and under the characteristic function such as whole blood Mn and serum Al and Zn. CONCLUSIONS The characteristic function was a useful means of deriving APS for trace elements in biological fluids where biological variation data or outcome studies were not available. However, OELM external quality assurance scheme data suggests that the characteristic functions are not appropriate for all elements.
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Affiliation(s)
- Josiane Arnaud
- Member of French Society for Clinical Biology (SFBC), and French Speaking Society for Trace Elements, Vitamins and Biofactors (SETViB), Paris, France
| | - Cas Weykamp
- MCA Laboratory, Queen Beatrix Hospital, Winterswijk, The Netherlands
| | - Ross Wenzel
- Pathology NSW, Royal North Shore Hospital, St Leonards, NSW, Australia
| | - Marina Patriarca
- Department of Food Safety, Nutrition and Veterinary Public Health, Istituto Superiore di Sanità, Rome, Italy
| | | | - Liesbeth Janssen
- MCA Laboratory, Queen Beatrix Hospital, Winterswijk, The Netherlands
| | | | | | - Valeria Patriarca
- Department of Food Safety, Nutrition and Veterinary Public Health, Istituto Superiore di Sanità, Rome, Italy
| | - Irene de Graaf
- MCA Laboratory, Queen Beatrix Hospital, Winterswijk, The Netherlands
| | - Renaud Persoons
- University of Grenoble Alpes, CNRS, Grenoble INP, CHU Grenoble Alpes, TIMC, Grenoble, France
| | - Mariona Panadès
- External Quality Assessment Schemes, Spanish Society of Laboratory Medicine, Barcelona, Spain
| | - Bernard China
- Department of Quality of Laboratories, Sciensano, Brussels, Belgium
| | - Marieke Te Winkel
- MCA Laboratory, Queen Beatrix Hospital, Winterswijk, The Netherlands
| | | | - Marc Thelen
- Foundation of Quality Assurance in Laboratory Medicine (SKML), Nijmegen, The Netherlands
- Department of Laboratory Medicine, Radboud University Medical Center, Nijmegen, The Netherlands
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2
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Chillon TS, Tuchtenhagen M, Schwarz M, Hackler J, Heller R, Kaghazian P, Moghaddam A, Schomburg L, Haase H, Kipp AP, Schwerdtle T, Maares M. Determination of copper status by five biomarkers in serum of healthy women. J Trace Elem Med Biol 2024; 84:127441. [PMID: 38579499 DOI: 10.1016/j.jtemb.2024.127441] [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] [Received: 02/04/2024] [Revised: 03/21/2024] [Accepted: 03/21/2024] [Indexed: 04/07/2024]
Abstract
BACKGROUND The essential trace element copper is relevant for many important physiological processes. Changes in copper homeostasis can result from disease and affect human health. A reliable assessment of copper status by suitable biomarkers may enable fast detection of subtle changes in copper metabolism. To this end, additional biomarkers besides serum copper and ceruloplasmin (CP) concentrations are required. OBJECTIVES The aim of this study was to investigate the emerging copper biomarkers CP oxidase (CPO) activity, exchangeable copper (CuEXC) and labile copper in serum of healthy women and compare them with the conventional biomarkers total serum copper and CP. METHOD AND MAIN FINDINGS This observational study determined CPO activity, the non CP-bound copper species CuEXC and labile copper, total serum copper and CP in sera of 110 healthy women. Samples were collected at four time points over a period of 24 weeks. The concentrations of total serum copper and CP were within the reference ranges. The comparison of all five biomarkers provided insight into their relationship, the intra- and inter-individual variability as well as the age dependence. The correlation and Principal Component Analyses (PCA) indicated that CP, CPO activity and total copper correlated well, followed by CuEXC, while the labile copper pool was unrelated to the other parameters. CONCLUSIONS This study suggests that the non-CP-bound copper species represent copper pools that are differently regulated from total copper or CP-bound copper, making them interesting complementary biomarkers to enable a more complete assessment of body copper status with potential relevance for clinical application.
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Affiliation(s)
- Thilo Samson Chillon
- TraceAge-DFG Research Unit on Interactions of Essential Trace Elements in Healthy and Diseased Elderly, Potsdam-Berlin, Jena, Germany; Max Rubner Center for Cardiovascular Metabolic Renal Research (CMR), Institute for Experimental Endocrinology, Charité-Universitätsmedizin Berlin, Hessische Straße 3-4, Berlin D-10115, Germany
| | - Max Tuchtenhagen
- TraceAge-DFG Research Unit on Interactions of Essential Trace Elements in Healthy and Diseased Elderly, Potsdam-Berlin, Jena, Germany; Department of Food Chemistry, Institute of Nutritional Science, University of Potsdam, Arthur-Scheunert-Allee 114-116, Nuthetal 14558, Germany
| | - Maria Schwarz
- TraceAge-DFG Research Unit on Interactions of Essential Trace Elements in Healthy and Diseased Elderly, Potsdam-Berlin, Jena, Germany; Department of Nutritional Physiology, Institute of Nutritional Sciences, Friedrich Schiller University Jena, Jena 07743, Germany
| | - Julian Hackler
- TraceAge-DFG Research Unit on Interactions of Essential Trace Elements in Healthy and Diseased Elderly, Potsdam-Berlin, Jena, Germany; Max Rubner Center for Cardiovascular Metabolic Renal Research (CMR), Institute for Experimental Endocrinology, Charité-Universitätsmedizin Berlin, Hessische Straße 3-4, Berlin D-10115, Germany
| | - Raban Heller
- Max Rubner Center for Cardiovascular Metabolic Renal Research (CMR), Institute for Experimental Endocrinology, Charité-Universitätsmedizin Berlin, Hessische Straße 3-4, Berlin D-10115, Germany; Bundeswehr Hospital Berlin, Clinic of Traumatology and Orthopaedics, Berlin D-10115, Germany; Technische Universität Berlin, Department of Food Chemistry and Toxicology, Straße des 17. Juni 135, Berlin 10623, Germany
| | - Peyman Kaghazian
- Orthopedic and Trauma Surgery, Frohsinnstraße 12, Aschaffenburg D-63739, Germany
| | - Arash Moghaddam
- Orthopedic and Trauma Surgery, Frohsinnstraße 12, Aschaffenburg D-63739, Germany
| | - Lutz Schomburg
- TraceAge-DFG Research Unit on Interactions of Essential Trace Elements in Healthy and Diseased Elderly, Potsdam-Berlin, Jena, Germany; Max Rubner Center for Cardiovascular Metabolic Renal Research (CMR), Institute for Experimental Endocrinology, Charité-Universitätsmedizin Berlin, Hessische Straße 3-4, Berlin D-10115, Germany
| | - Hajo Haase
- TraceAge-DFG Research Unit on Interactions of Essential Trace Elements in Healthy and Diseased Elderly, Potsdam-Berlin, Jena, Germany; Technische Universität Berlin, Department of Food Chemistry and Toxicology, Straße des 17. Juni 135, Berlin 10623, Germany
| | - Anna P Kipp
- TraceAge-DFG Research Unit on Interactions of Essential Trace Elements in Healthy and Diseased Elderly, Potsdam-Berlin, Jena, Germany; Department of Nutritional Physiology, Institute of Nutritional Sciences, Friedrich Schiller University Jena, Jena 07743, Germany
| | - Tanja Schwerdtle
- TraceAge-DFG Research Unit on Interactions of Essential Trace Elements in Healthy and Diseased Elderly, Potsdam-Berlin, Jena, Germany; Department of Food Chemistry, Institute of Nutritional Science, University of Potsdam, Arthur-Scheunert-Allee 114-116, Nuthetal 14558, Germany; German Federal Institute for Risk Assessment (BfR), Berlin, Germany
| | - Maria Maares
- TraceAge-DFG Research Unit on Interactions of Essential Trace Elements in Healthy and Diseased Elderly, Potsdam-Berlin, Jena, Germany; Department of Food Chemistry, Institute of Nutritional Science, University of Potsdam, Arthur-Scheunert-Allee 114-116, Nuthetal 14558, Germany; Technische Universität Berlin, Department of Food Chemistry and Toxicology, Straße des 17. Juni 135, Berlin 10623, Germany.
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3
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Choy KW, Carobene A, Loh TP, Chiang C, Wijeratne N, Locatelli M, Coskun A, Cavusoglu C, Unsal I. Biological Variation Estimates for Plasma Copeptin and Clinical Implications. J Appl Lab Med 2024; 9:430-439. [PMID: 38576222 DOI: 10.1093/jalm/jfae005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2023] [Accepted: 11/15/2023] [Indexed: 04/06/2024]
Abstract
BACKGROUND Plasma copeptin measurement is useful for the differential diagnoses of polyuria-polydipsia syndrome. It has also been proposed as a prognostic marker for cardiovascular diseases. However, limited information is available about the within- (CVI) and between-subject (CVG) biological variation (BV). This study presents BV estimates for copeptin in healthy individuals. METHODS Samples were collected weekly from 41 healthy subjects over 5 weeks and analyzed using the BRAHMS Copeptin proAVP KRYPTOR assay after at least 8 h of food and fluid abstinence. Outlier detection, variance homogeneity, and trend analysis were performed followed by CV-ANOVA for BV and analytical variation (CVA) estimation with 95% confidence intervals. Reference change values (RCVs), index of individuality (II), and analytical performance specification (APS) were also calculated. RESULTS The analysis included 178 results from 20 males and 202 values from 21 females. Copeptin concentrations were significantly higher in males than in females (mean 8.5 vs 5.2 pmol/L, P < 0.0001). CVI estimates were 18.0% (95% CI, 15.4%-21.6%) and 19.0% (95% CI, 16.4%-22.6%), for males and females, respectively; RCVs were -35% (decreasing value) and 54% (increasing value). There was marked individuality for copeptin. No result exceeded the diagnostic threshold (>21.4 pmol/L) for arginine vasopressin resistance. CONCLUSIONS The availability of BV data allows for refined APS and associated II, and RCVs applicable as aids in the serial monitoring of patients with specific diseases such as heart failure. The BV estimates are only applicable in subjects who abstained from oral intake due to the rapid and marked effects of fluids on copeptin physiology.
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Affiliation(s)
- Kay Weng Choy
- Department of Pathology, Northern Health, Epping, Australia
| | - Anna Carobene
- Laboratory Medicine, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Tze Ping Loh
- Department of Laboratory Medicine, National University Hospital, Singapore
| | - Cherie Chiang
- Department of Pathology, The University of Melbourne, Royal Melbourne Hospital, Parkville, Australia
| | - Nilika Wijeratne
- Eastern Health Pathology, Eastern Health, Box Hill, Australia
- Department of Biochemistry, Dorevitch Pathology, Heidelberg, Australia
- School of Clinical Sciences at Monash Health, Department of Medicine, Nursing and Health Sciences, Monash University, Clayton, Australia
| | - Massimo Locatelli
- Laboratory Medicine, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Abdurrahman Coskun
- School of Medicine, Acibadem Mehmet Ali Aydınlar University, Istanbul, Turkey
| | - Coskun Cavusoglu
- School of Medicine, Acibadem Mehmet Ali Aydınlar University, Istanbul, Turkey
| | - Ibrahim Unsal
- School of Medicine, Acibadem Mehmet Ali Aydınlar University, Istanbul, Turkey
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4
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France Štiglic A, Falnoga I, Briški AS, Žavbi M, Osredkar J, Skitek M, Marc J. Reference intervals of 24 trace elements in blood, plasma and erythrocytes for the Slovenian adult population. Clin Chem Lab Med 2024; 62:946-957. [PMID: 38008765 DOI: 10.1515/cclm-2023-0731] [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: 07/12/2023] [Accepted: 11/14/2023] [Indexed: 11/28/2023]
Abstract
OBJECTIVES The aim of the present study was to establish the population- and laboratory-specific reference intervals (RIs) for the Slovenian adult population for 24 trace elements (TEs) in blood, plasma and erythrocytes and to evaluate the impact of gender, age, seafood consumption, smoking habits and amalgam fillings on TEs levels. METHODS TEs (Mn, Co, Cu, Zn, Se and Mo, Li, Be, V, Cr, Ni, Ga, As, Rb, Sr, Ag, Cd, Sn, Cs, Au, Hg, Tl, Pb and U) were determined in 192 a priori selected blood donors (107 women and 85 men, aged 18-65 years), using inductively coupled plasma mass spectrometry (ICP-MS) with the Octopole Reaction System. Participants filled out a questionnaire, and RIs were established according to the Clinical and Laboratory Standards Institute (CLSI) guidelines for TEs. RESULTS Uniform RIs for non-essential and gender-specific for essential TEs in blood, plasma and erythrocytes were established. In our population, higher blood and plasma Cu, and erythrocyte Mn levels in women were found. In men, blood Zn, plasma Zn, Mn and Se, and erythrocyte Cu levels were higher. Zn levels were higher in 30-39 years age group. Pb and Sr increased with age. Smoking positively affected Cd, Pb, Cs and Rb; seafood consumption increased As, Hg and Zn; and amalgam increased Hg, Ag and Cu levels. CONCLUSIONS Essential TEs were inside recommended levels, and the non-essential ones were far below critical levels. Established RIs will provide an important foundation for clinical diagnostics, safety erythrocyte transfusions assessment, toxicology and epidemiological studies.
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Affiliation(s)
- Alenka France Štiglic
- Clinical Institute of Clinical Chemistry and Biochemistry, University Medical Centre Ljubljana, Ljubljana, Slovenia
| | - Ingrid Falnoga
- Department of Environmental Sciences, Jožef Stefan Institute, Ljubljana, Slovenia
| | - Alenka Sešek Briški
- Clinical Institute of Clinical Chemistry and Biochemistry, University Medical Centre Ljubljana, Ljubljana, Slovenia
| | - Marko Žavbi
- Clinical Institute of Clinical Chemistry and Biochemistry, University Medical Centre Ljubljana, Ljubljana, Slovenia
| | - Joško Osredkar
- Clinical Institute of Clinical Chemistry and Biochemistry, University Medical Centre Ljubljana, Ljubljana, Slovenia
- Faculty of Pharmacy, University of Ljubljana, Ljubljana, Slovenia
| | - Milan Skitek
- Clinical Institute of Clinical Chemistry and Biochemistry, University Medical Centre Ljubljana, Ljubljana, Slovenia
- Faculty of Pharmacy, University of Ljubljana, Ljubljana, Slovenia
| | - Janja Marc
- Clinical Institute of Clinical Chemistry and Biochemistry, University Medical Centre Ljubljana, Ljubljana, Slovenia
- Faculty of Pharmacy, University of Ljubljana, Ljubljana, Slovenia
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5
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Coşkun A, Carobene A, Demirelce O, Mussap M, Braga F, Sezer E, Aarsand AK, Sandberg S, Calle PF, Díaz-Garzón J, Erkaya M, Coskun C, Erol EN, Dağ H, Bartlett B, Serteser M, Jonker N, Unsal I. Sex-related differences in within-subject biological variation estimates for 22 essential and non-essential amino acids. Clin Chim Acta 2024; 552:117632. [PMID: 37940015 DOI: 10.1016/j.cca.2023.117632] [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: 11/02/2023] [Accepted: 11/04/2023] [Indexed: 11/10/2023]
Abstract
BACKGROUND Measurement of serum amino acid (AA) concentrations is important in particular for the diagnosis and monitoring of inborn errors of AA metabolism. To ensure optimal clinical interpretation of AAs, reliable biological variation (BV) data are essential. In the present study, we derived BV data for 22 non-essential, conditionally essential, and essential AAs and assessed differences in BV of AAs related to sex. METHODS Morning blood samples were drawn from 66 subjects (31 males and 35 females) once a week for 10 consecutive weeks. All samples were analyzed in duplicate using liquid chromatography-tandem mass-spectrometry. The data were assessed for outliers, trends, normality and variance homogeneity analysis prior to estimating within-subject (CVI) and between-subject (CVG) BV. RESULTS CVI estimates ranged from 9.0 % for histidine (male) to 33.0 % for taurine (male). CVI estimates in males and females were significantly different for all AAs except for aspartic acid, citrulline and phenylalanine, in most cases higher in females than in males. Apart from for arginine, CVG estimates in males and females were similar. CONCLUSIONS In this highly powered BV study, we provide updated BV estimates for 22 AAs and demonstrate that for most AAs, CVI estimates differ between males and females, with implications for interpretation and use of AAs in clinical practice.
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Affiliation(s)
- Abdurrahman Coşkun
- Acibadem Mehmet Ali Aydınlar University, School of Medicine, Department of Medical Biochemistry, Atasehir, Istanbul, Turkey; Acibadem Labmed Clinical Laboratories, Atasehir, Istanbul, Turkey; EFLM Working Group on Biological Variation, Milan, Italy; EFLM Task Group for the Biological Variation Database, Milan, Italy.
| | - Anna Carobene
- EFLM Working Group on Biological Variation, Milan, Italy; EFLM Task Group for the Biological Variation Database, Milan, Italy; Laboratory Medicine, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Ozlem Demirelce
- Acibadem Labmed Clinical Laboratories, Atasehir, Istanbul, Turkey
| | - Michele Mussap
- Laboratory Unit, Department of Surgical Sciences, University of Cagliari, Italy
| | - Federica Braga
- EFLM Working Group on Biological Variation, Milan, Italy; EFLM Task Group for the Biological Variation Database, Milan, Italy; Clinical Diagnostics Department, Laboratory Medicine Unit, ASST Bergamo Ovest, Treviglio, Bergamo, Italy
| | - Ebru Sezer
- EFLM Task Group for the Biological Variation Database, Milan, Italy; Ege University, School of Medicine, Department of Medicinal Biochemistry, Izmir, Turkey
| | - Aasne Karine Aarsand
- EFLM Working Group on Biological Variation, Milan, Italy; EFLM Task Group for the Biological Variation Database, Milan, Italy; Department of Medical Biochemistry and Pharmacology, Haukeland University Hospital, Bergen, Norway and Norwegian Organization for Quality Improvement of Laboratory Examinations (NOKLUS), Haraldsplass Deaconess Hospital, Bergen, Norway
| | - Sverre Sandberg
- EFLM Working Group on Biological Variation, Milan, Italy; EFLM Task Group for the Biological Variation Database, Milan, Italy; Norwegian Organization for Quality Improvement of Laboratory Examinations (NOKLUS), Haraldsplass Deaconess Hospital, Bergen, Norway and Department of Global Health and Primary Care, Faculty of Medicine, University of Bergen, Bergen, Norway
| | - Pilar Fernández Calle
- EFLM Working Group on Biological Variation, Milan, Italy; EFLM Task Group for the Biological Variation Database, Milan, Italy; Department of Laboratory Medicine, La Paz University Hospital, Madrid, Spain; and Analytical Quality Commission, Spanish Society of Laboratory Medicine (SEQCML), Barcelona, Spain
| | - Jorge Díaz-Garzón
- EFLM Working Group on Biological Variation, Milan, Italy; EFLM Task Group for the Biological Variation Database, Milan, Italy; Department of Laboratory Medicine, La Paz University Hospital, Madrid, Spain; and Analytical Quality Commission, Spanish Society of Laboratory Medicine (SEQCML), Barcelona, Spain
| | - Metincan Erkaya
- Acibadem Mehmet Ali Aydınlar University, School of Medicine, Atasehir, Istanbul, Turkey
| | - Cihan Coskun
- Department of Medical Biochemistry, Basaksehir Cam and Sakura City Hospital, Basaksehir, Istanbul, Turkey
| | - Esila Nur Erol
- Department of Laboratory Medicine, La Paz University Hospital, Madrid, Spain; and Analytical Quality Commission, Spanish Society of Laboratory Medicine (SEQCML), Barcelona, Spain
| | - Hunkar Dağ
- Acibadem Mehmet Ali Aydınlar University, School of Medicine, Atasehir, Istanbul, Turkey
| | - Bill Bartlett
- EFLM Working Group on Biological Variation, Milan, Italy; EFLM Task Group for the Biological Variation Database, Milan, Italy; School of Science and Engineering, University of Dundee, Dundee, UK
| | - Mustafa Serteser
- Acibadem Mehmet Ali Aydınlar University, School of Medicine, Department of Medical Biochemistry, Atasehir, Istanbul, Turkey; Acibadem Labmed Clinical Laboratories, Atasehir, Istanbul, Turkey
| | - Niels Jonker
- EFLM Working Group on Biological Variation, Milan, Italy; EFLM Task Group for the Biological Variation Database, Milan, Italy; Certe, Wilhelmina Ziekenhuis Assen, Assen, The Netherlands
| | - Ibrahim Unsal
- Acibadem Labmed Clinical Laboratories, Atasehir, Istanbul, Turkey
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6
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Carobene A, Maiese K, Abou-Diwan C, Locatelli M, Serteser M, Coskun A, Unsal I. Biological variation estimates for serum neurofilament light chain in healthy subjects. Clin Chim Acta 2023; 551:117608. [PMID: 37844678 DOI: 10.1016/j.cca.2023.117608] [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: 09/06/2023] [Revised: 10/11/2023] [Accepted: 10/13/2023] [Indexed: 10/18/2023]
Abstract
OBJECTIVES Neurofilament light chain (NfL) is an emerging biomarker of neurodegeneration disorders. Knowledge of the biological variation (BV) can facilitate proper interpretation between serial measurements. Here BV estimates for serum NfL (sNfL) are provided. METHODS Serum samples were collected weekly from 24 apparently healthy subjects for 10 consecutive weeks and analyzed in duplicate using the Siemens Healthineers sNfL assay on the Atellica® IM Analyzer. Outlier detection, variance homogeneity analyses, and trend analysis were performed followed by CV-ANOVA to determine BV and analytical variation (CVA) estimates with 95%CI and the associated reference change values (RCV) and analytical performance specifications (APS). RESULTS Despite observed differences in sNfL concentrations between males and females, BV estimates remained consistent across genders. Both within-subject BV (CVI) for males (10.7%, 95%CI; 9.2-12.6) and females (9.1%, 95%CI; 7.8-10.9) and between-subject BV (CVG) for males (26.1%, 95%CI; 18.0-45.6) and females (30.2%, 95%CI; 20.9-53.5) were comparable. An index of individuality value of 0.33 highlights significant individuality, indicating the potential efficacy of personalized reference intervals in patient monitoring. CONCLUSIONS The established BV estimates for sNfL underscore its potential as a valuable biomarker for monitoring neurodegenerative diseases, offering a foundation for improved decision-making in clinical settings.
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Affiliation(s)
- Anna Carobene
- Laboratory Medicine, IRCCS San Raffaele Scientific Institute, Milan, Italy.
| | | | | | - Massimo Locatelli
- Laboratory Medicine, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Mustafa Serteser
- Acibadem Mehmet Ali Aydınlar University, School of Medicine, Atasehir, Istanbul, Turkey
| | - Abdurrahman Coskun
- Acibadem Mehmet Ali Aydınlar University, School of Medicine, Atasehir, Istanbul, Turkey
| | - Ibrahim Unsal
- Acibadem Mehmet Ali Aydınlar University, School of Medicine, Atasehir, Istanbul, Turkey
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7
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Ozkanay H, Arslan FD, Narin F, Koseoglu MH. Biological variation of plasma 25-Hydroxyvitamin D 3, Serum vitamin B12, folate and ferritin in Turkish healthy subject. Scand J Clin Lab Invest 2023; 83:509-518. [PMID: 37961767 DOI: 10.1080/00365513.2023.2278537] [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: 06/13/2023] [Accepted: 10/30/2023] [Indexed: 11/15/2023]
Abstract
Biological variation (BV) plays a crucial role in determining analytical performance specifications, assessing serial measurements of individuals, and establishing the use of population-based reference intervals. Our study aimed to calculate the BV and BV-based quality goals of 25-hydroxyvitamin D3 (25-OH D3), ferritin, folate and vitamin B12 tests. We included a total of 22 apparently healthy volunteers (9 women and 13 men) aged 18-55 years in the study that we conducted in Turkey. Blood samples were collected from the participants once a week for five weeks. Serum ferritin, folate and vitamin B12 levels were measured using immunochemical method, while plasma 25-OH D3 levels were determined using the high-performance liquid chromatography method. Analysis of variance (ANOVA) was used to estimate analytical variation(CVA), within-subject BV(CVI) and between-subject BV(CVG). The individuality index (II) and reference change value (RCV) were calculated based on these data. The CVI of 25-OH D3, ferritin, folate, and vitamin B12 were found to be 1.8% (0.6%-2.5%), 16.9% (14.4%-20.2%), 10.7% (9.2%-12.7%), and 8.6% (6.8%-10.5%), respectively. CVG were 44.2% (34.3%-69.9%), 132% (87.7%-238%), 19.4% (14.4%-28.8%), and 39.6% (29.8%-59.0%) for the same biomarkers, while CVA were 3.2% (2.81%-3.71%), 3.5% (3.1%-4.1%), 4.0% (3.5%-4.6%), and 7.5% (6.6%-8.6%), respectively. The II values for 25-OH D3, ferritin, folate, and vitamin B12 were calculated as 0.04, 0.13, 0.55, and 0.22, respectively. The RCV were 10.2%, 47.8%, 31.7%, and 31.6%, respectively. Because the tests analyzed in this study exhibit high individuality, RCV should be preferred rather than population-based reference ranges in clinical interpretation of results.
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Affiliation(s)
- Hayat Ozkanay
- Department of Medical Biochemistry, Katip Celebi University, Izmir, Turkey
| | | | - Figen Narin
- Department of Medical Biochemistry, Katip Celebi University, Izmir, Turkey
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8
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Lippi G, Plebani M. Clinical Chemistry and laboratory medicine: enjoying the present and assessing the future. Clin Chem Lab Med 2022; 60:1313-1315. [PMID: 35822713 DOI: 10.1515/cclm-2022-0627] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Affiliation(s)
- Giuseppe Lippi
- Section of Clinical Biochemistry and School of Medicine, University of Verona, Verona, Italy
| | - Mario Plebani
- Department of Medicine-DIMED, University of Padova, Padova, Italy
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9
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Sandberg S, Carobene A, Aarsand AK. Biological variation - eight years after the 1st Strategic Conference of EFLM. Clin Chem Lab Med 2022; 60:465-468. [PMID: 35138052 DOI: 10.1515/cclm-2022-0086] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Affiliation(s)
- Sverre Sandberg
- Norwegian Organization for Quality Improvement of Laboratory Examinations (Noklus), Haraldsplass Deaconess Hospital, Bergen, Norway.,Department of Medical Biochemistry and Pharmacology, Norwegian Porphyria Centre, Haukeland University Hospital, Bergen, Norway.,Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway
| | - Anna Carobene
- Laboratory Medicine, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Aasne K Aarsand
- Norwegian Organization for Quality Improvement of Laboratory Examinations (Noklus), Haraldsplass Deaconess Hospital, Bergen, Norway.,Department of Medical Biochemistry and Pharmacology, Norwegian Porphyria Centre, Haukeland University Hospital, Bergen, Norway
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Coşkun A, Aarsand AK, Braga F, Carobene A, Díaz-Garzón J, Fernandez-Calle P, Jonker N, Lao EG, Marques-Garcia F, Sandberg S. Systematic review and meta-analysis of within-subject and between-subject biological variation estimates of serum Zinc, Copper and Selenium. Clin Chem Lab Med 2021; 60:479-482. [PMID: 34225400 DOI: 10.1515/cclm-2021-0723] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2021] [Accepted: 06/24/2021] [Indexed: 11/15/2022]
Affiliation(s)
- Abdurrahman Coşkun
- Department of Medical Biochemistry Atasehir, School of Medicine, Acibadem Mehmet Ali Aydınlar University, Istanbul, Turkey
| | - Aasne K Aarsand
- Department of Medical Biochemistry and Pharmacology, Norwegian Porphyria Centre (NAPOS), Haukeland University Hospital, Bergen, Norway.,Norwegian Organization for Quality Improvement of Laboratory Examinations (NOKLUS), Haraldsplass Deaconess Hospital, Bergen, Norway
| | - Federica Braga
- Research Centre for Metrological Traceability in Laboratory Medicine (CIRME), University of Milan, Milan, Italy
| | - Anna Carobene
- Laboratory Medicine, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Jorge Díaz-Garzón
- Department of Laboratory Medicine, La Paz University Hospital, Madrid, Spain.,Analytical Quality Commission, Spanish Society of Laboratory Medicine (SEQCML), Barcelona, Spain
| | - Pilar Fernandez-Calle
- Department of Laboratory Medicine, La Paz University Hospital, Madrid, Spain.,Analytical Quality Commission, Spanish Society of Laboratory Medicine (SEQCML), Barcelona, Spain
| | - Niels Jonker
- Certe, Wilhelmina Ziekenhuis Assen, Assen, The Netherlands
| | - Elisabet Gonzalez Lao
- Analytical Quality Commission, Spanish Society of Laboratory Medicine (SEQCML), Barcelona, Spain.,Quality Healthcare Consulting, Grupo ACMS, Madrid, Spain
| | - Fernando Marques-Garcia
- Analytical Quality Commission, Spanish Society of Laboratory Medicine (SEQCML), Barcelona, Spain.,Clinical Biochemistry Department, Metropolitan North Clinical Laboratory (LUMN), Germans Trias i Pujol University Hospital, Badalona, Barcelona, Spain
| | - Sverre Sandberg
- Department of Medical Biochemistry and Pharmacology, Norwegian Porphyria Centre (NAPOS), Haukeland University Hospital, Bergen, Norway.,Norwegian Organization for Quality Improvement of Laboratory Examinations (NOKLUS), Haraldsplass Deaconess Hospital, Bergen, Norway.,Department of Global Health and Primary Care, Faculty of Medicine, University of Bergen, Bergen, Norway
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