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Cowper B, Lyle AN, Vesper HW, Van Uytfanghe K, Burns C. Standardisation and harmonisation of thyroid-stimulating hormone measurements: historical, current, and future perspectives. Clin Chem Lab Med 2024; 62:824-829. [PMID: 38295422 DOI: 10.1515/cclm-2023-1332] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2023] [Accepted: 01/18/2024] [Indexed: 02/02/2024]
Abstract
Thyroid-stimulating hormone (TSH) is an important clinical marker in the diagnosis and management of thyroid disease. TSH measurements are reported in milli-International Units per Litre (mIU/L), traceable to a World Health Organisation (WHO) reference material. There is a wide variety of commercial immunoassays for TSH measurements available, which have historically been poorly harmonised due to a lack of commutability of the WHO reference materials with patient samples. This led to the recent development of a serum-based reference panel for TSH, traceable to the WHO reference material, available via the International Federation for Clinical Chemistry and Laboratory Medicine (IFCC), aimed at harmonisation of TSH immunoassays. This report describes recent developments in the TSH reference system, including establishment of the 4th WHO International Standard for TSH, and aims to clarify the relationship between the available reference materials and their intended uses. This 4th WHO IS is widely available and defines the unit of TSH activity, therefore its continued existence is of paramount importance, however it continues to show a lack of commutability with patient in many TSH immunoassays. This makes the C-STFT TSH panel, albeit available in restricted numbers, a critical resource to ensure better TSH assay harmonisation.
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Affiliation(s)
- Ben Cowper
- Medicines and Healthcare Products Regulatory Agency (MHRA), South Mimms, Hertfordshire, UK
| | - Alicia N Lyle
- Centers for Disease Control and Prevention, Division of Laboratory Sciences, Atlanta, GA, USA
| | - Hubert W Vesper
- Centers for Disease Control and Prevention, Division of Laboratory Sciences, Atlanta, GA, USA
| | | | - Chris Burns
- Medicines and Healthcare Products Regulatory Agency (MHRA), South Mimms, Hertfordshire, UK
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2
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van Rossum HH, Holdenrieder S, Ballieux BEPB, Badrick TC, Yun YM, Zhang C, Patel D, Thelen M, Song J, Wojtalewicz N, Unsworth N, Vesper HW, Cui W, Ramanathan LV, Sturgeon C, Meng QH. Investigating the Current Harmonization Status of Tumor Markers Using Global External Quality Assessment Programs: A Feasibility Study. Clin Chem 2024; 70:669-679. [PMID: 38385453 DOI: 10.1093/clinchem/hvae005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2023] [Accepted: 12/11/2023] [Indexed: 02/23/2024]
Abstract
BACKGROUND The harmonization status of most tumor markers (TMs) is unknown. We report a feasibility study performed to determine whether external quality assessment (EQA) programs can be used to obtain insights into the current harmonization status of the tumor markers α-fetoprotein (AFP), prostate specific antigen (PSA), carcinoembryonic antigen (CEA), cancer antigen (CA)125, CA15-3 and CA19-9. METHODS EQA sample results provided by 6 EQA providers (INSTAND [Germany], Korean Association of External Quality Assessment Service [KEQAS, South Korea], National Center for Clinical Laboratories [NCCL, China], United Kingdom National External Quality Assessment Service [UK NEQAS, United Kingdom], Stichting Kwaliteitsbewaking Medische Laboratoriumdiagnostiek [SKML, the Netherlands], and the Royal College of Pathologists of Australasia Quality Assurance Programs [RCPAQAP, Australia]) between 2020 and 2021 were used. The consensus means, calculated from the measurement procedures present in all EQA programs (Abbott Alinity, Beckman Coulter DxI, Roche Cobas, and Siemens Atellica), was used as reference values. Per measurement procedure, the relative difference between consensus mean for each EQA sample and the mean of all patient-pool-based EQA samples were calculated and compared to minimum, desirable, and optimal allowable bias criteria based on biological variation. RESULTS Between 19040 (CA15-3) and 25398 (PSA) individual results and 56 (PSA) to 76 (AFP) unique EQA samples were included in the final analysis. The mean differences with the consensus mean of patient-pool-based EQA samples for all measurement procedures were within the optimum bias criterion for AFP, the desirable bias for PSA, and the minimum bias criterion for CEA. However, CEA results <8 µg/L exceeded the minimum bias criterion. For CA125, CA15-3, and CA19-9, the harmonization status was outside the minimum bias criterion, with systematic differences identified. CONCLUSIONS This study provides relevant information about the current harmonization status of 6 tumor markers. A pilot harmonization investigation for CEA, CA125, CA15-3, and CA19-9 would be desirable.
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Affiliation(s)
- Huub H van Rossum
- Department of Laboratory Medicine, Netherlands Cancer Institute, Amsterdam, the Netherlands
| | - Stefan Holdenrieder
- Institute of Laboratory Medicine, Munich Biomarker Research Center, Deutsches Herzzentrum München, Technische Universität München, Munich, Germany
- INSTAND e.V., Society for Promoting Quality Assurance in Medical Laboratories, Duesseldorf, Germany
| | - Bart E P B Ballieux
- Department of Clinical Chemistry, Leiden University Medical Center, Leiden, the Netherlands
| | - Tony C Badrick
- RCPA Quality Assurance Programs, St Leonards, Sydney, Australia
| | - Yeo-Min Yun
- Department of Laboratory Medicine, Konkuk University Medical Center, Seoul, South Korea
| | - Chuanbao Zhang
- National Center for Clinical Laboratories, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing Hospital/National Center of Gerontology, Beijing, China
| | - Dina Patel
- UK NEQAS Immunology, Immunochemistry & Allergy, Northern General Hospital, Sheffield, United Kingdom
| | - Marc Thelen
- SKML, Nijmegen, the Netherlands
- Department of Laboratory Medicine of the Radboud University Medical Center, Nijmegen, the Netherlands
| | - Junghan Song
- Department of Laboratory Medicine, Seoul National University Bundang Hospital and College of Medicine, Seongnam, South Korea
| | - Nathalie Wojtalewicz
- INSTAND e.V., Society for Promoting Quality Assurance in Medical Laboratories, Duesseldorf, Germany
| | - Nick Unsworth
- UK NEQAS [Edinburgh], Department of Laboratory Medicine, Royal Infirmary of Edinburgh, Edinburgh, United Kingdom
| | - Hubert W Vesper
- Division of Laboratory Sciences, National Center for Environmental Health, Centers for Disease Control and Prevention, Atlanta, GA, United States
| | - Wei Cui
- Department of Laboratory Medicine, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Lakshmi V Ramanathan
- Clinical Chemistry Service, Department of Laboratory Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, United States
| | - Catharine Sturgeon
- UK NEQAS [Edinburgh], Department of Laboratory Medicine, Royal Infirmary of Edinburgh, Edinburgh, United Kingdom
| | - Qing H Meng
- Department of Laboratory Medicine, Division of Pathology and Laboratory Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX, United States
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3
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Lyle AN, Budd JR, Kennerley VM, Smith BN, Danilenko U, Pfeiffer CM, Vesper HW. Assessment of WHO 07/202 reference material and human serum pools for commutability and for the potential to reduce variability among soluble transferrin receptor assays. Clin Chem Lab Med 2023; 61:1719-1729. [PMID: 37071928 DOI: 10.1515/cclm-2022-1198] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2022] [Accepted: 04/04/2023] [Indexed: 04/20/2023]
Abstract
OBJECTIVES The clinical use of soluble transferrin receptor (sTfR) as an iron status indicator is hindered by a lack of assay standardization and common reference ranges and decision thresholds. In 2009, the WHO and National Institute for Biological Standards and Controls (NIBSC) released a sTfR reference material (RM), 07/202, for assay standardization; however, a comprehensive, formal commutability study was not conducted. METHODS This study evaluated the commutability of WHO 07/202 sTfR RM and human serum pools and the impacts of their use as common calibrators. Commutability was assessed for six different measurement procedures (MPs). Serum pools were prepared according to updated CLSI C37-A procedures (C37) or non-C37 procedures. The study design and analyses were based on Parts 2 and 3 of the 2018 IFCC Commutability in Metrological Traceability Working Group's Recommendations for Commutability Assessment. WHO 07/202 and serum pools were used for instrument/assay and mathematical recalibration, respectively, to determine if their use decreases inter-assay measurement variability for clinical samples. RESULTS The WHO 07/202 RM dilutions were commutable for all 6 MPs assessed and, when used for instrument calibration, decreased inter-assay variability from 208 to 55.7 %. Non-C37 and C37 serum pools were commutable for all 6 MPs assessed and decreased inter-assay variability from 208 to 13.8 % and 4.6 %, respectively, when used for mathematical recalibration. CONCLUSIONS All materials evaluated, when used as common calibrators, substantially decreased inter-assay sTfR measurement variability. MP calibration to non-C37 and C37 serum pools may reduce the sTfR IMPBR to a greater extent than WHO 07/202 RM.
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Affiliation(s)
- Alicia N Lyle
- Division of Laboratory Sciences, National Center for Environmental Health, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | | | - Victoria M Kennerley
- Division of Laboratory Sciences, National Center for Environmental Health, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | | | - Uliana Danilenko
- Division of Laboratory Sciences, National Center for Environmental Health, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Christine M Pfeiffer
- Division of Laboratory Sciences, National Center for Environmental Health, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Hubert W Vesper
- Division of Laboratory Sciences, National Center for Environmental Health, Centers for Disease Control and Prevention, Atlanta, GA, USA
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Jansen HI, van der Steen R, Brandt A, Olthaar AJ, Vesper HW, Shimizu E, Heijboer AC, Van Uytfanghe K, van Herwaarden AE. Description and validation of an equilibrium dialysis ID-LC-MS/MS candidate reference measurement procedure for free thyroxine in human serum. Clin Chem Lab Med 2023; 61:1605-1611. [PMID: 36994743 DOI: 10.1515/cclm-2022-1134] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2022] [Accepted: 03/15/2023] [Indexed: 03/31/2023]
Abstract
OBJECTIVES Free thyroxine (FT4) in serum is routinely measured in clinical practice to diagnose and monitor thyroid disease. Due to its concentration in picomolar range and the delicate equilibrium of free and protein-bound T4, accurate measurement is challenging. As a consequence, large inter-method differences in FT4 results exists. Optimal method design and standardization of the FT4 measurement is therefore necessary. The IFCC Working Group for Standardization of Thyroid Function Tests proposed a reference system with a conventional reference measurement procedure (cRMP) for FT4 in serum. In this study, we describe our FT4 candidate cRMP and its validation in clinical samples. METHODS This candidate cRMP is based on equilibrium dialysis (ED) combined with determination of T4 with an isotope-dilution liquid chromatography tandem mass-spectrometry (ID-LC-MS/MS) procedure and was developed according to the endorsed conventions. Its accuracy, reliability, and comparability was investigated using human sera. RESULTS It was shown that the candidate cRMP adhered to the conventions and its accuracy, precision, and robustness were adequate in serum of healthy volunteers. CONCLUSIONS Our candidate cRMP measures FT4 accurately and performs well in serum matrix.
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Affiliation(s)
- Heleen I Jansen
- Department of Clinical Chemistry, Endocrine Laboratory, Amsterdam UMC Location Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
- Department of Clinical Chemistry, Endocrine Laboratory, Amsterdam UMC Location University of Amsterdam, Amsterdam, The Netherlands
- Amsterdam Gastroenterology Endocrinology & Metabolism, Amsterdam, The Netherlands
| | - Rob van der Steen
- Department of Laboratory Medicine, Radboud University Medical Center, Nijmegen, The Netherlands
| | - André Brandt
- Department of Laboratory Medicine, Radboud University Medical Center, Nijmegen, The Netherlands
| | - André J Olthaar
- Department of Laboratory Medicine, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Hubert W Vesper
- Division of Laboratory Sciences, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Eri Shimizu
- Reference Material Institute for Clinical Chemistry Standards, Yokohama, Kanagawa, Japan
| | - Annemieke C Heijboer
- Department of Clinical Chemistry, Endocrine Laboratory, Amsterdam UMC Location Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
- Department of Clinical Chemistry, Endocrine Laboratory, Amsterdam UMC Location University of Amsterdam, Amsterdam, The Netherlands
- Amsterdam Gastroenterology Endocrinology & Metabolism, Amsterdam, The Netherlands
- Amsterdam Reproduction & Development Research Institute, Amsterdam, The Netherlands
| | - Katleen Van Uytfanghe
- Department of Bioanalysis, Faculty of Pharmaceutical Sciences, Laboratory of Toxicology, Ref4U, Ghent University, Ghent, Belgium
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Ribera A, Zhang L, Ribeiro C, Vazquez N, Thonkulpitak J, Botelho JC, Danilenko U, van Uytfanghe K, Vesper HW. Practical considerations for accurate determination of free thyroxine by equilibrium dialysis. J Mass Spectrom Adv Clin Lab 2023; 29:9-15. [PMID: 37449264 PMCID: PMC10336244 DOI: 10.1016/j.jmsacl.2023.06.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2022] [Revised: 05/17/2023] [Accepted: 06/20/2023] [Indexed: 07/18/2023] Open
Abstract
Background Free thyroxine (FT4) measurement is one of the most requested tests in patient care for diagnosing and treating thyroid-related illnesses. Equilibrium dialysis (ED) is considered the "gold standard" for FT4 measurement; however, several factors have a profound effect on the reliability of FT4 assays and require special consideration. Methods In the current study, we focused on evaluating critical factors that could contribute to reporting errors, such as adsorption of thyroxine (T4) to labware surfaces, stability of serum samples, stock solutions, and calibrator storage conditions, as well as the solvents used to prepare T4 solutions. Results The adsorption of T4 in ethanolic solutions and dialysates to labware surfaces can be reduced with the careful selection of pipette tips, test tubes, and 96-well plates. Adding pH modifiers to neat T4 solutions can improve its stability. FT4 in serum samples remains stable after exposure to four freeze-thaw cycles, 5 °C for 18-20 h, or -70 °C for a minimum of three years. Conclusion The presented study has demonstrated that the loss of analyte due to pre-analytical and analytical factors during operation of the FT4 reference measurement procedure (RMP) can be minimized by careful selection of all labware for sample preparation. It was found that the accuracy and imprecision of FT4 assays can be influenced by different types of dialysis devices, but acceptable alternatives to ED membranes were identified. This study demonstrates approaches to establish a FT4 method that is independent from specific suppliers and addresses critical pre-analytical and analytical factors important for FT4 measurements.
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Affiliation(s)
- Ashley Ribera
- Division of Laboratory Sciences, National Center for Environmental Health, Centers for Disease Control and Prevention, Atlanta, GA, United States
| | - Li Zhang
- Division of Laboratory Sciences, National Center for Environmental Health, Centers for Disease Control and Prevention, Atlanta, GA, United States
| | - Carla Ribeiro
- Ref4U, Laboratory of Toxicology, Faculty of Pharmaceutical Sciences, Ghent University, Ghent, Belgium
| | - Norma Vazquez
- Battelle Memorial Institute, Atlanta, GA, United States
| | | | - Julianne C. Botelho
- Division of Laboratory Sciences, National Center for Environmental Health, Centers for Disease Control and Prevention, Atlanta, GA, United States
| | - Uliana Danilenko
- Division of Laboratory Sciences, National Center for Environmental Health, Centers for Disease Control and Prevention, Atlanta, GA, United States
| | - Katleen van Uytfanghe
- Ref4U, Laboratory of Toxicology, Faculty of Pharmaceutical Sciences, Ghent University, Ghent, Belgium
| | - Hubert W. Vesper
- Division of Laboratory Sciences, National Center for Environmental Health, Centers for Disease Control and Prevention, Atlanta, GA, United States
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Ribera A, Zhang L, Dabbs-Brown A, Sugahara O, Poynter K, van Uytfanghe K, Shimizu E, van Herwaarden AE, Botelho JC, Danilenko U, Vesper HW. Development of an equilibrium dialysis ID-UPLC-MS/MS candidate reference measurement procedure for free thyroxine in human serum. Clin Biochem 2023; 116:42-51. [PMID: 36940844 PMCID: PMC10996286 DOI: 10.1016/j.clinbiochem.2023.03.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2022] [Revised: 03/14/2023] [Accepted: 03/16/2023] [Indexed: 03/23/2023]
Abstract
BACKGROUND Accurate and reliable measurement of human serum free thyroxine (FT4) is critical for the diagnosis and treatment of thyroid diseases. However, concerns have been raised regarding the performance of FT4 measurements in patient care. Centers for Disease Control and Prevention Clinical Standardization Programs (CDC-CSP) address these concerns by creating a FT4 standardization program to standardize FT4 measurements. The study aims to develop a highly accurate and precise candidate Reference Measurement Procedure (cRMP), as one key component of CDC-CSP, for standardization of FT4 measurements. METHODS Serum FT4 was separated from protein-bound thyroxine with equilibrium dialysis (ED) following the recommended conditions in the Clinical and Laboratory Standards Institute C45-A guideline and the published RMP [20,21,23]. FT4 in dialysate was directly quantified with liquid chromatography-tandem mass spectrometry (LC-MS/MS) without derivatization. Gravimetric measurements of specimens and calibrator solutions, calibrator bracketing, isotope dilution, enhanced chromatographic resolution, and T4 specific mass transitions were used to ensure the accuracy, precision, and specificity of the cRMP. RESULTS The described cRMP agreed well with the established RMP and two other cRMPs in an interlaboratory comparison study. The mean biases of each method to the overall laboratory mean were within ±2.5%. The intra-day, inter-day, and total imprecision for the cRMP were within 4.4%. The limit of detection was 0.90 pmol/L, which was sufficiently sensitive to determine FT4 for patients with hypothyroidism. The structural analogs of T4 and endogenous components in dialysate did not interfere with the measurements. CONCLUSION Our ED-LC-MS/MS cRMP provides high accuracy, precision, specificity, and sensitivity for FT4 measurement. The cRMP can serve as a higher-order standard for establishing measurement traceability and provide an accuracy base for the standardization of FT4 assays.
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Affiliation(s)
- Ashley Ribera
- Division of Laboratory Sciences, National Center for Environmental Health, Centers for Disease Control and Prevention, 4770 Buford Hwy NE, Atlanta, GA, 30341, United States
| | - Li Zhang
- Division of Laboratory Sciences, National Center for Environmental Health, Centers for Disease Control and Prevention, 4770 Buford Hwy NE, Atlanta, GA, 30341, United States.
| | - Amonae Dabbs-Brown
- Division of Laboratory Sciences, National Center for Environmental Health, Centers for Disease Control and Prevention, 4770 Buford Hwy NE, Atlanta, GA, 30341, United States
| | - Otoe Sugahara
- Division of Laboratory Sciences, National Center for Environmental Health, Centers for Disease Control and Prevention, 4770 Buford Hwy NE, Atlanta, GA, 30341, United States
| | - Krista Poynter
- Division of Laboratory Sciences, National Center for Environmental Health, Centers for Disease Control and Prevention, 4770 Buford Hwy NE, Atlanta, GA, 30341, United States
| | - Katleen van Uytfanghe
- Ref4U-Laboratory of Toxicology, Department of Bioanalysis, Faculty of Pharmaceutical Sciences, Ghent University, Ghent, Belgium
| | - Eri Shimizu
- Reference Material Institute for Clinical Chemistry Standards, Yokohama, Kanagawa, Japan
| | | | - Julianne C Botelho
- Division of Laboratory Sciences, National Center for Environmental Health, Centers for Disease Control and Prevention, 4770 Buford Hwy NE, Atlanta, GA, 30341, United States
| | - Uliana Danilenko
- Division of Laboratory Sciences, National Center for Environmental Health, Centers for Disease Control and Prevention, 4770 Buford Hwy NE, Atlanta, GA, 30341, United States
| | - Hubert W Vesper
- Division of Laboratory Sciences, National Center for Environmental Health, Centers for Disease Control and Prevention, 4770 Buford Hwy NE, Atlanta, GA, 30341, United States
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7
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Ruhaak LR, Romijn FPHTM, Begcevic Brkovic I, Kuklenyik Z, Dittrich J, Ceglarek U, Hoofnagle AN, Althaus H, Angles-Cano E, Coassin S, Delatour V, Deprez L, Dikaios I, Kostner GM, Kronenberg F, Lyle A, Prinzing U, Vesper HW, Cobbaert CM. Development of an LC-MRM-MS-Based Candidate Reference Measurement Procedure for Standardization of Serum Apolipoprotein (a) Tests. Clin Chem 2023; 69:251-261. [PMID: 36644914 DOI: 10.1093/clinchem/hvac204] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2022] [Accepted: 11/02/2022] [Indexed: 01/17/2023]
Abstract
BACKGROUND Medical results generated by European CE Marking for In Vitro Diagnostic or in-house tests should be traceable to higher order reference measurement systems (RMS), such as International Federation of Clinical Chemistry and Laboratory Medicine (IFCC)-endorsed reference measurement procedures (RMPs) and reference materials. Currently, serum apolipoprotein (a) [apo(a)] is recognized as a novel risk factor for cardiovascular risk assessment and patient management. The former RMS for serum apo(a) is no longer available; consequently, an International System of Units (SI)-traceable, ideally multiplexed, and sustainable RMS for apo(a) is needed. METHODS A mass spectrometry (MS)-based candidate RMP (cRMP) for apo(a) was developed using quantitative bottom-up proteomics targeting 3 proteotypic peptides. The method was provisionally validated according to ISO 15193 using a single human serum based calibrator traceable to the former WHO-IFCC RMS. RESULTS The quantitation of serum apo(a) was by design independent of its size polymorphism, was linear from 3.8 to 456 nmol/L, and had a lower limit of quantitation for apo(a) of 3.8 nmol/L using peptide LFLEPTQADIALLK. Interpeptide agreement showed Pearson Rs of 0.987 and 0.984 for peptides GISSTVTGR and TPENYPNAGLTR, and method comparison indicated good correspondence (slopes 0.977, 1.033, and 1.085 for LFLEPTQADIALLK, GISSTVTGR, and TPENYPNAGLTR). Average within-laboratory imprecision of the cRMP was 8.9%, 11.9%, and 12.8% for the 3 peptides. CONCLUSIONS A robust, antibody-independent, MS-based cRMP was developed as higher order RMP and an essential part of the apo(a) traceability chain and future RMS. The cRMP fulfils predefined analytical performance specifications, making it a promising RMP candidate in an SI-traceable MS-based RMS for apo(a).
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Affiliation(s)
- L Renee Ruhaak
- Department of Clinical Chemistry and Laboratory Medicine, Leiden University Medical Center, Leiden, The Netherlands
| | - Fred P H T M Romijn
- Department of Clinical Chemistry and Laboratory Medicine, Leiden University Medical Center, Leiden, The Netherlands
| | - Ilijana Begcevic Brkovic
- Institute of Laboratory Medicine, Clinical Chemistry and Molecular Diagnostics, University Hospital Leipzig, Leipzig, Germany
| | - Zsusanna Kuklenyik
- Division of Laboratory Sciences, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Julia Dittrich
- Institute of Laboratory Medicine, Clinical Chemistry and Molecular Diagnostics, University Hospital Leipzig, Leipzig, Germany
| | - Uta Ceglarek
- Institute of Laboratory Medicine, Clinical Chemistry and Molecular Diagnostics, University Hospital Leipzig, Leipzig, Germany
- Division Clinical Mass Spectrometry of the German Society of Clinical Chemistry and Laboratory Medicine (DGKL), Berlin, Germany
| | - Andrew N Hoofnagle
- Department of Laboratory Medicine and Pathology, University of Washington, Seattle, WA, USA
| | - Harald Althaus
- Siemens Healthcare Diagnostics Products GmbH, Marburg, Germany
| | - Eduardo Angles-Cano
- French Institute of Health and Medical Research (Inserm), Université Paris Descartes, Paris, France
| | - Stefan Coassin
- Department of Genetics and Pharmacology, Institute of Genetic Epidemiology, Medical University of Innsbruck, Innsbruck, Austria
| | | | - Liesbet Deprez
- European Commission, Joint Research Centre, Geel, Belgium
| | | | - Gerhard M Kostner
- Division of Molecular Biology and Biochemistry, Gottfried Schatz Research Center (for Cell Signaling, Metabolism and Aging), Medical University of Graz, Graz, Austria
| | - Florian Kronenberg
- Department of Genetics and Pharmacology, Institute of Genetic Epidemiology, Medical University of Innsbruck, Innsbruck, Austria
| | - Alicia Lyle
- Division of Laboratory Sciences, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | | | - Hubert W Vesper
- Division of Laboratory Sciences, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Christa M Cobbaert
- Department of Clinical Chemistry and Laboratory Medicine, Leiden University Medical Center, Leiden, The Netherlands
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8
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Dikaios I, Althaus H, Angles-Cano E, Ceglarek U, Coassin S, Cobbaert CM, Delatour V, Dieplinger B, Grimmler M, Hoofnagle AN, Kostner GM, Kronenberg F, Kuklenyik Z, Lyle AN, Prinzing U, Ruhaak LR, Scharnagl H, Vesper HW, Deprez L. Commutability Assessment of Candidate Reference Materials for Lipoprotein(a) by Comparison of a MS-based Candidate Reference Measurement Procedure with Immunoassays. Clin Chem 2023; 69:262-272. [PMID: 36644921 DOI: 10.1093/clinchem/hvac203] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2022] [Accepted: 11/02/2022] [Indexed: 01/17/2023]
Abstract
BACKGROUND Elevated concentrations of lipoprotein(a) [Lp(a)] are directly related to an increased risk of cardiovascular diseases, making it a relevant biomarker for clinical risk assessment. However, the lack of global standardization of current Lp(a) measurement procedures (MPs) leads to inconsistent patient care. The International Federation for Clinical Chemistry and Laboratory Medicine working group on quantitating apolipoproteins by mass spectrometry (MS) aims to develop a next-generation SI (International system of units)-traceable reference measurement system consisting of a MS-based, peptide-calibrated reference measurement procedure (RMP) and secondary serum-based reference materials (RMs) certified for their apolipoprotein(a) [apo(a)] content. To reach measurement standardization through this new measurement system, 2 essential requirements need to be fulfilled: a sufficient correlation among the MPs and appropriate commutability of future serum-based RMs. METHODS The correlation among the candidate RMP (cRMP) and immunoassay-based MPs was assessed by measuring a panel of 39 clinical samples (CS). In addition, the commutability of 14 different candidate RMs was investigated. RESULTS Results of the immunoassay-based MPs and the cRMPs demonstrated good linear correlations for the CS but some significant sample-specific differences were also observed. The results of the commutability study show that RMs based on unspiked human serum pools can be commutable with CS, whereas human pools spiked with recombinant apo(a) show different behavior compared to CS. CONCLUSIONS The results of this study show that unspiked human serum pools are the preferred candidate secondary RMs in the future SI-traceable Lp(a) Reference Measurement System.
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Affiliation(s)
- Ioannis Dikaios
- European Commission, Joint Research Centre (JRC), Geel, Belgium
| | - Harald Althaus
- Siemens Healthcare Diagnostics Products GmbH, Marburg, Germany
| | - Eduardo Angles-Cano
- French Institute of Health and Medical Research (INSERM) Université Paris Cité, Paris, France
| | - Uta Ceglarek
- Institute of Laboratory Medicine, Clinical Chemistry and Molecular Diagnostics, University Hospital Leipzig, Leipzig, Germany
- LIFE-Leipzig Research Center for Civilization Diseases, University of Leipzig, Leipzig, Germany
- Division Clinical Mass Spectrometry of the German Society of Clinical Chemistry and Laboratory Medicine (DGKL), Berlin, Germany
| | - Stefan Coassin
- Institute of Genetic Epidemiology, Medical University of Innsbruck, Innsbruck, Austria
| | - Christa M Cobbaert
- Department of Clinical Chemistry and Laboratory Medicine, Leiden University Medical Center, Leiden, The Netherlands
| | | | - Benjamin Dieplinger
- Department of Laboratory Medicine, Konventhospital Barmherzige Brueder Linz and Ordensklinikum Linz Barmherzige Schwestern, Linz, Austria
| | | | - Andrew N Hoofnagle
- Department of Laboratory Medicine and Pathology, University of Washington, Seattle, USA
| | - Gerhard M Kostner
- Division of Molecular Biology and Biochemistry, Medical University of Graz, Graz, Austria
| | - Florian Kronenberg
- Institute of Genetic Epidemiology, Medical University of Innsbruck, Innsbruck, Austria
| | - Zsusanna Kuklenyik
- Division of Laboratory Sciences, Centers for Disease Control and Prevention (CDC), Atlanta, USA
| | - Alicia N Lyle
- Division of Laboratory Sciences, Centers for Disease Control and Prevention (CDC), Atlanta, USA
| | | | - L Renee Ruhaak
- Department of Clinical Chemistry and Laboratory Medicine, Leiden University Medical Center, Leiden, The Netherlands
| | - Hubert Scharnagl
- Division of Molecular Biology and Biochemistry, Medical University of Graz, Graz, Austria
| | - Hubert W Vesper
- Division of Laboratory Sciences, Centers for Disease Control and Prevention (CDC), Atlanta, USA
| | - Liesbet Deprez
- European Commission, Joint Research Centre (JRC), Geel, Belgium
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9
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Ulmer CZ, Kritmetapak K, Singh RJ, Vesper HW, Kumar R. High-Resolution Mass Spectrometry for the Measurement of PTH and PTH Fragments: Insights into PTH Physiology and Bioactivity. J Am Soc Nephrol 2022; 33:1448-1458. [PMID: 35396262 PMCID: PMC9342634 DOI: 10.1681/asn.2022010036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
Full-length parathyroid hormone (PTH 1-84) is crucial for the regulation of calcium and phosphate homeostasis and bone remodeling. PTH 1-84 is metabolized into various PTH fragments, which are measured with varying levels of efficiency by PTH immunoassays. These PTH fragments, which increase in serum as CKD progresses, could potentially modulate the effects of PTH 1-84 and contribute to CKD-associated bone disorders. To obtain a true biologic representation of total PTH bioactivity, it is necessary to measure not only PTH 1-84 but also PTH fragments that are present in circulation. Traditional second-generation PTH immunoassays collectively measure PTH 1-84, PTH fragments, and post-translationally modified PTH 1-84, making it difficult to accurately predict the character of underlying renal osteodystrophy. This review highlights current advances in methods available for PTH measurement and the clinical relevance of PTH fragments in CKD. We emphasize the usefulness of mass spectrometry as a potential reference method for PTH measurement.
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Affiliation(s)
- Candice Z. Ulmer
- Clinical Chemistry Branch, Division of Laboratory Sciences, National Center for Environmental Health, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Kittrawee Kritmetapak
- Division of Nephrology, Department of Medicine, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
| | - Ravinder J. Singh
- Immunochemical Core Laboratory, Mayo Clinic, Rochester, Minnesota,Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, Minnesota
| | - Hubert W. Vesper
- Clinical Chemistry Branch, Division of Laboratory Sciences, National Center for Environmental Health, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Rajiv Kumar
- Division of Nephrology and Hypertension, Department of Internal Medicine, Mayo Clinic, Rochester, Minnesota,Department of Biochemistry and Molecular Biology, Mayo Clinic, Rochester, Minnesota
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10
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Lyle AN, Pokuah F, Dietzen DJ, Wong ECC, Pyle-Eilola AL, Fuqua JS, Woodworth A, Jones PM, Akinbami LJ, Garibaldi LR, Vesper HW. Current State of Pediatric Reference Intervals and the Importance of Correctly Describing the Biochemistry of Child Development: A Review. JAMA Pediatr 2022; 176:699-714. [PMID: 35467725 PMCID: PMC10155856 DOI: 10.1001/jamapediatrics.2022.0794] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Importance Appropriately established pediatric reference intervals are critical to the clinical decision-making process and should reflect the physiologic changes that occur during healthy child development. Reference intervals used in pediatric care today remain highly inconsistent across a broad range of common clinical biomarkers. Observations This narrative review assesses biomarker-specific pediatric reference intervals and their clinical utility with respect to the underlying biological changes occurring during development. Pediatric reference intervals from PubMed-indexed articles published from January 2015 to April 2021, commercial laboratory websites, study cohorts, and pediatric reference interval books were all examined. Although large numbers of pediatric reference intervals are published for some biomarkers, very few are used by clinical and commercial laboratories. The patterns, extent, and timing of biomarker changes are highly variable, particularly during developmental stages with rapid physiologic changes. However, many pediatric reference intervals do not capture these changes and thus do not accurately reflect the underlying biochemistry of development, resulting in significant inconsistencies between reference intervals. Conclusions and Relevance There is a need to correctly describe the biochemistry of child development as well as to identify strategies to develop accurate and consistent pediatric reference intervals for improved pediatric care.
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Affiliation(s)
- Alicia N Lyle
- Division of Laboratory Sciences, National Center for Environmental Health, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Fidelia Pokuah
- Division of Laboratory Sciences, National Center for Environmental Health, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Dennis J Dietzen
- Department of Pediatrics, Washington University School of Medicine, Laboratory Services, St Louis Children's Hospital, St Louis, Missouri
| | - Edward C C Wong
- Quest Diagnostics Nichols Institute and Children's National Hospital, Chantilly, Virginia
| | - Amy L Pyle-Eilola
- Department of Pathology and Laboratory Medicine, Nationwide Children's Hospital, Columbus, Ohio
| | - John S Fuqua
- Division of Pediatric Endocrinology, Indiana University School of Medicine, Indianapolis.,Riley Hospital for Children at IU Health, Indianapolis, Indiana
| | - Alison Woodworth
- Department of Pathology and Laboratory Medicine, University of Kentucky Medical Center, Lexington
| | - Patricia M Jones
- Department of Pathology, University of Texas Southwestern Medical Center and Children's Medical Center, Dallas
| | - Lara J Akinbami
- National Center for Health Statistics, Centers for Disease Control and Prevention, Hyattsville, Maryland
| | - Luigi R Garibaldi
- Division of Endocrinology, Department of Pediatrics, Children's Hospital of Pittsburgh, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania
| | - Hubert W Vesper
- Division of Laboratory Sciences, National Center for Environmental Health, Centers for Disease Control and Prevention, Atlanta, Georgia
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11
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Wilson PWF, Jacobson TA, Martin SS, Jackson EJ, Le NA, Davidson MH, Vesper HW, Frikke-Schmidt R, Ballantyne CM, Remaley AT. Lipid measurements in the management of cardiovascular diseases: Practical recommendations a scientific statement from the national lipid association writing group. J Clin Lipidol 2021; 15:629-648. [PMID: 34802986 DOI: 10.1016/j.jacl.2021.09.046] [Citation(s) in RCA: 55] [Impact Index Per Article: 18.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2021] [Revised: 09/13/2021] [Accepted: 09/14/2021] [Indexed: 01/31/2023]
Abstract
Lipoprotein measurements are pivotal in the management of patients at risk for atherosclerotic coronary heart disease (CHD) with myocardial infarction and coronary death as the main outcomes, and for atherosclerotic cardiovascular disease (ASCVD), which includes CHD and stroke. Recent developments and changes in guidelines affect optimization of using lipid measures as cardiovascular biomarkers. This scientific statement reviews the pre-analytical, analytical, post-analytical, and clinical aspects of lipoprotein measurements. Highlights include the following: i) It is acceptable to screen with nonfasting lipids. ii) non-high-density lipoprotein HDL-cholesterol (non-HDL-C) is measured reliably in either the fasting or the nonfasting state and can effectively guide ASCVD prevention. iii) low density lipoprotein cholesterol (LDL-C) can be estimated from total cholesterol, high density lipoprotein cholesterol (HDL-C), and triglyceride (TG) measurements. For patients with LDL-C>100 mg/dL and TG ≤150 mg/dL it is reasonable to use the Friedewald formula. However, for those with TG 150-400 mg/dL the Friedewald formula for LDL-C estimation is less accurate. The Martin/Hopkins method is recommended for LDL-C estimation throughout the range of LDL-C levels and up to TG levels of 399 mg/dL. For TG levels ≥400 mg/dL LDL-C estimating equations are currently not recommended and newer methods are being evaluated. iv) When LDL-C or TG screening results are abnormal the clinician should consider obtaining fasting lipids. v) Advanced lipoprotein tests using apolipoprotein B (apoB), LDL Particle Number (LDL-P) or remnant cholesterol may help to guide therapeutic decisions in select patients, but data are limited for patients already on lipid lowering therapy with low LDL-C levels. Better harmonization of advanced lipid measurement methods is needed. Lipid measurements are recommended 4-12 weeks after a change in lipid treatment. Lipid laboratory reports should denote desirable values and specifically identify extremely elevated LDL-C levels (≥190 mg/dL at any age or ≥160 mg/dL in children) as severe hypercholesterolemia. Potentially actionable abnormal lipid test results, including fasting triglycerides (TG) ≥500 mg/dL, should be reported as hypertriglyceridemia. Appropriate use and reporting of lipid tests should improve their utility in the management of persons at high risk for ASCVD events.
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Affiliation(s)
- Peter W F Wilson
- Emory University School of Medicine, Atlanta, GA, United States; Atlanta Veterans Affairs Medical Center, Atlanta, GA, United States.
| | | | - Seth S Martin
- Johns Hopkins University School of Medicine, Baltimore, MD, United States
| | | | - N-Anh Le
- Atlanta Veterans Affairs Medical Center, Atlanta, GA, United States
| | | | - Hubert W Vesper
- Centers for Disease Control and Prevention, Atlanta, GA, United States
| | - Ruth Frikke-Schmidt
- Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark; Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | | | - Alan T Remaley
- National Heart, Lung and Blood Institute, Bethesda, MD, United States
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12
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Panteghini M, Braga F, Camara JE, Delatour V, Van Uytfanghe K, Vesper HW, Zhang T. Optimizing Available Tools for Achieving Result Standardization: Value Added by Joint Committee on Traceability in Laboratory Medicine (JCTLM). Clin Chem 2021; 67:1590-1605. [PMID: 34633037 DOI: 10.1093/clinchem/hvab178] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2021] [Accepted: 08/12/2021] [Indexed: 12/14/2022]
Abstract
BACKGROUND The JCTLM created a Task Force on Reference Measurement System Implementation (TF-RMSI) to provide guidance on metrological traceability implementation for the in vitro diagnostics (IVD) community. CONTENT TF-RMSI investigated the reference measurement systems (RMS) for 13 common measurands by applying the following procedural steps: (a) extracting data from the JCTLM database of available certified reference materials (CRMs) and reference measurement procedures (RMPs); (b) describing the RMS to which each recruited CRM or RMP belongs; (c) identifying the intended use of the CRMs, and, if used as a common calibrator for IVD measuring systems and/or trueness assessment of field methods was included, checking the CRM's certificate for information about commutability with clinical samples; and (d) checking if the CRM or RMP measurement uncertainty (MU) has the potential to be small enough to avoid significantly affecting the analytical performance specifications (APS) for MU of clinical sample results when the MU from the IVD calibrator and from the end-user measuring system were combined. SUMMARY We produced a synopsis of JCTLM-listed higher-order CRMs and RMPs for the selected measurands, including their main characteristics for implementing traceability and fulfilling (or not) the APS for suitable MU. Results showed that traceability to higher-order references can be established by IVD manufacturers within the defined APS for most of the 13 selected measurands. However, some measurands do not yet have suitable CRMs for use as common calibrators. For these measurands, splitting clinical samples with a laboratory performing the RMP may provide a practical alternative for establishing a calibration hierarchy.
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Affiliation(s)
- Mauro Panteghini
- 'L. Sacco' Department of Biomedical and Clinical Sciences, Research Centre for Metrological Traceability in Laboratory Medicine (CIRME), University of Milan, Milano, Italy
| | - Federica Braga
- 'L. Sacco' Department of Biomedical and Clinical Sciences, Research Centre for Metrological Traceability in Laboratory Medicine (CIRME), University of Milan, Milano, Italy
| | - Johanna E Camara
- Chemical Sciences Division, National Institute of Standards and Technology, Gaithersburg, MD
| | - Vincent Delatour
- Chemistry and Biology Division, Laboratoire National de Metrologie et d'Essais (LNE), Paris, France
| | - Katleen Van Uytfanghe
- Ref4U-Laboratory of Toxicology, Department of Bioanalysis, Faculty of Pharmaceutical Sciences, Ghent University, Ghent, Belgium
| | - Hubert W Vesper
- Division of Laboratory Sciences, Centers for Disease Control and Prevention, Atlanta, GA
| | - Tianjiao Zhang
- Division of clinical chemistry, National Center for Clinical Laboratories, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, China
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13
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Chin HB, Kelly A, Adgent MA, Patchel SA, James K, Vesper HW, Botelho JC, Chandler DW, Zemel BS, Schall JI, Ford EG, Darge K, Stallings VA, Baird DD, Rogan WJ, Umbach DM. Reproductive Hormone Concentrations and Associated Anatomical Responses: Does Soy Formula Affect Minipuberty in Boys? J Clin Endocrinol Metab 2021; 106:2635-2645. [PMID: 34013335 PMCID: PMC8372659 DOI: 10.1210/clinem/dgab354] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/01/2021] [Indexed: 12/19/2022]
Abstract
CONTEXT Soy formula feeding is common in infancy and is a source of high exposure to phytoestrogens, documented to influence vaginal cytology in female infants. Its influence on minipuberty in males has not been established. OBJECTIVE To assess the association between infant feeding practice and longitudinally measured reproductive hormones and hormone-responsive tissues in infant boys. METHODS The Infant Feeding and Early Development study was a prospective cohort of maternal-infant dyads requiring exclusive soy formula, cow milk formula, or breast milk feeding during study follow-up. In the 147 infant boy participants, serum testosterone, luteinizing hormone, stretched penile length, anogenital distance, and testis volume were longitudinally assessed from birth to 28 weeks. We examined feeding-group differences in age trajectories for these outcomes using mixed-effects regression splines. RESULTS Median serum testosterone was at pubertal levels at 2 weeks (176 ng/dL [quartiles: 124, 232]) and remained in this range until 12 weeks in all feeding groups. We did not observe differences in trajectories of hormone concentrations or anatomical measures between boys fed soy formula (n = 55) and boys fed cow milk formula (n = 54). Compared with breastfed boys (n = 38), soy formula-fed boys had a more rapid increase in penile length (P = .004) and slower initial lengthening of anogenital distance (P = .03), but no differences in hormone trajectories. CONCLUSION Reproductive hormone concentrations and anatomical responses followed similar trajectories in soy and cow milk formula-fed infant boys. Our findings suggest that these measures of early male reproductive development do not respond to phytoestrogen exposure during infancy.
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Affiliation(s)
- Helen B Chin
- Department of Global and Community Health, George Mason University, Fairfax, VA 22030, USA
| | - Andrea Kelly
- University of Pennsylvania Perelman School of Medicine, Philadelphia, PA 19104, USA
- Department of Pediatrics, Division of Endocrinology, The Children’s Hospital of Philadelphia, Philadelphia, PA 19104, USA
| | - Margaret A Adgent
- Department of Health Policy, Vanderbilt University Medical Center, Nashville, TN 37203, USA
| | | | - Kerry James
- Social & Scientific Systems, Inc., Durham, NC 27703, USA
| | - Hubert W Vesper
- Clinical Standardization Programs, CDC, Atlanta, GA 30341, USA
| | - Julianne C Botelho
- Division of Laboratory Sciences, National Center for Environmental Health, CDC, Atlanta, GA 30341, USA
| | | | - Babette S Zemel
- University of Pennsylvania Perelman School of Medicine, Philadelphia, PA 19104, USA
- Department of Pediatrics, Division of Gastroenterology, Hepatology and Nutrition, The Children’s Hospital of Philadelphia, Philadelphia, PA 19104, USA
| | - Joan I Schall
- Department of Pediatrics, Division of Gastroenterology, Hepatology and Nutrition, The Children’s Hospital of Philadelphia, Philadelphia, PA 19104, USA
| | - Eileen G Ford
- Department of Pediatrics, Division of Gastroenterology, Hepatology and Nutrition, The Children’s Hospital of Philadelphia, Philadelphia, PA 19104, USA
| | - Kassa Darge
- University of Pennsylvania Perelman School of Medicine, Philadelphia, PA 19104, USA
- Department of Radiology, The Children’s Hospital of Philadelphia, Philadelphia, PA 19104, USA
| | - Virginia A Stallings
- University of Pennsylvania Perelman School of Medicine, Philadelphia, PA 19104, USA
- Department of Pediatrics, Division of Gastroenterology, Hepatology and Nutrition, The Children’s Hospital of Philadelphia, Philadelphia, PA 19104, USA
| | - Donna D Baird
- Epidemiology Branch, National Institute of Environmental Health Sciences, National Institutes of Health, Research Triangle Park, NC 27709, USA
| | - Walter J Rogan
- Epidemiology Branch, National Institute of Environmental Health Sciences, National Institutes of Health, Research Triangle Park, NC 27709, USA
| | - David M Umbach
- Biostatistics and Computational Biology Branch, National Institute of Environmental Health Sciences, National Institutes of Health, Research Triangle Park, NC 27709, USA
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14
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Ortega MT, McGrath JA, Carlson L, Flores Poccia V, Larson G, Douglas C, Sun BZ, Zhao S, Beery B, Vesper HW, Duke L, Botelho JC, Filie AC, Shaw ND. Longitudinal Investigation of Pubertal Milestones and Hormones as a Function of Body Fat in Girls. J Clin Endocrinol Metab 2021; 106:1668-1683. [PMID: 33630047 PMCID: PMC8118584 DOI: 10.1210/clinem/dgab092] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/16/2020] [Indexed: 11/19/2022]
Abstract
CONTEXT Epidemiologic studies have demonstrated that overweight/obese girls (OW/OB) undergo thelarche and menarche earlier than normal weight girls (NW). There have been no longitudinal studies to specifically investigate how body weight/fat affects both clinical and biochemical pubertal markers in girls. OBJECTIVE To investigate the effect of total body fat on reproductive hormones and on the maturation of estrogen-sensitive tissues during puberty in girls. METHODS Ninety girls (36 OW/OB, 54 NW), aged 8.2 to 14.7 years, completed 2.8 ± 1.7 study visits over 4 years. Visits included dual-energy x-ray absorptiometry to calculate total body fat (TBF), Tanner staging, breast ultrasound for morphological staging (BMORPH; A-E), pelvic ultrasound, hormone tests, and assessment of menarchal status. The effect of TBF on pubertal markers was determined using a mixed, multistate, or Cox proportional hazards model, controlling for baseline BMORPH. RESULTS NW were older than OW/OB (11.3 vs 10.2 years, P < .01) at baseline and had more advanced BMORPH (P < .01). Luteinizing hormone, estradiol, and ovarian and uterine volumes increased with time with no effect of TBF. There was a time × TBF interaction for follicle-stimulating hormone, inhibin B, estrone, total and free testosterone, and androstenedione: Levels were initially similar, but after 1 year, levels increased in girls with higher TBF, plateaued in girls with midrange TBF, and decreased in girls with lower TBF. Girls with higher TBF progressed through BMORPH stage D more slowly but achieved menarche earlier than girls with lower TBF. CONCLUSION In late puberty, girls with higher TBF demonstrate differences in standard hormonal and clinical markers of puberty. Investigation of the underlying causes and clinical consequences of these differences in girls with higher TBF deserves further study.
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Affiliation(s)
- Madison T Ortega
- National Institutes of Environmental Health Sciences, National Institutes of Health, Durham, North Carolina, USA
| | - John A McGrath
- Social & Scientific Systems Inc, Durham, North Carolina, USA
| | - Lauren Carlson
- National Institutes of Environmental Health Sciences, National Institutes of Health, Durham, North Carolina, USA
| | - Vanessa Flores Poccia
- National Institutes of Environmental Health Sciences, National Institutes of Health, Durham, North Carolina, USA
| | - Gary Larson
- Social & Scientific Systems Inc, Durham, North Carolina, USA
| | | | - Bob Z Sun
- National Institutes of Environmental Health Sciences, National Institutes of Health, Durham, North Carolina, USA
| | - Shanshan Zhao
- National Institutes of Environmental Health Sciences, National Institutes of Health, Durham, North Carolina, USA
| | - Breana Beery
- National Institutes of Environmental Health Sciences, National Institutes of Health, Durham, North Carolina, USA
| | - Hubert W Vesper
- Division of Laboratory Sciences, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Lumi Duke
- Division of Laboratory Sciences, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Julianne C Botelho
- Division of Laboratory Sciences, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Armando C Filie
- Cytopathology Section, Laboratory of Pathology, Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda, Maryland, USA
| | - Natalie D Shaw
- National Institutes of Environmental Health Sciences, National Institutes of Health, Durham, North Carolina, USA
- Correspondence: Natalie D. Shaw, MD, MMSc, National Institute of Environmental Health Sciences, 111 T.W. Alexander Dr, MD D3-02, Research Triangle Park, NC 27709, USA.
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15
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Ulmer CZ, Smith B, Thonkulpitak J, Vesper HW. Improving the Accuracy and Reliability of Parathyroid Hormone Levels Through the Mass-Spectrometric Measurement of Full-length PTH and C-Terminal PTH Fragments. J Endocr Soc 2021. [PMCID: PMC8090143 DOI: 10.1210/jendso/bvab048.535] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
Abstract
Parathyroid hormone (PTH) is a key biomarker for hypo/hyperparathyrioidism as well as chronic kidney disease, one of the leading health conditions in the USA. As a result, the most recent update of the Kidney Disease Improving Global Outcomes (KDIGO) guideline for CKD-MBD management emphasized the role of PTH as one of the key biomarkers of this disorder. The earlier stages of CKD generate few symptoms and only until the kidney is significantly impaired do patients begin experiencing signs of renal failure. Therefore, the measurement of parathyroid hormone (PTH) in serum and/or plasma is critical not only for the correct detection, diagnosis, and prevention of renal failure, but also calcium, phosphate, and vitamin D disorders. Current laboratory methods for PTH show high variability and inaccuracy, thus creating the need for a reference measurement procedure that can help laboratories and assay manufacturers improve their measurement accuracy and reliability to avoid the misclassification of patients. Due to the short half-life of PTH, this 84 amino-acid polypeptide hormone is produced at low circulating levels in normal conditions ranging from 10 - 65 pg/mL. In addition, N-terminal and C-terminal peptides, which have shown to interfere with clinical analyzer platforms, account for over 80% of all circulating PTH levels. Therefore, a highly specific and sensitive method is needed for the accurate detection of full-length PTH and these PTH fragments. There is clinical relevancy in the ability to measure C-terminal PTH fragments as the ratio of these PTH fragments to full-length PTH has been diagnostic for severe or end-stage renal disease, non-dynamic bone disease, and hyperparathyroid-associated bone loss. Bottom-up proteomics approaches that incorporate enzymatic digestion steps during sample preparation will result in the loss of information for the fragments. Therefore, a new, innovative, top-down proteomics method was developed to measure full-length PTH and its breakdown products (fragments) by mass spectrometry (UHPLC-HRMS). This method enabled, for the first time, the detection of full-length PTH at very low concentrations typically observed in patients with hypoparathyroidism as well as C-terminal fragments that may interfere with regular immunoassays typically used in patient care. The highly specific and sensitive method for PTH and related peptides in CKD patient sera demonstrated no interference from the internal standards and other PTH fragments. Therefore, the optimized method was applied for the screening of normal and CKD serum at various stages of disease progression. Preliminary results demonstrated that certain PTH fragments are correlated with eGFR and different stages of chronic kidney diseases (CKD). This method along with the respective findings from this study will help to improve the diagnosis, treatment, and prevention of CKD-MBD.
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Affiliation(s)
- Candice Z Ulmer
- Centers for Disease Control and Prevention, Atlanta, GA, USA
| | | | | | - Hubert W Vesper
- Centers for Disease Control and Prevention, Atlanta, GA, USA
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16
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Zhang L, Amonae DB, Ribera A, Krista P, Sugahara O, Danilenko U, Vesper HW. Development of High-Throughput Measurement of Free Thyroxine in Serum Using Equilibrium Dialysis in Couple With Liquid Chromatography-Tandem Mass Spectrometry. J Endocr Soc 2021. [PMCID: PMC8089588 DOI: 10.1210/jendso/bvab048.1688] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/04/2022] Open
Abstract
Free thyroxine (FT4) measurements are critical in the diagnosis, classification, and treatment of thyroid diseases. It is estimated that about 18 million FT4 tests are requested in the USA per year annually. In clinical laboratories, most of FT4 assays are performed by using immunoassays (I As). However, the significant bias of IAs and large variation between laboratories have been reported. The reference measurement procedures (RMPs) of FT4based on equilibrium dialysis (ED) - liquid chromatography-tandem mass spectrometry (LC-MS/MS) have been established and recognized by the clinical chemistry community. However, the FT4 RMP is relatively low throughput and labor-intensive. Also, an aliquot of 1 mL sample is required for an RMP. A routine FT4 assay high-throughput procedure that is based on ED LC-MS/MS and utilized less sample volume will allow to conduct large biomonitoring studies and establish FT4 levels in US population. In the described method, FT4 in 150 uL of serum was separated from protein-bound T4 at 37.0 oC in 96-well Micro-ED Teflon devices from HTDialysis. The ED conditions suggested by CLSI C45-A guideline were followed. A volume of 150 uL dialysate samples with FT4 was obtained after the ED step. FT4 in the dialysate was purified by extractions before LC-MS/MS analysis. Chromatographic separation of T4 from the sample matrix is achieved on a C18 UPLC column with a gradient of methanol and water with 0.1% formic acid. Quantification of FT4 was performed by using selective reaction monitoring in positive electrospray ionization mode. The IRMM-468 certified primary reference material (JRC, Belgium) of T4 is used for the calibration curves. FT4 concentrations reached equilibrium after 4 hours under current dialysis conditions, which was also observed in the RMP setting. The developed routine FT4 assay 96-well ED system is within 5% bias from the FT4 RMP based on preliminary method comparison study using human serum. The studies to further characterize the FT4 routine method performance are ongoing. In summary, we are developing an analytical method based on a 96-well ED-LC-MS/MS system for the measurements of FT4 in serum. By comparison with RMP, the described method significantly improve throughput and reduce sample volume, which will fulfill the requirement of FT4 routine assay in clinical laboratories and allow for its use in the large biomonitoring studies and other activities in the research and public health settings.
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Affiliation(s)
| | | | - Ashley Ribera
- Centers for Disease Control and Prevention, Atlanta, GA, USA
| | | | | | | | - Hubert W Vesper
- Centers for Disease Control and Prevention, Atlanta, GA, USA
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17
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Zhou H, Ribera A, Dabbs-Brown A, Danilenko U, Vesper HW. Measurement of Free Testosterone in Serum Using Equilibrium DialysisCoupled With ID-UHPLC-MS/MS: Comparison Between Equilibrium Devices. J Endocr Soc 2021. [PMCID: PMC8090003 DOI: 10.1210/jendso/bvab048.1545] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
Free testosterone (FT) has been used as a biomarker in clinical patient care and public health research to assess and manage patients with androgenic abnormalities. The latest Endocrine Society clinical practice guideline for testosterone therapy in men with hypogonadism recommends measuring FT for those with borderline and low total testosterone concentrations, or those who have conditions that change SHBG concentrations, such as some metabolic or hormonal diseases, certain medication use, or SHBG genetic polymorphisms. Measuring FT is technically challenging and shows high variability. The CDC clinical standardization program is developing a high throughput method using the gold-standard equilibrium dialysis (ED) procedure with isotope dilution ultra-high-performance liquid chromatography tandem mass spectrometry (ID-UHPLC-MS/MS). A serum sample was dialyzed against a protein-free HEPES buffer (pH 7.4) at 37 °C until equilibrium. After isolating endogenous FT from protein-bound testosterone by ED, isotope-labeled internal standard (13C3-testosterone) was added to the dialysate for quantification. Certified pure primary reference material (National Measurement Institute M914) was used to prepare calibrators, enabling traceable quantitation and ensuring measurement trueness. FT was further isolated from the dialysate matrix using supported liquid extraction and a chromatographic separation from interfering compounds and quantitation by tandem MS. The dialysis step requires maintaining the endogenous free hormone equilibrium so that results in dialysate reflect FT concentrations in the blood without influence from dilution, temperature, or pH. The dialyzer system has a 1:1 sample-to-buffer volume and has been used in reference measurement procedures for free hormone measurements, serving as the standard for method performance comparison. Four commercially available devices designed for high throughput in a multiple well-plate format, requiring respective sample-to-buffer ratios, were evaluated for their recovery, speed, ease of automation by a liquid handling system, repeatability, and robustness. Preliminary results showed that a device with 1:1 sample-to-buffer volume had the most comparable results to those obtained from the standard dialyzer, with the mean bias less than 15%. The device with the highest sample-to-buffer ratio showed bias as high as 50%. These data suggest that controlling sample-to-buffer ratio is a critical step in ED FT method.
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Affiliation(s)
- Hui Zhou
- Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Ashley Ribera
- Centers for Disease Control and Prevention, Atlanta, GA, USA
| | | | | | - Hubert W Vesper
- Centers for Disease Control and Prevention, Atlanta, GA, USA
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Sugahara O, Danilenko U, Poynter K, Collins L, Khoshnam N, Buchannan T, Coffman C, Ribera A, Laughlin B, Dahya K, Smith B, Dabbs-Brown A, Pokuah F, Wirtz D, Ulmer CZ, Zhou H, Lyle A, Zhang L, Vesper HW. Improving the Diagnosis, Treatment, and Prevention of Endocrine Diseases Through Accurate and Reliable Laboratory Measurements With CDC Clinical Standardization Programs. J Endocr Soc 2021. [PMCID: PMC8089724 DOI: 10.1210/jendso/bvab048.1647] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
Laboratory measurements are critical for correct diagnosis and treatment of patients with chronic diseases such as hypogonadism, PCOS, and thyroid diseases. Inaccurate measurements of disease biomarkers can lead to misclassification of patients/incorrect treatment and prevent the effective use of research findings in patient care. The CDC Clinical Standardization Programs (CDC CSP) improve the accuracy and reliability of clinical biomarker measurements by assessing and improving the analytical performance of assays. The CDC CSP assist with assay calibration, the certification of analytical performance, and the monitoring of routine patient and research testing. The CDC CSP work with clinical/research laboratories and assay manufacturers to improve laboratory measurements. Its current programs include the following analytes: total testosterone (TT), estradiol (E2), vitamin D (VD), free thyroxine (FT4), total cholesterol (TC), total glycerides (TG), HDL-cholesterol (HDL-C), and LDL-cholesterol (LDL-C). The work is being conducted through certification/monitoring programs and technical assistance. Most assays participating in the certification programs have seen performance improvements and maintain performance over time by continuous participation. Most major commercial laboratories and assays manufactures are enrolled in the certification programs. Currently certified and non-certified assays are available. Assays certified by CDC CSP are listed on the website at https://www.cdc.gov/labstandards/hs.html. The CDC Lipid Standardization Programs and CDC Accuracy-based Monitoring Programs allow for weekly monitoring of analytical performance of routine tests for analytes including TT, VD, TC, TG, HDL-C, apolipoprotein A1 and B. These monitoring programs assist researchers with assessing measurement accuracy of research studies over time and across laboratories. The CDC CSP also support accuracy-based external quality assurance surveys such as those offered by the College of American Pathologists (CAP). The CDC CSP assist researchers and stakeholders with developing and establishing reference intervals and conducting studies to better assess and diagnose patients. Based on the needs and requests from clinical community, programs for new biomarkers such as Lp(a), PTH and glucose are being developed. The CDC CSP work with stakeholders, such as the Endocrine Society and the Partnership for the Accurate Testing of Hormones, to educate the clinical and laboratory communities about the importance of using standardized assays in patient care, research, and public health.
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Ortega MT, McGrath J, Carlson L, Poccia VF, Larson G, Douglas C, Sun BZ, Zhao S, Vesper HW, Duke L, Botelho JC, Filie AC, Shaw N. Longitudinal Investigation of Pubertal Milestones and Hormones as a Function of Body Fat in Girls. J Endocr Soc 2021. [PMCID: PMC8265920 DOI: 10.1210/jendso/bvab048.1474] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
Background: Studies comparing the timing and pace of puberty in overweight/obese girls (OW/OB) vs normal weight girls (NW) have produced conflicting results; some suggest earlier activation of the central components of the reproductive axis in OB while others are more consistent with a peripheral source of estrogen (e.g. adipose tissue) driving puberty in OB. Importantly, there have been no longitudinal assessments of both clinical and biochemical pubertal markers in OB vs. NW. Methods: 90 healthy pre-menarchal girls (26 OW/OB, 54 NW) from the community, aged 8.2-14.7 years, completed 2.8 ± 1.7 (mean, SD) study visits over the course of 4 years. Visits included dual-energy x-ray absorptiometry to calculate percent total body fat (TBF), Tanner staging, breast ultrasound for morphological staging (BMORPH; stages A-E), pelvic ultrasound, hand x-ray (bone age, BA), blood tests for reproductive hormones, and urine collection to determine a vaginal maturation index (VMI), an index of estrogen exposure in urogenital epithelial cells. Menarchal status was determined at each visit and via follow-up questionnaires. The effect of TBF on hormones and markers of estrogen action, the pace of breast maturation, and age at menarche were determined using a mixed, multi-state, or Cox proportional hazards model, respectively. Mixed and Cox models controlled for BMORPH at visit 1 (V1) and race. Results: NW girls were older than OW/OB (11.3 vs. 10.2 yrs, p<0.01) at V1, more likely to be non-Hispanic White (66 vs. 40%, p=0.03), and had more advanced breast morphology BMORPH (p<0.01). LH, E2, VMI, BA, and ovarian and uterine volume increased with time with no effect of TBF. There was an interaction between time and TBF for FSH, INHB, E1, Total T, Free T, and A’dione (p<0.05): levels were initially similar in all TBF groups, but after 1 yr, levels increased in girls with higher TBF, plateaued in girls with mid-range TBF, and decreased in girls with lower TBF. Girls with higher TBF progressed through BMORPH stage D (corresponding to growth/arborization of the breast ductal system), more slowly than girls with lower TBF but achieved menarche at a younger age (risk 1.04x higher per 1 unit increase in TBF). Conclusions: Intensive reproductive phenotyping of girls during the pubertal transition reveals that both the neuroendocrine and ovarian components of the axis are generally preserved in girls with higher TBF but that the axis appears to be activated earlier than in girls with lower TBF. In late puberty, however, girls with higher TBF demonstrate subtle differences in standard hormonal (e.g. serum FSH, INHB, and androgen) and clinical (e.g. delayed growth of breast bud) markers of puberty. Investigation of the mechanistic basis for these differences and their potential clinical consequences for girls with higher TBF deserves further study.
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Affiliation(s)
| | - John McGrath
- Social & Scientific Systems, Inc., Durham, NC, USA
| | - Lauren Carlson
- National Institute of Environmental Health Sciences, Durham, NC, USA
| | | | - Gary Larson
- Social & Scientific Systems, Inc., Durham, NC, USA
| | | | - Bob Zhe Sun
- National Institute of Environmental Health Sciences, Durham, NC, USA
| | - Shanshan Zhao
- National Institute of Environmental Health Sciences, Durham, NC, USA
| | - Hubert W Vesper
- Division of Laboratory Sciences, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Lumi Duke
- Division of Laboratory Sciences, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Julianne Cook Botelho
- Division of Laboratory Sciences, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Armando C Filie
- Cytopathology Section, Laboratory of Pathology, Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA
| | - Natalie Shaw
- National Institute of Environmental Health Sciences, Durham, NC, USA
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20
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Ribera A, Dabbs-Brown A, Poynter K, Sugahara O, Zhang L, Danilenko U, Vesper HW. CDC Clinical Standardization Programs (CSP) for Free Thyroxine (FT4) to Improve the Accuracy and Reliability of FT4 Measurements in Patient Care and Clinical Research. J Endocr Soc 2021. [PMCID: PMC8090330 DOI: 10.1210/jendso/bvab048.1684] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
Reliable FT4 measurement is critical to assess thyroid function and diagnose and treat thyroid disorders. The Partnership for the Accurate Testing of Hormones (PATH) categorizes FT4 as a biomarker in high need for standardization, and currently high inter-assay variability restricts the interpretation of FT4 results in patient care to assay-specific reference intervals. The CDC CSP has partnered with the International Federation of Clinical Chemistry and Laboratory Medicine (IFCC) and PATH to create a standardization program for FT4 to improve accuracy, reliability, and comparability of current methods and thus to improve diagnosis, treatment and prevention of thyroidal illnesses. Currently, there are no serum FT4 reference materials available to assess the accuracy and reliability of FT4 assays. CDC has developed an accurate and sensitive reference measurement procedure (RMP) to create commutable serum reference materials with FT4 target values. Assay manufacturers, research and clinical laboratories can use these reference materials to assess their calibration, certify the analytical performance of their measurements, and monitor performance over time by collaborating with CDC CSP. The CDC FT4 RMP uses equilibrium dialysis (ED) with LC-MS/MS based on an internationally recognized ED procedure[1] followed by solid-phase and solvent extractions. Certified primary reference material IRMM468 was used to prepare calibrators. Chromatographic separation is achieved with a gradient of methanol and water with 0.1% formic acid. FT4 is quantified using positive electrospray ionization in positive mode. The intra- and inter-day imprecision of the CDC RMP are 3.0% and 1.1%. A comparison among FT4 RMPs resulted in a +2.5% bias for the CDC RMP to the mean for all labs. The CDC RMP measurement range was 3.02-258 pmol/L and thus suitable for analysis of hypo- and hyperthyroid patients. The CDC FT4 RMP demonstrates good accuracy and precision, and can be used as a viable accuracy base to which routine methods can be compared. An initial comparison study of a commercially available FT4 immunoassay (IA) and the CDC RMP with 24 samples (7.98-109 pmol/L) indicated a mean bias of -37.7%, further indicating a need for standardization. Findings from an IFCC study suggest that alignment of IA measurements to a FT4 RMP can improve comparability and would allow for a uniform reference interval for FT4.[2] CDC CSP established a new standardization program for FT4 to address the needs of the community and assist with improving test comparability and reliability.1. Clin. Chem. Lab. Med. 2011, 49: 1275-81. 2. Clin. Chem. 2017, 63: 1642-52.
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Affiliation(s)
- Ashley Ribera
- Centers for Disease Control and Prevention, Atlanta, GA, USA
| | | | - Krista Poynter
- Centers for Disease Control and Prevention, Atlanta, GA, USA
| | | | | | | | - Hubert W Vesper
- Centers for Disease Control and Prevention, Atlanta, GA, USA
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21
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Li C, Richter P, Cobb LK, Kuiper HC, Seymour J, Vesper HW. Dietary Sources of Plasma trans Fatty Acids among Adults in the United States: NHANES 2009-2010. Curr Dev Nutr 2021; 5:nzab063. [PMID: 34027294 PMCID: PMC8128720 DOI: 10.1093/cdn/nzab063] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2020] [Revised: 02/11/2021] [Accepted: 04/07/2021] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Intake of trans fatty acids (TFAs) increases LDL cholesterol, decreases HDL cholesterol, and increases the risk of heart disease morbidity and mortality. Many food products potentially contain industrially produced or ruminant TFAs. However, little is known about the dietary sources of plasma TFA concentrations. OBJECTIVE The objective of this study was to examine associations between foods consumed and plasma TFA concentrations using 24-h dietary recall data and plasma TFA measures among adults aged ≥20 y who participated in the NHANES 2009-2010 in the United States. METHODS Over 4400 food products in the dietary interview data were categorized into 32 food and beverage groups/subgroups. Four major plasma TFAs (palmitelaidic acid, elaidic acid, vaccenic acid, linolelaidic acid) and the sum of the 4 TFAs (sumTFAs) were analyzed using GC-MS. Multivariable linear regression analyses were conducted to identify associations of plasma TFAs with all 32 food and beverage groups/subgroups, controlling for the potential confounding effects of 11 demographic, socioeconomic, behavioral, lifestyle, and health-related variables. RESULTS Consumption of the following food groups/subgroups was significantly associated with elevated plasma TFA concentrations: cream substitutes (P < 0.001 for palmitelaidic acid, elaidic acid, vaccenic acid, and sumTFAs); cakes, cookies, pastries, and pies (P < 0.001 for elaidic acid, vaccenic acid, and sumTFAs; P < 0.05 for linolelaidic acid); milk and milk desserts (P < 0.01 for palmitelaidic acid and vaccenic acid; P < 0.05 for linolelaidic acid and sumTFAs); beef/veal, lamb/goat, and venison/deer (P < 0.01 for vaccenic acid; P < 0.05 for sumTFAs); and butters (P < 0.001 for palmitelaidic acid and vaccenic acid; P < 0.05 for sumTFAs). CONCLUSIONS The findings suggest that the above 5 food groups/subgroups could be the main dietary sources of plasma TFAs among adults in the United States in 2009-2010.
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Affiliation(s)
- Chaoyang Li
- Division of Global Health Protection, Center for Global Health, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Patricia Richter
- Division of Global Health Protection, Center for Global Health, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Laura K Cobb
- Resolve to Save Lives, Vital Strategies, New York, NY, USA
| | - Heather C Kuiper
- Division of Laboratory Sciences, National Center for Environmental Health, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Jennifer Seymour
- Division of Nutrition, Physical Activity, and Obesity, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Hubert W Vesper
- Division of Laboratory Sciences, National Center for Environmental Health, Centers for Disease Control and Prevention, Atlanta, GA, USA
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22
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Danilenko U, Vesper HW, Myers GL, Clapshaw PA, Camara JE, Miller WG. An updated protocol based on CLSI document C37 for preparation of off-the-clot serum from individual units for use alone or to prepare commutable pooled serum reference materials. Clin Chem Lab Med 2021; 58:368-374. [PMID: 31665109 DOI: 10.1515/cclm-2019-0732] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2019] [Accepted: 09/20/2019] [Indexed: 11/15/2022]
Abstract
Manufacturers of in vitro diagnostic medical devices, clinical laboratories, research laboratories and calibration laboratories require commutable reference materials that can be used in the calibration hierarchies of medical laboratory measurement procedures used for human specimens to establish metrological traceability to higher order reference systems. Commutable materials are also useful in external quality assessment surveys. In order to achieve these goals, matrix-based reference materials with long-term stability, appropriate measurand concentrations and commutability with individual human specimens are required. The Clinical and Laboratory Standards Institute (CLSI) guideline C37-A (now archived) provided guidance to prepare commutable pooled serum reference materials for use in the calibration hierarchies of cholesterol measurement procedures. Experience using the C37-A guideline has identified a number of technical enhancements as well as applications to measurands other than cholesterol. This experience is incorporated into this updated protocol to ensure the procedure will continue to meet the needs of the medical laboratory. The updated protocol describes a procedure for preparing frozen human serum units or pools with minimal matrix alterations that are likely to be commutable with individual human serum samples. The protocol provides step-by-step guidance for the planning phase, collection of individual serum units, processing the units, qualifying the units for use in a pool and frozen storage of aliquots of pooled sera to manufacture frozen serum pools. Guidance on how to perform quality control of the final product and suggestions on documentation are also provided.
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Affiliation(s)
- Uliana Danilenko
- Division of Laboratory Sciences, National Center for Environmental Health, Centers for Disease Control and Prevention, 4770 Buford Hwy NE, MS F25, Atlanta, GA 30341, USA, Phone: +770-488-7346
| | - Hubert W Vesper
- Division of Laboratory Sciences, National Center for Environmental Health, Centers for Disease Control and Prevention, Atlanta, GA 30341, USA
| | | | | | - Johanna E Camara
- National Institute of Standards and Technology, Gaithersburg, MD, USA
| | - W Greg Miller
- Department of Pathology, Virginia Commonwealth University, Richmond, VA, USA
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23
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Hogervorst J, Vesper HW, Madhloum N, Gyselaers W, Nawrot T. Cord blood acrylamide levels and birth size, and interactions with genetic variants in acrylamide-metabolising genes. Environ Health 2021; 20:35. [PMID: 33794901 PMCID: PMC8015021 DOI: 10.1186/s12940-021-00715-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2020] [Accepted: 03/07/2021] [Indexed: 05/05/2023]
Abstract
BACKGROUND Up to now, 3 epidemiological studies have shown clear inverse associations between prenatal acrylamide exposure and birth size. In addition to studying the association between acrylamide and birth size, we investigated the interaction between acrylamide and polymorphisms in acrylamide-metabolising genes, with the aim of probing the causality of the inverse relationship between acrylamide and fetal growth. METHODS We investigated the association between prenatal acrylamide exposure (acrylamide and glycidamide hemoglobin adduct levels (AA-Hb and GA-Hb) in cord blood) and birth weight, length and head circumference in 443 newborns of the ENVIRONAGE (ENVIRonmental influence ON AGEing in early life) birth cohort. In addition, we studied interaction with single nucleotide polymorphisms (SNPs) in CYP2E1, EPHX1 and GSTP1, using multiple linear regression analysis. RESULTS Among all neonates, the body weight, length and head circumference of neonates in the highest quartile was - 101 g (95% CI: - 208, 7; p for trend = 0.12), - 0.13 cm (95% CI: - 0.62, 0.36; p for trend = 0.69) and - 0.41 cm (- 0.80, - 0.01; p for trend = 0.06) lower, respectively, compared to neonates in the lowest quartile of AA-Hb in cord blood, For GA-Hb, the corresponding effect estimates were - 222 g (95% CI: - 337, - 108; p for trend = 0.001), - 0.85 (95% CI: - 1.38, - 0.33; p for trend = 0.02) and - 0.55 (95% CI: - 0.98, - 0.11; p for trend = 0.01), respectively. The associations for GA-Hb were similar or stronger in newborns of non-smoking mothers. There was no statistically significant interaction between acrylamide exposure and the studied genetic variations but there was a trend of stronger inverse associations with birth weight and head circumference among newborns with homozygous wildtypes alleles for the CYP2E1 SNPS and with variant alleles for a GSTP1 SNP (rs1138272). CONCLUSIONS Prenatal dietary acrylamide exposure, specifically in the form of its metabolite glycidamide, was inversely associated with birth weight, length and head circumference. The interaction pattern with SNPs in CYP2E1, although not statistically significant, is an indication for the causality of this association. Other studies are needed to corroborate this finding.
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Affiliation(s)
- Janneke Hogervorst
- Centre for Environmental Sciences, Hasselt University, Agoralaan gebouw D, 3590 Diepenbeek, Hasselt, Belgium.
| | - Hubert W Vesper
- Division of Laboratory Sciences, Centers for Disease Control and Prevention, Atlanta, USA
| | - Narjes Madhloum
- Centre for Environmental Sciences, Hasselt University, Agoralaan gebouw D, 3590 Diepenbeek, Hasselt, Belgium
| | | | - Tim Nawrot
- Centre for Environmental Sciences, Hasselt University, Agoralaan gebouw D, 3590 Diepenbeek, Hasselt, Belgium
- Department of Public Health & Primary Care, Leuven University, Leuven, Belgium
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24
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Kritmetapak K, Losbanos LA, Hines JM, O'Grady KL, Ulmer CZ, Vesper HW, Enders FT, Singh RJ, Kumar R. Chemical Characterization and Quantification of Circulating Intact PTH and PTH Fragments by High-Resolution Mass Spectrometry in Chronic Renal Failure. Clin Chem 2021; 67:843-853. [PMID: 33693557 PMCID: PMC8167341 DOI: 10.1093/clinchem/hvab013] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2020] [Accepted: 01/12/2021] [Indexed: 01/26/2023]
Abstract
BACKGROUND The precise concentrations of full-length parathyroid hormone (PTH1-84) and the identity and concentrations of PTH fragments in patients with various stages of chronic renal failure are unknown. METHODS We developed a liquid chromatography-high resolution mass spectrometry (LC-HRMS) method to characterize and quantify PTH1-84 and PTH fragments in serum of 221 patients with progressive renal dysfunction. Following capture by matrix-bound amino-terminal or carboxyl-terminal region-specific antibodies and elution from matrix, PTH1-84 and PTH fragments were identified and quantitated using LC-HRMS. PTH was simultaneously measured using an intact PTH (iPTH) immunoassay. RESULTS Full-length PTH1-84 and 8 PTH fragments (PTH28-84, 34-77, 34-84, 37-77, 37-84, 38-77, 38-84, and 45-84) were unequivocally identified and were shown to increase significantly when an eGFR declined to ≤17-23 mL/min/1.73m2. Serum concentrations of PTH1-84 were similar when measured by LC-HRMS following capture by amino-terminal or carboxyl-terminal immunocapture methods. In patients with an eGFR of <30 mL/min/1.73 m2, serum PTH concentrations measured using LC-HRMS were significantly lower than PTH measured using an iPTH immunoassay. PTH7-84 and oxidized forms of PTH1-84 were below the limit of detection (30 and 50 pg/mL, respectively). CONCLUSIONS LC-HRMS identifies circulating PTH1-84, carboxyl-terminal PTH fragments, and mid-region PTH fragments, in patients with progressive renal failure. Serum PTH1-84 and its fragments markedly rise when an eGFR decreases to ≤17-23 mL/min/1.73 m2. PTH concentrations measured using LC-HRMS tend to be lower than those measured using an iPTH immunoassay, particularly in severe chronic renal failure. Our data do not support the existence of circulating PTH7-84 and oxidized PTH1-84.
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Affiliation(s)
- Kittrawee Kritmetapak
- Division of Nephrology and Hypertension, Department of Internal Medicine, Mayo Clinic, Rochester, MN, USA.,Division of Nephrology, Department of Medicine, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
| | - Louis A Losbanos
- Division of Nephrology and Hypertension, Department of Internal Medicine, Mayo Clinic, Rochester, MN, USA
| | - Jolaine M Hines
- Immunochemical Core Laboratory, Mayo Clinic, Rochester, MN, USA
| | | | - Candice Z Ulmer
- Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Hubert W Vesper
- Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Felicity T Enders
- Division of Biomedical Statistics and Informatics, Department of Health Sciences Research, Mayo Clinic, Rochester, MN, USA
| | - Ravinder J Singh
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN, USA
| | - Rajiv Kumar
- Division of Nephrology and Hypertension, Department of Internal Medicine, Mayo Clinic, Rochester, MN, USA.,Department of Biochemistry and Molecular Biology, Mayo Clinic, Rochester, MN, USA
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25
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Cobbaert CM, Althaus H, Begcevic Brkovic I, Ceglarek U, Coassin S, Delatour V, Deprez L, Dikaios I, Dittrich J, Hoofnagle AN, Kostner GM, Kronenberg F, Kuklenyik Z, Prinzing U, Vesper HW, Zegers I, Ruhaak LR. Towards an SI-Traceable Reference Measurement System for Seven Serum Apolipoproteins Using Bottom-Up Quantitative Proteomics: Conceptual Approach Enabled by Cross-Disciplinary/Cross-Sector Collaboration. Clin Chem 2021; 67:478-489. [PMID: 33331636 DOI: 10.1093/clinchem/hvaa239] [Citation(s) in RCA: 44] [Impact Index Per Article: 14.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2020] [Accepted: 09/15/2020] [Indexed: 12/15/2022]
Abstract
Current dyslipidemia management in patients with atherosclerotic cardiovascular disease (ASCVD) is based on traditional serum lipids. Yet, there is some indication from basic research that serum apolipoproteins A-I, (a), B, C-I, C-II, C-III, and E may give better pathophysiological insight into the root causes of dyslipidemia. To facilitate the future adoption of clinical serum apolipoprotein (apo) profiling for precision medicine, strategies for accurate testing should be developed in advance. Recent discoveries in basic science and translational medicine set the stage for the IFCC Working Group on Apolipoproteins by Mass Spectrometry. Main drivers were the convergence of unmet clinical needs in cardiovascular disease (CVD) patients with enabling technology and metrology. First, the residual cardiovascular risk after accounting for established risk factors demonstrates that the current lipid panel is too limited to capture the full complexity of lipid metabolism in patients. Second, there is a need for accurate test results in highly polymorphic and atherogenic apolipoproteins such as apo(a). Third, sufficient robustness of mass spectrometry technology allows reproducible protein quantification at the molecular level. Fourth, several calibration hierarchies in the revised ISO 17511:2020 guideline facilitate metrological traceability of test results, the highest achievable standard being traceability to SI. This article outlines the conceptual approach aimed at achieving a novel, multiplexed Reference Measurement System (RMS) for seven apolipoproteins based on isotope dilution mass spectrometry and peptide-based calibration. This RMS should enable standardization of existing and emerging apolipoprotein assays to SI, within allowable limits of measurement uncertainty, through a sustainable network of Reference Laboratories.
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Affiliation(s)
- Christa M Cobbaert
- Department of Clinical Chemistry and Laboratory Medicine, Leiden University Medical Center, Leiden, The Netherlands
| | - Harald Althaus
- Siemens Healthcare Diagnostics Products GmbH, Marburg, Germany
| | - Ilijana Begcevic Brkovic
- Institute of Laboratory Medicine, Clinical Chemistry and Molecular Diagnostics, University Hospital Leipzig, Leipzig,Germany.,LIFE-Leipzig Research Center for Civilization Diseases, University of Leipzig, Leipzig, Germany
| | - Uta Ceglarek
- Institute of Laboratory Medicine, Clinical Chemistry and Molecular Diagnostics, University Hospital Leipzig, Leipzig,Germany.,LIFE-Leipzig Research Center for Civilization Diseases, University of Leipzig, Leipzig, Germany
| | - Stefan Coassin
- Institute of Genetic Epidemiology, Department of Genetics and Pharmacology, Medical University of Innsbruck, Innsbruck, Austria
| | | | - Liesbet Deprez
- European Commission, Joint Research Centre (JRC), Geel, Belgium
| | - Ioannis Dikaios
- European Commission, Joint Research Centre (JRC), Geel, Belgium
| | - Julia Dittrich
- Institute of Laboratory Medicine, Clinical Chemistry and Molecular Diagnostics, University Hospital Leipzig, Leipzig,Germany.,LIFE-Leipzig Research Center for Civilization Diseases, University of Leipzig, Leipzig, Germany
| | - Andrew N Hoofnagle
- Department of Laboratory Medicine and Pathology, University of Washington, Seattle, WA
| | - Gerhard M Kostner
- Gottfried Schatz Research Center (for Cell Signaling, Metabolism and Aging), Division of Molecular Biology and Biochemistry, Medical University of Graz, Graz, Austria
| | - Florian Kronenberg
- Institute of Genetic Epidemiology, Department of Genetics and Pharmacology, Medical University of Innsbruck, Innsbruck, Austria
| | - Zsusanna Kuklenyik
- Division of Laboratory Sciences, Centers for Disease Control and Prevention, Atlanta, GA
| | | | - Hubert W Vesper
- Division of Laboratory Sciences, Centers for Disease Control and Prevention, Atlanta, GA
| | - Ingrid Zegers
- Laboratoire National de Métrologie et d'Essais, Paris, France
| | - L Renee Ruhaak
- Department of Clinical Chemistry and Laboratory Medicine, Leiden University Medical Center, Leiden, The Netherlands
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26
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Cavalier E, Fraser CG, Bhattoa HP, Heijboer AC, Makris K, Ulmer CZ, Vesper HW, Vasikaran S, Lukas P, Delanaye P, Carobene A. Analytical Performance Specifications for 25-Hydroxyvitamin D Examinations. Nutrients 2021; 13:431. [PMID: 33525653 PMCID: PMC7911223 DOI: 10.3390/nu13020431] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2021] [Revised: 01/25/2021] [Accepted: 01/25/2021] [Indexed: 12/21/2022] Open
Abstract
Currently the 25-hydroxy vitamin D (25(OH)D) concentration is thought to be the best estimate of the vitamin D status of an individual. Unfortunately, its measurement remains complex, despite recent technological advances. We evaluated the biological variation (BV) of 25(OH)D in order to set analytical performance specifications (APS) for measurement uncertainty (MU). Six European laboratories recruited 91 healthy participants. The 25(OH)D concentrations in K3-EDTA plasma were examined weekly for up to 10 weeks in duplicate on a Lumipulse G1200 (Fujirebio, Tokyo, Japan). The linear regression of the mean 25(OH)D concentrations at each blood collection showed that participants were not in a steady state. The dissection of the 10-sample collection into two subsets, namely collections 1-5 and 6-10, did not allow for correction of the lack of homogeneity: estimates of the within-subject BV ranged from 5.8% to 7.1% and the between-subject BV ranged from 25.0% to 39.2%. Methods that would differentiate a difference induced by 25(OH)D supplementation at p < 0.05 should have MU < 13.6%, while at p < 0.01, the MU should be <9.6%. The development of APS using BV assumes a steady state of patients. The findings in this study suggest that patients are not in steady state. Therefore, APS that are based on MU appear to be more appropriate.
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Affiliation(s)
- Etienne Cavalier
- CHU de Liège and Centre de Recherche Intégré sur les Médicaments (CIRM), Department of Clinical Chemistry, University of Liège, Domaine du Sart-Tilman, B-4000 Liège, Belgium;
| | - Callum G. Fraser
- Centre for Research into Cancer Prevention and Screening, Ninewells Hospital and Medical School, University of Dundee, Dundee DD1 9SY, UK;
| | - Harjit P. Bhattoa
- Department of Laboratory Medicine, Faculty of Medicine, University of Debrecen, H-4032 Debrecen, Hungary;
| | - Annemieke C. Heijboer
- Endocrine Laboratory, Department of Clinical Chemistry, Amsterdam Gastroenterology & Metabolism, Vrije Universiteit Amsterdam and University of Amsterdam, Amsterdam UMC, 1081 HVAmsterdam, The Netherlands;
| | - Konstantinos Makris
- Clinical Biochemistry Department, KAT General Hospital, GR-14561 Athens, Greece;
| | - Candice Z. Ulmer
- National Center for Environmental Health, Centers for Disease Control and Prevention, Division of Laboratory Sciences, Atlanta, GA 30329, USA; (C.Z.U.); (H.W.V.)
| | - Hubert W. Vesper
- National Center for Environmental Health, Centers for Disease Control and Prevention, Division of Laboratory Sciences, Atlanta, GA 30329, USA; (C.Z.U.); (H.W.V.)
| | - Samuel Vasikaran
- PathWest Laboratory Medicine, Fiona Stanley Hospital, Murdoch 6150, Australia;
| | - Pierre Lukas
- CHU de Liège and Centre de Recherche Intégré sur les Médicaments (CIRM), Department of Clinical Chemistry, University of Liège, Domaine du Sart-Tilman, B-4000 Liège, Belgium;
| | - Pierre Delanaye
- Department of Nephrology, Dialysis and Transplantation, University of Liege, CHU de Liege, B-4000 Liège, Belgium;
- Department of Nephrology-Dialysis-Apheresis, Hôpital Universitaire Caremeau, 30900 Nîmes, France
| | - Anna Carobene
- Laboratory Medicine, IRCCS San Raffaele Scientific Institute, 20132 Milan, Italy;
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Ulmer CZ, Smith B, Thonkulpitak J, Hardin J, Danilenko U, Frame T, Cheng PY, Vesper HW. Development of a Sensitive High-Resolution Mass Spectrometry Approach for Urea Nitrogen Quantitation in Small Volumes of Bronchoalveolar Lavage Fluid (BALF). J Am Soc Mass Spectrom 2020; 31:2270-2276. [PMID: 32931276 DOI: 10.1021/jasms.0c00231] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
A sensitive, selective, and quantitative method incorporating high-resolution mass spectrometry was developed for the determination of blood urea nitrogen (BUN) in bronchoalveolar lavage fluid. The method requires no sample cleanup or derivatization prior to analysis. High-performance liquid chromatography (HPLC) on a Hypersil Gold PFP column (100 × 3 mm, 3 μm particle size) connected to a C18 guard column was employed for a 10 min chromatographic separation. The detection of urea was achieved using a Thermo Scientific Q-Exactive Plus instrument incorporating selected ion monitoring (SIM) modes for the protonated adduct of urea. The urea analytical measuring range for the method is 0.047-17.134 mg/dL, resulting in a BUN analytical measurement range of 0.022-8.007 mg/dL, which allows for quantitation over 3 orders of magnitude (R2 = 0.999). In addition, the method is suitable for small sample volumes (15 μL) with a high level of accuracy, precision, and specificity.
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Affiliation(s)
- Candice Z Ulmer
- Division of Laboratory Sciences, National Center for Environmental Health, Centers for Disease Control and Prevention, 4770 Buford Hwy NE, MS F25, Atlanta, Georgia 30341, United States
| | - Bianca Smith
- Battelle, 505 King Avenue, Columbus, Ohio 43201, United States
| | - Janet Thonkulpitak
- Oak Ridge Institute for Science and Education, P.O. Box 117, Oak Ridge, Tennessee 37831, United States
| | - Joshua Hardin
- Oak Ridge Institute for Science and Education, P.O. Box 117, Oak Ridge, Tennessee 37831, United States
| | - Uliana Danilenko
- Division of Laboratory Sciences, National Center for Environmental Health, Centers for Disease Control and Prevention, 4770 Buford Hwy NE, MS F25, Atlanta, Georgia 30341, United States
| | - Tunde Frame
- Division of Laboratory Sciences, National Center for Environmental Health, Centers for Disease Control and Prevention, 4770 Buford Hwy NE, MS F25, Atlanta, Georgia 30341, United States
| | - Po-Yung Cheng
- Division of Laboratory Sciences, National Center for Environmental Health, Centers for Disease Control and Prevention, 4770 Buford Hwy NE, MS F25, Atlanta, Georgia 30341, United States
| | - Hubert W Vesper
- Division of Laboratory Sciences, National Center for Environmental Health, Centers for Disease Control and Prevention, 4770 Buford Hwy NE, MS F25, Atlanta, Georgia 30341, United States
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Ulmer CZ, Koelmel JP, Jones CM, Garrett TJ, Aristizabal-Henao JJ, Vesper HW, Bowden JA. A Review of Efforts to Improve Lipid Stability during Sample Preparation and Standardization Efforts to Ensure Accuracy in the Reporting of Lipid Measurements. Lipids 2020; 56:3-16. [PMID: 32519378 DOI: 10.1002/lipd.12263] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2020] [Revised: 05/03/2020] [Accepted: 05/19/2020] [Indexed: 11/07/2022]
Abstract
Lipidomics is a rapidly growing field, fueled by developments in analytical instrumentation and bioinformatics. To date, most researchers and industries have employed their own lipidomics workflows without a consensus on best practices. Without a community-wide consensus on best practices for the prevention of lipid degradation and transformations through sample collection and analysis, it is difficult to assess the quality of lipidomics data and hence trust results. Clinical studies often rely on samples being stored for weeks or months until they are analyzed, but inappropriate sampling techniques, storage temperatures, and analytical protocols can result in the degradation of complex lipids and the generation of oxidized or hydrolyzed metabolite artifacts. While best practices for lipid stability are sample dependent, it is generally recommended that strategies during sample preparation capable of quenching enzymatic activity and preventing oxidation should be considered. In addition, after sample preparation, lipid extracts should be stored in organic solvents with antioxidants at -20 °C or lower in an airtight container without exposure to light or oxygen. This will reduce or eliminate sublimation, and chemically and physically induced molecular transformations such as oxidation, enzymatic transformation, and photon/heat-induced degradation. This review explores the available literature on lipid stability, with a particular focus on human health and/or clinical lipidomic applications. Specifically, this includes a description of known mechanisms of lipid degradation, strategies, and considerations for lipid storage, as well as current efforts for standardization and quality insurance of protocols.
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Affiliation(s)
- Candice Z Ulmer
- Division of Laboratory Sciences, National Center for Environmental Health, Centers for Disease Control and Prevention, 4770 Buford Hwy NE, MS F25, Atlanta, GA, 30341, USA
| | - Jeremy P Koelmel
- Department of Environmental Health Sciences, Yale School of Medicine, Yale University, 60 College Street, Room 510, New Haven, CT, 06520, USA
| | - Christina M Jones
- Chemical Sciences Division, Organic Chemical Metrology Group, National Institute of Standards and Technology, 100 Bureau Drive, Gaithersburg, MD, 20899, USA
| | - Timothy J Garrett
- Department of Pathology, Immunology and Laboratory Medicine, University of Florida, Gainesville, FL, 32610, USA
| | - Juan J Aristizabal-Henao
- Center for Environmental and Human Toxicology & Department of Physiological Sciences, College of Veterinary Medicine, University of Florida, Gainesville, FL, 32611, USA
| | - Hubert W Vesper
- Division of Laboratory Sciences, National Center for Environmental Health, Centers for Disease Control and Prevention, 4770 Buford Hwy NE, MS F25, Atlanta, GA, 30341, USA
| | - John A Bowden
- Center for Environmental and Human Toxicology & Department of Physiological Sciences, College of Veterinary Medicine, University of Florida, Gainesville, FL, 32611, USA
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Sugahara O, Danilenko U, Poynter K, Collins L, Khoshnam N, Coffman C, Ribera A, Laughlin B, Dahya K, Bianca S, Arndt A, Ulmer CZ, Fidelia P, Wirtz D, Vesper HW, Zhou H. SAT-733 Improving the Diagnosis, Treatment, and Prevention of Endocrine Diseases Through Accurate and Reliable Laboratory Measurements with CDC’s Clinical Standardization Programs. J Endocr Soc 2020. [PMCID: PMC7207912 DOI: 10.1210/jendso/bvaa046.099] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
Laboratory measurements are critical for the correct diagnosis and treatment of patients as well as in the investigation of chronic diseases such as hypogonadism, PCOS, and bone-and kidney-related diseases. Inaccurate measurements can lead to misclassification of patients and incorrect treatment. Furthermore, the effective use of research findings in patient care is prevented. The CDC Clinical Standardization Programs (CDC CSP) assess the analytical performance of assays against performance goals defined by clinical and medical organizations. The CDC CSP assist with assay calibration, the certification of analytical performance, and the monitoring of analytical performance during the measurement of patient and/or study samples. CDC CSP have programs in place for the calibration and certification of commercial assays and laboratory developed tests (LDTs) for total testosterone (TT), estradiol (E2), vitamin D (VD), free thyroxine (FT4), total cholesterol (TC), total glycerides (TG), HDL-cholesterol (HDL-C), and LDL-cholesterol (LDL-C). The programs available for monitoring analytical performance during routine testing include TT, VD, TC, TG, HDL-C, apolipoprotein AI and B. CDC CSP also support accuracy-based external quality assurance surveys such as those offered by the College of American Pathologists. Enrollment of assays and LDTs in CDC’s certification programs has resulted in improvements in calibration accuracy; i.e. the absolute mean bias of assays participating in the CDC Vitamin D Standardization Certification Program was well below the allowable bias of 5% each year. Assays standardized in CDC’s certification programs also demonstrated higher accuracy in routine patient testing; i.e. CDC VD certified assays have a lower bias compared to non-certified assays. Similar observations were made with assays certified in the CDC’s program for TT. Monitoring data over the past 10 years from the CDC Lipid Standardization Program indicated that the majority of TC measurements performed in routine testing were consistently within the recommended bias limits of ±3%. CDC CSP continue to improve the analytical performance of assays by addressing measurement bias caused by factors other than incorrect calibration such as interfering compounds. The programs are responding to new clinical and public health needs with the addition of new analytes such as PTH and glucose. The CDC CSP support projects aiming at establishing reference intervals and other research studies. The CDC CSP work with stakeholders, such as the Partnership for the Accurate Testing of Hormones and the Endocrine Society, to educate the clinical and laboratory communities about the importance of using standardized assays in patient care, research, and public health. References: Partnership for Accurate Hormone Testing (PATH). www.hormoneassays.org. College of American Pathologists (CAP). www.cap.org.
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Han J, Heinemann L, Ginsberg BH, Alva S, Appel M, Bess S, Chen KY, Freckmann G, Harris DR, Hartwig M, Hinzmann R, Kerr D, Krouwer J, Morrow L, Nichols J, Pfützner A, Pleus S, Rice M, Sacks DB, Schlueter K, Vesper HW, Klonoff DC. The YSI 2300 Analyzer Replacement Meeting Report. J Diabetes Sci Technol 2020; 14:679-686. [PMID: 32174135 PMCID: PMC7576944 DOI: 10.1177/1932296820911471] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
This is a summary report of the most important aspects discussed during the YSI 2300 Analyzer Replacement Meeting. The aim is to provide the interested reader with an overview of the complex topic and propose solutions for the current issue. This solution should not only be adequate for the United States or Europe markets but also for all other countries. The meeting addendum presents three outcomes of the meeting.
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Affiliation(s)
- Julia Han
- Diabetes Research Institute, Mills-Peninsula Medical Center, San Mateo, CA, USA
| | - Lutz Heinemann
- Profil Institut für Stoffwechselforschung GmbH, Neuss, Germany
| | | | | | | | | | - Kong Y. Chen
- National Institute of Diabetes and Digestive and Kidney Diseases, Bethesda, MD, USA
| | - Guido Freckmann
- Institut für Diabetes-Technologie Forschungs- und Entwicklungsgesellschaft mbH, Ulm, Germany
| | | | | | | | - David Kerr
- Sansum Diabetes Research Institute, Santa Barbara, CA, USA
| | | | | | - James Nichols
- Vanderbilt University School of Medicine, Nashville, TN, USA
| | | | - Stefan Pleus
- Institut für Diabetes-Technologie Forschungs- und Entwicklungsgesellschaft mbH, Ulm, Germany
| | - Mark Rice
- Vanderbilt University School of Medicine, Nashville, TN, USA
| | | | | | | | - David C. Klonoff
- Diabetes Research Institute, Mills-Peninsula Medical Center, San Mateo, CA, USA
- David C. Klonoff, MD, FACP, FRCP (Edin), Fellow AIMBE, Medical Director, Diabetes Research Institute, Mills-Peninsula Medical Center, 100 South San Mateo Drive, Room 5147, San Mateo, CA 94401, USA.
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Abstract
Trans-fatty acid (TFA) intake can increase the risk of coronary heart disease (CHD) morbidity and mortality and all-cause mortality. Industrially produced TFAs and ruminant TFAs are the major sources in foods. TFA intake and TFA-attributed CHD mortality vary widely worldwide. Excessive TFA intake is a health threat in high-income countries; however, it is also a threat in low- and middle-income countries (LMICs). Data on TFA intake are scarce in many LMICs and an urgent need exists to monitor TFAs globally. We reviewed global TFA intake and TFA-attributed CHD mortality and current progress toward policy or regulation on elimination of industrially produced TFAs in foods worldwide. Human biological tissues can be used as biomarkers of TFAs because they reflect actual intake from various foods. Measuring blood TFA levels is a direct and reliable method to quantify TFA intake.
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Affiliation(s)
- Chaoyang Li
- Division of Global Health Protection, Center for Global Health, Centers for Disease Control and Prevention, 1825 Century Blvd, Atlanta, GA 30345.
| | - Laura K Cobb
- Resolve to Save Lives, Vital Strategies, New York, New York
| | - Hubert W Vesper
- Division of Laboratory Sciences, National Center for Environmental Health, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Samira Asma
- World Health Organization, Geneva, Switzerland
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Carlson L, Flores Poccia V, Sun BZ, Mosley B, Kirste I, Rice A, Sridhar R, Kangarloo T, Vesper HW, Duke L, Botelho JC, Filie AC, Adams JM, Shaw ND. Early breast development in overweight girls: does estrogen made by adipose tissue play a role? Int J Obes (Lond) 2019; 43:1978-1987. [PMID: 31462689 PMCID: PMC6774855 DOI: 10.1038/s41366-019-0446-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/05/2018] [Revised: 07/09/2019] [Accepted: 07/22/2019] [Indexed: 11/10/2022]
Abstract
Background Girls who are overweight/obese (OB) develop breast tissue but do not
undergo menarche (the first menstrual period) significantly earlier than
girls of normal weight (NW). It has been proposed that estrogen synthesized
by adipose tissue may be contributory, yet OB do not have higher serum
estrogen levels than NW matched on breast stage. We hypothesized that
estrogen synthesized locally, in mammary fat, may contribute to breast
development. This hypothesis would predict that breast development would be
more advanced than other estrogen-sensitive tissues as a function of obesity
and body fat. Methods 80 pre-menarchal girls (26 OB, 54 NW), aged 8.2–14.7 yrs,
underwent dual-energy x-ray absorptiometry to calculate percent body fat
(%BF), Tanner staging of the breast, breast ultrasound for morphological
staging, trans-abdominal pelvic ultrasound, hand x-ray (bone age), a blood
test for reproductive hormones, and urine collection to determine the
vaginal maturation index (VMI), an index of estrogen exposure in urogenital
epithelial cells. Results When controlling for breast morphological stage determined by
ultrasound, %BF was not associated with serum estrogen or gonadotropin (LH
and FSH) levels or on indices of systemic estrogen action (uterine volume,
endometrial thickness, bone age advancement, and VMI). Tanner breast stage
did not correlate with breast morphological stage and led to
misclassification of chest fatty tissue as breast tissue in some OB. Conclusions These studies do not support the hypothesis that estrogen derived
from total body fat or local (mammary) fat contributes to breast development
in overweight/obese girls.
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Affiliation(s)
- Lauren Carlson
- Clinical Research Branch, National Institutes of Environmental Health Sciences, National Institutes of Health, Research Triangle Park, Durham, NC, USA
| | - Vanessa Flores Poccia
- Clinical Research Branch, National Institutes of Environmental Health Sciences, National Institutes of Health, Research Triangle Park, Durham, NC, USA
| | - Bob Z Sun
- Clinical Research Branch, National Institutes of Environmental Health Sciences, National Institutes of Health, Research Triangle Park, Durham, NC, USA
| | - Brittany Mosley
- Clinical Research Branch, National Institutes of Environmental Health Sciences, National Institutes of Health, Research Triangle Park, Durham, NC, USA
| | - Imke Kirste
- Clinical Research Branch, National Institutes of Environmental Health Sciences, National Institutes of Health, Research Triangle Park, Durham, NC, USA
| | - Annette Rice
- Clinical Research Branch, National Institutes of Environmental Health Sciences, National Institutes of Health, Research Triangle Park, Durham, NC, USA
| | - Rithi Sridhar
- Clinical Research Branch, National Institutes of Environmental Health Sciences, National Institutes of Health, Research Triangle Park, Durham, NC, USA
| | - Tairmae Kangarloo
- Reproductive Endocrine Unit, Massachusetts General Hospital, Boston, MA, USA
| | - Hubert W Vesper
- Division of Laboratory Sciences, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Lumi Duke
- Division of Laboratory Sciences, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Julianne C Botelho
- Division of Laboratory Sciences, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Armando C Filie
- Cytopathology Section, Laboratory of Pathology, Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA
| | - Judy M Adams
- Reproductive Endocrine Unit, Massachusetts General Hospital, Boston, MA, USA
| | - Natalie D Shaw
- Clinical Research Branch, National Institutes of Environmental Health Sciences, National Institutes of Health, Research Triangle Park, Durham, NC, USA. .,Reproductive Endocrine Unit, Massachusetts General Hospital, Boston, MA, USA.
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Duke L, Kim PH, Botelho JC, Zhou H, Ulmer CZ, Vesper HW. Abstract 587: Highly sensitive and accurate method for measuring serum estradiol in postmenopausal women and other population subgroups. Cancer Res 2019. [DOI: 10.1158/1538-7445.am2019-587] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Meta-analyses consistently show that postmenopausal women with elevated levels of estradiol have an increased risk for certain cancers, such as breast cancer. At the same time, estradiol therapy is used to treat menopausal symptoms. Data on blood levels of estradiol are highly variable, especially in postmenopausal women, which prevents the formulation of generally recognized normal ranges and the consistent treatment of postmenopausal women. Similarly, no generally recognized reference ranges for estradiol exist for men and children. One reason for this variability in estradiol blood levels is the lack of appropriate analytical methods. To overcome these challenges, new, highly sensitive, specific, and standardized methods for measuring estradiol are needed. This study describes a new analytical method for measuring estradiol in serum from post and premenopausal women, men and children, which is standardized to the CDC Hormone Standardization Program (HoSt). Data produced by this analytical method can be compared with data produced by other methods standardized to CDC HoSt. The analytical method optimizes the extraction of estradiol from serum using two liquid-liquid extractions with pH and polarity adjustments prior to LC-MS/MS analysis. All sample handling and extraction procedures are automated using 96-well plates. Chromatographic separation is carried out using a phenyl-hexyl HPLC column and a gradient of methanol and methanol:water. E2 and its C13 internal standard were analyzed by selected reaction monitoring (SRM) in the negative ion mode with transitions of m/z 271 to 145 and 274 to 148, respectively.
The mean biases of this method to certified reference materials ranged between −1.3% and −1.7% and were statistically not significant. No significant difference to established metrological reference methods was determined. The limit of detection for estradiol using 200 µL of serum is 11.0 pM (2.99 pg/mL). The method is highly precise with a within-run, among-day (determined over 68 days), and total within-laboratory imprecision ranging between 2.9-5.0%, 1.5-1.8%, and 3.3-5.3% CV, respectively [1].
The sensitivity of the method was found to be suitable for determining estradiol levels in postmenopausal women, men, and children, and is being applied to measure estradiol in postmenopausal women in NHANES 2013-2014. Data generated by this method are comparable to those of other analytical methods that are standardized to the CDC HoSt program. This method allows for the development of generally recognized normal ranges of estradiol in postmenopausal women and other population subgroups.
References:
1. Zhou, Hui et al. “Simultaneous measurement of total estradiol and testosterone in human serum by isotope dilution liquid chromatography tandem mass spectrometry” Analytical and bioanalytical chemistry vol. 409,25 (2017): 5943-5954.
Citation Format: Lumi Duke, Paul H. Kim, Julianne Cook Botelho, Hui Zhou, Candice Z. Ulmer, Hubert W. Vesper. Highly sensitive and accurate method for measuring serum estradiol in postmenopausal women and other population subgroups [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2019; 2019 Mar 29-Apr 3; Atlanta, GA. Philadelphia (PA): AACR; Cancer Res 2019;79(13 Suppl):Abstract nr 587.
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Wright M, McKelvey W, Curtis CJ, Thorpe LE, Vesper HW, Kuiper HC, Angell SY. Impact of a Municipal Policy Restricting Trans Fatty Acid Use in New York City Restaurants on Serum Trans Fatty Acid Levels in Adults. Am J Public Health 2019; 109:634-636. [PMID: 30789777 DOI: 10.2105/ajph.2018.304930] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
OBJECTIVES To estimate the impact of the 2006 policy restricting use of trans fatty acids (TFAs) in New York City restaurants on change in serum TFA concentrations in New York City adults. METHODS Two cross-sectional population-based New York City Health and Nutrition Examination Surveys conducted in 2004 (n = 212) and 2013-2014 (n = 247) provided estimates of serum TFA exposure and average frequency of weekly restaurant meals. We estimated the geometric mean of the sum of serum TFAs by year and restaurant meal frequency by using linear regression. RESULTS Among those who ate less than 1 restaurant meal per week, geometric mean of the sum of serum TFAs declined 51.1% (95% confidence interval [CI] = 42.7, 58.3)-from 44.6 (95% CI = 39.7, 50.1) to 21.8 (95% CI = 19.3, 24.5) micromoles per liter. The decline in the geometric mean was greater (P for interaction = .04) among those who ate 4 or more restaurant meals per week: 61.6% (95% CI = 55.8, 66.7) or from 54.6 (95% CI = 49.3, 60.5) to 21.0 (95% CI = 18.9, 23.3) micromoles per liter. CONCLUSIONS New York City adult serum TFA concentrations declined between 2004 and 2014. The indication of greater decline in serum TFAs among those eating restaurant meals more frequently suggests that the municipal restriction on TFA use was effective in reducing TFA exposure. Public Health Implications. Local policies focused on restaurants can promote nutritional improvements.
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Affiliation(s)
- Melecia Wright
- At the time of the writing, Melecia Wright, Wendy McKelvey, Christine Johnson Curtis, and Sonia Y. Angell were with the New York City Department of Health and Mental Hygiene, Queens, NY. Lorna E. Thorpe is with the New York University School of Medicine, Department of Population Health, New York, NY. Hubert W. Vesper and Heather C. Kuiper are with Centers for Disease Control and Prevention, National Center for Environmental Health, Atlanta, GA
| | - Wendy McKelvey
- At the time of the writing, Melecia Wright, Wendy McKelvey, Christine Johnson Curtis, and Sonia Y. Angell were with the New York City Department of Health and Mental Hygiene, Queens, NY. Lorna E. Thorpe is with the New York University School of Medicine, Department of Population Health, New York, NY. Hubert W. Vesper and Heather C. Kuiper are with Centers for Disease Control and Prevention, National Center for Environmental Health, Atlanta, GA
| | - Christine Johnson Curtis
- At the time of the writing, Melecia Wright, Wendy McKelvey, Christine Johnson Curtis, and Sonia Y. Angell were with the New York City Department of Health and Mental Hygiene, Queens, NY. Lorna E. Thorpe is with the New York University School of Medicine, Department of Population Health, New York, NY. Hubert W. Vesper and Heather C. Kuiper are with Centers for Disease Control and Prevention, National Center for Environmental Health, Atlanta, GA
| | - Lorna E Thorpe
- At the time of the writing, Melecia Wright, Wendy McKelvey, Christine Johnson Curtis, and Sonia Y. Angell were with the New York City Department of Health and Mental Hygiene, Queens, NY. Lorna E. Thorpe is with the New York University School of Medicine, Department of Population Health, New York, NY. Hubert W. Vesper and Heather C. Kuiper are with Centers for Disease Control and Prevention, National Center for Environmental Health, Atlanta, GA
| | - Hubert W Vesper
- At the time of the writing, Melecia Wright, Wendy McKelvey, Christine Johnson Curtis, and Sonia Y. Angell were with the New York City Department of Health and Mental Hygiene, Queens, NY. Lorna E. Thorpe is with the New York University School of Medicine, Department of Population Health, New York, NY. Hubert W. Vesper and Heather C. Kuiper are with Centers for Disease Control and Prevention, National Center for Environmental Health, Atlanta, GA
| | - Heather C Kuiper
- At the time of the writing, Melecia Wright, Wendy McKelvey, Christine Johnson Curtis, and Sonia Y. Angell were with the New York City Department of Health and Mental Hygiene, Queens, NY. Lorna E. Thorpe is with the New York University School of Medicine, Department of Population Health, New York, NY. Hubert W. Vesper and Heather C. Kuiper are with Centers for Disease Control and Prevention, National Center for Environmental Health, Atlanta, GA
| | - Sonia Y Angell
- At the time of the writing, Melecia Wright, Wendy McKelvey, Christine Johnson Curtis, and Sonia Y. Angell were with the New York City Department of Health and Mental Hygiene, Queens, NY. Lorna E. Thorpe is with the New York University School of Medicine, Department of Population Health, New York, NY. Hubert W. Vesper and Heather C. Kuiper are with Centers for Disease Control and Prevention, National Center for Environmental Health, Atlanta, GA
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Zahoor N, Danilenko U, Vesper HW. A fully automated high-throughput liquid chromatography tandem mass spectrometry method for measuring creatinine in urine. Clin Mass Spectrom 2019; 11:1-7. [PMID: 34414261 PMCID: PMC8372835 DOI: 10.1016/j.clinms.2018.11.002] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/01/2018] [Revised: 11/16/2018] [Accepted: 11/19/2018] [Indexed: 10/27/2022]
Abstract
Reliable creatinine measurements are important to evaluate kidney function and for creatinine correction to reduce biological variability of other urinary analytes. A high-throughput, accurate liquid chromatography tandem mass spectrometry method for quantitation of human urinary creatinine has been developed and validated. Sample preparation was fully automated including cryovial decapping, sample ID scanning and two serial dilution steps. Quantitation was performed using a stable isotope-labeled internal standard. Multiplexed chromatographic separation of creatinine was achieved within a one-minute analysis and followed by tandem mass spectrometry in positive electrospray ionization mode. The precursor and product ions of creatinine and D3-creatinine were monitored in selected reaction monitoring mode. Method validation results showed reproducibility with within-run precision of 3.59, 3.49 and 2.84% and between-run precision of 4.01, 3.28 and 3.57% for low, medium and high quality control materials prepared from pooled donor urine, respectively. The method showed excellent accuracy with a bias of -1.94%, -0.78% and -1.07% for three levels of certified reference material. The calibration curve was linear throughout a 7.50-300 mg/dL (0.663-26.5 mmol/L) measurement range (R2 = 0.999), with the mean slope of 0.0115 (95%CI, 0.0108-0.0122) and intercept of 0.0027 (95%CI, 0.0003-0.0051). The limit of detection (LOD) of the method was 3.17 mg/dL (0.280 mmol/L). Analytical specificity was achieved by chromatographically separating creatinine from potentially interfering creatine within a one-minute run and monitoring the Quantitation Ion/Confirmation Ion (QI/CI) ratios in samples. A simple, accurate, high-throughput method was successfully developed for measuring creatinine in human urine samples.
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Affiliation(s)
- Neelam Zahoor
- Division of Laboratory Sciences, National Center for Environmental Health, Centers for Disease Control and Prevention, 4770 Buford Hwy NE, MS F25, Atlanta, GA 30341, USA
| | - Uliana Danilenko
- Division of Laboratory Sciences, National Center for Environmental Health, Centers for Disease Control and Prevention, 4770 Buford Hwy NE, MS F25, Atlanta, GA 30341, USA
| | - Hubert W. Vesper
- Division of Laboratory Sciences, National Center for Environmental Health, Centers for Disease Control and Prevention, 4770 Buford Hwy NE, MS F25, Atlanta, GA 30341, USA
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Delatour V, Liu Q, Vesper HW. Commutability Assessment of External Quality Assessment Materials with the Difference in Bias Approach: Are Acceptance Criteria Based on Medical Requirements too Strict? Clin Chem 2018; 62:1670-1671. [PMID: 27899458 DOI: 10.1373/clinchem.2016.261008] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Affiliation(s)
- Vincent Delatour
- Laboratoire national de métrologie et d'essais (LNE) Paris, France
| | - Qinde Liu
- Chemical Metrology Division Applied Sciences Group Health Science Authority Singapore
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Delatour V, Clouet-Foraison N, Gaie-Levrel F, Marcovina SM, Hoofnagle AN, Kuklenyik Z, Caulfield MP, Otvos JD, Krauss RM, Kulkarni KR, Contois JH, Remaley AT, Vesper HW, Cobbaert CM, Gillery P. Comparability of Lipoprotein Particle Number Concentrations Across ES-DMA, NMR, LC-MS/MS, Immunonephelometry, and VAP: In Search of a Candidate Reference Measurement Procedure for apoB and non-HDL-P Standardization. Clin Chem 2018; 64:1485-1495. [PMID: 30087138 DOI: 10.1373/clinchem.2018.288746] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2018] [Accepted: 07/10/2018] [Indexed: 12/15/2022]
Abstract
BACKGROUND Despite the usefulness of standard lipid parameters for cardiovascular disease risk assessment, undiagnosed residual risk remains high. Advanced lipoprotein testing (ALT) was developed to provide physicians with more predictive diagnostic tools. ALT methods separate and/or measure lipoproteins according to different parameters such as size, density, charge, or content, and equivalence of results across methods has not been demonstrated. METHODS Through a split-sample study, 25 clinical specimens (CSs) were assayed in 10 laboratories before and after freezing using the major ALT methods for non-HDL particles (non-HDL-P) or apolipoprotein B-100 (apoB-100) measurements with the intent to assess their comparability in the current state of the art. RESULTS The overall relative standard deviation (CV) of non-HDL-P and apoB-100 concentrations measured by electrospray differential mobility analysis, nuclear magnetic resonance, immunonephelometry, LC-MS/MS, and vertical autoprofile in the 25 frozen CSs was 14.1%. Within-method comparability was heterogeneous, and CV among 4 different LC-MS/MS methods was 11.4% for apoB-100. No significant effect of freezing and thawing was observed. CONCLUSIONS This study demonstrates that ALT methods do not yet provide equivalent results for the measurement of non-HDL-P and apoB-100. The better agreement between methods harmonized to the WHO/IFCC reference material suggests that standardizing ALT methods by use of a common commutable calibrator will improve cross-platform comparability. This study provides further evidence that LC-MS/MS is the most suitable candidate reference measurement procedure to standardize apoB-100 measurement, as it would provide results with SI traceability. The absence of freezing and thawing effect suggests that frozen serum pools could be used as secondary reference materials.
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Affiliation(s)
- Vincent Delatour
- Laboratoire National de Métrologie et d'Essais (LNE), Paris, France;
| | | | | | - Santica M Marcovina
- Northwest Lipid Metabolism and Diabetes Research Laboratories, University of Washington, Seattle, WA
| | - Andrew N Hoofnagle
- Department of Laboratory Medicine, University of Washington, Seattle, WA
| | - Zsuzsanna Kuklenyik
- Centers for Disease Control and Prevention, Division of Laboratory Sciences, Atlanta, GA
| | | | - James D Otvos
- Laboratory Corporation of America® Holdings, Morrisville, NC
| | | | | | | | - Alan T Remaley
- Lipoprotein Metabolism Section, National Heart, Lung, and Blood Institute, Bethesda, MD
| | - Hubert W Vesper
- Centers for Disease Control and Prevention, Division of Laboratory Sciences, Atlanta, GA
| | - Christa M Cobbaert
- Department of Clinical Chemistry and Laboratory Medicine, Leiden University Medical Center, Leiden, the Netherlands
| | - Philippe Gillery
- University Hospital of Reims, Laboratory of Pediatric Biology and Research, Reims, France
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Adgent MA, Umbach DM, Zemel BS, Kelly A, Schall JI, Ford EG, James K, Darge K, Botelho JC, Vesper HW, Chandler DW, Nakamoto JM, Rogan WJ, Stallings VA. A Longitudinal Study of Estrogen-Responsive Tissues and Hormone Concentrations in Infants Fed Soy Formula. J Clin Endocrinol Metab 2018; 103:1899-1909. [PMID: 29506126 PMCID: PMC6456922 DOI: 10.1210/jc.2017-02249] [Citation(s) in RCA: 31] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/11/2017] [Accepted: 02/26/2018] [Indexed: 02/02/2023]
Abstract
PURPOSE Chemicals with hormonelike activity, such as estrogenic isoflavones, may perturb human development. Infants exclusively fed soy-based formula are highly exposed to isoflavones, but their physiologic responses remain uncharacterized. Estrogen-responsive postnatal development was compared in infants exclusively fed soy formula, cow-milk formula, and breast milk. METHODS We enrolled 410 infants born in Philadelphia-area hospitals between 2010 and 2014; 283 were exclusively fed soy formula (n = 102), cow-milk formula (n = 111), or breast milk (n = 70) throughout the study (birth to 28 or 36 weeks for boys and girls, respectively). We repeatedly measured maturation index (MI) in vaginal and urethral epithelial cells using standard cytological methods, uterine volume and breast-bud diameter using ultrasound, and serum estradiol and follicle-stimulating hormone levels. We estimated MI, organ-growth, and hormone trajectories by diet using mixed-effects regression splines. RESULTS Maternal demographics did not differ between cow-milk-fed and soy-fed infants but did differ between formula-fed and breastfed infants. Vaginal-cell MI trended higher (P = 0.01) and uterine volume decreased more slowly (P = 0.01) in soy-fed girls compared with cow-milk-fed girls; however, their trajectories of breast-bud diameter and hormone concentrations did not differ. We observed no significant differences between boys fed cow-milk vs soy formula; estradiol was not detectable. Breastfed infants differed from soy-formula-fed infants in vaginal-cell MI, uterine volume, and girls' estradiol and boys' breast-bud diameter trajectories. CONCLUSIONS Relative to girls fed cow-milk formula, those fed soy formula demonstrated tissue- and organ-level developmental trajectories consistent with response to exogenous estrogen exposure. Studies are needed to further evaluate the effects of soy on child development.
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Affiliation(s)
- Margaret A Adgent
- Epidemiology Branch, National Institute of Environmental Health Sciences, National Institutes of Health, Research Triangle Park, North Carolina
- Department of Pediatrics, Vanderbilt University Medical Center, Nashville, Tennessee
- Correspondence and Reprint Requests: Margaret A. Adgent, PhD, 1313 21st Avenue S, Suite 313, Nashville, Tennessee 37232. E-mail:
| | - David M Umbach
- Biostatistics and Computational Biology Branch, National Institute of Environmental Health Sciences, National Institutes of Health, Research Triangle Park, North Carolina
| | - Babette S Zemel
- Department of Pediatrics, Division of Gastroenterology, Hepatology and Nutrition, The Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania
- University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania
| | - Andrea Kelly
- University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania
- Department of Pediatrics, Division of Endocrinology, The Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania
| | - Joan I Schall
- Department of Pediatrics, Division of Gastroenterology, Hepatology and Nutrition, The Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania
| | - Eileen G Ford
- Department of Pediatrics, Division of Gastroenterology, Hepatology and Nutrition, The Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania
| | - Kerry James
- Social & Scientific Systems, Inc., Durham, North Carolina
| | - Kassa Darge
- University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania
- Department of Radiology, The Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania
| | - Julianne C Botelho
- Division of Laboratory Sciences, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Hubert W Vesper
- Division of Laboratory Sciences, Centers for Disease Control and Prevention, Atlanta, Georgia
| | | | - Jon M Nakamoto
- Quest Diagnostics Nichols Institute, San Juan Capistrano, California
| | - Walter J Rogan
- Epidemiology Branch, National Institute of Environmental Health Sciences, National Institutes of Health, Research Triangle Park, North Carolina
| | - Virginia A Stallings
- Department of Pediatrics, Division of Gastroenterology, Hepatology and Nutrition, The Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania
- University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania
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Miller WG, Schimmel H, Rej R, Greenberg N, Ceriotti F, Burns C, Budd JR, Weykamp C, Delatour V, Nilsson G, MacKenzie F, Panteghini M, Keller T, Camara JE, Zegers I, Vesper HW. IFCC Working Group Recommendations for Assessing Commutability Part 1: General Experimental Design. Clin Chem 2018; 64:447-454. [PMID: 29348163 DOI: 10.1373/clinchem.2017.277525] [Citation(s) in RCA: 87] [Impact Index Per Article: 14.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2017] [Accepted: 12/14/2017] [Indexed: 11/06/2022]
Abstract
Commutability is a property of a reference material (RM) that relates to the closeness of agreement between results for an RM and results for clinical samples (CSs) when measured by ≥2 measurement procedures (MPs). Commutability of RMs used in a calibration traceability scheme is an essential property for them to be fit for purpose. Similarly, commutability of trueness controls or external quality assessment samples is essential when those materials are used to assess trueness of results for CSs. This report is part 1 of a 3-part series describing how to assess commutability of RMs. Part 1 defines commutability and addresses critical components of the experimental design for commutability assessment, including selection of individual CSs, use of pooled CSs, qualification of MPs for inclusion, establishing criteria for the determination that an RM is commutable, generalization of commutability conclusions to future measurements made with the MPs included in the assessment, and information regarding commutability to be included in the certificate for an RM. Parts 2 and 3 in the series present 2 different statistical approaches to commutability assessment that use fixed criteria related to the medical decisions that will be made using the laboratory test results.
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Affiliation(s)
- W Greg Miller
- Department of Pathology, Virginia Commonwealth University, Richmond, VA;
| | - Heinz Schimmel
- European Commission, Joint Research Centre (JRC), Directorate F, Geel, Belgium
| | - Robert Rej
- Wadsworth Center for Laboratories and Research, New York State Department of Health, and School of Public Health, State University of New York at Albany, Albany, NY
| | | | | | - Chris Burns
- National Institute for Biological Standards and Control, A Centre of the MHRA, Hertfordshire, UK
| | | | - Cas Weykamp
- Queen Beatrix Hospital, Winterswijk, the Netherlands
| | - Vincent Delatour
- Laboratoire national de métrologie et d'essais (LNE), Paris, France
| | | | - Finlay MacKenzie
- Birmingham Quality/UK NEQAS, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK
| | - Mauro Panteghini
- Research Centre for Metrological Traceability in Laboratory Medicine (CIRME), University of Milan, Milan, Italy
| | | | - Johanna E Camara
- National Institute of Standards and Technology, Gaithersburg, MD
| | - Ingrid Zegers
- European Commission, Joint Research Centre (JRC), Directorate F, Geel, Belgium
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40
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Nilsson G, Budd JR, Greenberg N, Delatour V, Rej R, Panteghini M, Ceriotti F, Schimmel H, Weykamp C, Keller T, Camara JE, Burns C, Vesper HW, MacKenzie F, Miller WG. IFCC Working Group Recommendations for Assessing Commutability Part 2: Using the Difference in Bias between a Reference Material and Clinical Samples. Clin Chem 2018; 64:455-464. [PMID: 29348165 DOI: 10.1373/clinchem.2017.277541] [Citation(s) in RCA: 80] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2017] [Accepted: 12/15/2017] [Indexed: 11/06/2022]
Abstract
A process is described to assess the commutability of a reference material (RM) intended for use as a calibrator, trueness control, or external quality assessment sample based on the difference in bias between an RM and clinical samples (CSs) measured using 2 different measurement procedures (MPs). This difference in bias is compared with a criterion based on a medically relevant difference between an RM and CS results to make a conclusion regarding commutability. When more than 2 MPs are included, the commutability is assessed pairwise for all combinations of 2 MPs. This approach allows the same criterion to be used for all combinations of MPs included in the assessment. The assessment is based on an error model that allows estimation of various random and systematic sources of error, including those from sample-specific effects of interfering substances. An advantage of this approach is that the difference in bias between an RM and the average bias of CSs at the concentration (i.e., amount of substance present or quantity value) of the RM is determined and its uncertainty estimated. An RM is considered fit for purpose for those MPs for which commutability is demonstrated.
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Affiliation(s)
| | | | | | - Vincent Delatour
- Laboratoire national de métrologie et d'essais (LNE), Paris, France
| | - Robert Rej
- Wadsworth Center for Laboratories and Research, New York State Department of Health, and School of Public Health, State University of New York at Albany, Albany, NY
| | - Mauro Panteghini
- Research Centre for Metrological Traceability in Laboratory Medicine (CIRME), University of Milan, Milan, Italy
| | | | - Heinz Schimmel
- European Commission, Joint Research Centre (JRC), Directorate F, Geel, Belgium
| | - Cas Weykamp
- Queen Beatrix Hospital, Winterswijk, the Netherlands
| | | | - Johanna E Camara
- National Institute of Standards and Technology, Gaithersburg, MD
| | - Chris Burns
- National Institute for Biological Standards and Control, A Centre of the MHRA, Hertfordshire, UK
| | | | - Finlay MacKenzie
- Birmingham Quality/UK NEQAS, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK
| | - W Greg Miller
- Department of Pathology, Virginia Commonwealth University, Richmond, VA.
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Budd JR, Weykamp C, Rej R, MacKenzie F, Ceriotti F, Greenberg N, Camara JE, Schimmel H, Vesper HW, Keller T, Delatour V, Panteghini M, Burns C, Miller WG. IFCC Working Group Recommendations for Assessing Commutability Part 3: Using the Calibration Effectiveness of a Reference Material. Clin Chem 2018; 64:465-474. [PMID: 29348164 DOI: 10.1373/clinchem.2017.277558] [Citation(s) in RCA: 39] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2017] [Accepted: 12/18/2017] [Indexed: 11/06/2022]
Abstract
A process is described to assess the commutability of a reference material (RM) intended for use as a calibrator based on its ability to fulfill its intended use in a calibration traceability scheme to produce equivalent clinical sample (CS) results among different measurement procedures (MPs) for the same measurand. Three sources of systematic error are elucidated in the context of creating the calibration model for translating MP signals to measurand amounts: calibration fit, calibrator level trueness, and commutability. An example set of 40 CS results from 7 MPs is used to illustrate estimation of bias and variability for each MP. The candidate RM is then used to recalibrate each MP, and its effectiveness in reducing the systematic error among the MPs within an acceptable level of equivalence based on medical requirements confirms its commutability for those MPs. The RM is declared noncommutable for MPs for which, after recalibration, the CS results do not agree with those from other MPs. When a lack of agreement is found, other potential causes, including lack of calibration fit, should be investigated before concluding the RM is noncommutable. The RM is considered fit for purpose for those MPs where commutability is demonstrated.
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Affiliation(s)
| | - Cas Weykamp
- Queen Beatrix Hospital, Winterswijk, the Netherlands
| | - Robert Rej
- Wadsworth Center for Laboratories and Research, New York State Department of Health, and School of Public Health, State University of New York at Albany, Albany, NY
| | - Finlay MacKenzie
- Birmingham Quality/UK NEQAS, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK
| | | | | | - Johanna E Camara
- National Institute of Standards and Technology, Gaithersburg, MD
| | - Heinz Schimmel
- European Commission, Joint Research Centre (JRC), Directorate F, Geel, Belgium
| | | | | | - Vincent Delatour
- Laboratoire national de métrologie et d'essais (LNE), Paris, France
| | - Mauro Panteghini
- Research Centre for Metrological Traceability in Laboratory Medicine (CIRME), University of Milan, Milan, Italy
| | - Chris Burns
- National Institute for Biological Standards and Control, A Centre of the MHRA, Hertfordshire, UK
| | - W Greg Miller
- Department of Pathology, Virginia Commonwealth University, Richmond, VA.
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Kuiper HC, Wei N, McGunigale SL, Vesper HW. Quantitation of trans-fatty acids in human blood via isotope dilution-gas chromatography-negative chemical ionization-mass spectrometry. J Chromatogr B Analyt Technol Biomed Life Sci 2018; 1076:35-43. [PMID: 29396366 DOI: 10.1016/j.jchromb.2017.12.038] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2017] [Revised: 12/27/2017] [Accepted: 12/30/2017] [Indexed: 12/14/2022]
Abstract
Trans-fatty acids (TFA) are geometric isomers of naturally occurring cis-fatty acids. High dietary TFA intake has been associated with risk factors for cardiovascular disease. However, little is known about TFA levels in humans. To address this data need, we developed and validated a new isotope dilution-gas chromatography-negative chemical ionization-mass spectrometry (ID-GC-NCI-MS) method for quantitation of 27 fatty acids (FA) including 4 major TFA in human plasma, serum, and red blood cells (RBC) from 66 donors. Quantitation was performed with 18 isotope labeled internal standards and results are presented in μM and % of total FA. This method has high sensitivity and specificity due to use of pentafluorobenzyl-bromide derivatization combined with NCI-MS and a 200m column to optimize positional and geometric FA isomer separation. The four major TFA, palmitelaidic acid, elaidic acid, trans-vaccenic acid, and linoelaidic acid, were detected in all samples, with median total TFA concentrations of 17.7μM in plasma, 19.6μM in serum, and 21.5μM in RBC. The % of total FA for the TFA was 0.20% in plasma, 0.20% in serum, and 0.30% in RBC. Patterns for % FA are similar to those reported in other studies. We developed a highly specific, ID-GC-NCI-MS method to quantitate TFA and other FA in humans.
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Affiliation(s)
- Heather C Kuiper
- Division of Laboratory Sciences, National Center for Environmental Health, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Na Wei
- Division of Laboratory Sciences, National Center for Environmental Health, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Samantha L McGunigale
- Centers for Disease Control and Prevention, Battelle Memorial Institute, Atlanta, GA, USA
| | - Hubert W Vesper
- Division of Laboratory Sciences, National Center for Environmental Health, Centers for Disease Control and Prevention, Atlanta, GA, USA.
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43
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Yang M, Ospina M, Tse C, Toth S, Caudill SP, Vesper HW. Ultraperformance Liquid Chromatography Tandem Mass Spectrometry Method To Determine Formaldehyde Hemoglobin Adducts in Humans as Biomarker for Formaldehyde Exposure. Chem Res Toxicol 2017; 30:1592-1598. [PMID: 28662331 PMCID: PMC5652314 DOI: 10.1021/acs.chemrestox.7b00114] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Formaldehyde (FA) is an environmental chemical classified as a human carcinogen. It is highly reactive and can bind covalently with hemoglobin (Hb) to produce Hb adducts. Measurement of these Hb adducts provides valuable information about exposure to this chemical. We developed a robust, ultraperformance liquid chromatography-tandem mass spectrometry (UPLC-MS/MS) method for quantifying FA-Hb adducts in red blood cells. The method measures the FA-VHLTPEEK peptide after trypic digestion. The peptide is a FA adduct at the N-terminus of the beta chain of human Hb. Method mean (±SD) accuracy, determined by recovery in quality control and blank material was 103.2% ± 8.11. The mean among-day and within-day coefficients of variation determined at three concentration levels (%CV) were 9.2% (range: 7.2-10.2%) and 4.9% (range 3.1-7.3%), respectively. The limit of detection was 3.4 nmol/g Hb. This method was applied to the analysis of 135 human blood samples, and FA-VHLTPEEK was detected in all study samples. FA-VHLTPEEK concentrations were not significantly different between smokers and nonsmokers. This work is the first validated UPLC-MS/MS method in which a FA peptide derived from a FA-Hb adduct could be used to monitor exposure to FA in population studies.
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Affiliation(s)
- Min Yang
- Centers for Disease Control and Prevention, Battelle Memorial Institute, Atlanta, Georgia 30345, United States
| | - Maria Ospina
- Division of Laboratory Sciences, Centers for Disease Control and Prevention, Atlanta, Georgia 30341, United States
| | - Chui Tse
- Division of Laboratory Sciences, Centers for Disease Control and Prevention, Atlanta, Georgia 30341, United States
| | - Stephen Toth
- Division of Laboratory Sciences, Centers for Disease Control and Prevention, Atlanta, Georgia 30341, United States
| | - Samuel P. Caudill
- Division of Laboratory Sciences, Centers for Disease Control and Prevention, Atlanta, Georgia 30341, United States
| | - Hubert W. Vesper
- Division of Laboratory Sciences, Centers for Disease Control and Prevention, Atlanta, Georgia 30341, United States
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44
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Zhou H, Wang Y, Gatcombe M, Farris J, Botelho JC, Caudill SP, Vesper HW. Simultaneous measurement of total estradiol and testosterone in human serum by isotope dilution liquid chromatography tandem mass spectrometry. Anal Bioanal Chem 2017; 409:5943-5954. [PMID: 28801832 DOI: 10.1007/s00216-017-0529-x] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2017] [Revised: 07/05/2017] [Accepted: 07/18/2017] [Indexed: 12/13/2022]
Abstract
Reliable measurement of total testosterone and estradiol is critical for their use as biomarkers of hormone-related disorders in patient care and translational research. We developed and validated a mass spectrometry method to simultaneously quantify these analytes in human serum without chemical derivatization. Serum is equilibrated with isotopic internal standards and treated with acidic buffer to release hormones from their binding proteins. Lipids are isolated and polar impurities are removed by two serial liquid-liquid extraction steps. Total testosterone and estradiol are measured using liquid chromatography tandem mass spectrometry (LC-MS/MS) in combination of positive and negative electrospray ionization modes. The method shows broad analytical measurement range for both testosterone 0.03-48.5 nM (0.75-1400 ng/dL) and estradiol 11.0-5138 pM (2.99-1400 pg/mL) and excellent agreement with certified reference materials (mean bias less than 2.1% to SRM 971, BCR 576, 577, and 578) and a high order reference method (mean bias 1.25% for testosterone and -0.84% for estradiol). The high accuracy of the method was monitored and certified by CDC Hormone Standardization (HoSt) Program for 2 years with mean bias -0.7% (95% CI -1.6% to 0.2%) for testosterone and 0.1% (95% CI -2.2% to 2.3%) for estradiol. The method precision over a 2-year period for quality control pools at low, medium, and high concentrations was 2.7-2.9% for testosterone and 3.3-5.3% for estradiol. With the consistently excellent accuracy and precision, this method is readily applicable for high-throughput clinical and epidemiological studies.
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Affiliation(s)
- Hui Zhou
- Centers For Disease Control and Prevention, National Center For Environmental Health, Division of Laboratory Sciences, Clinical Chemistry Branch, 4770 Buford Hwy NE, Atlanta, GA, 30341, USA
| | - Yuesong Wang
- Centers For Disease Control and Prevention, National Center For Environmental Health, Division of Laboratory Sciences, Clinical Chemistry Branch, 4770 Buford Hwy NE, Atlanta, GA, 30341, USA
| | - Matthew Gatcombe
- Centers For Disease Control and Prevention, National Center For Environmental Health, Division of Laboratory Sciences, Clinical Chemistry Branch, 4770 Buford Hwy NE, Atlanta, GA, 30341, USA
| | - Jacob Farris
- Centers For Disease Control and Prevention, National Center For Environmental Health, Division of Laboratory Sciences, Clinical Chemistry Branch, 4770 Buford Hwy NE, Atlanta, GA, 30341, USA
| | - Julianne C Botelho
- Centers For Disease Control and Prevention, National Center For Environmental Health, Division of Laboratory Sciences, Clinical Chemistry Branch, 4770 Buford Hwy NE, Atlanta, GA, 30341, USA
| | - Samuel P Caudill
- Centers For Disease Control and Prevention, National Center For Environmental Health, Division of Laboratory Sciences, Clinical Chemistry Branch, 4770 Buford Hwy NE, Atlanta, GA, 30341, USA
| | - Hubert W Vesper
- Centers For Disease Control and Prevention, National Center For Environmental Health, Division of Laboratory Sciences, Clinical Chemistry Branch, 4770 Buford Hwy NE, Atlanta, GA, 30341, USA.
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Vesper HW, Caudill SP, Kuiper HC, Yang Q, Ahluwalia N, Lacher DA, Pirkle JL. Plasma trans-fatty acid concentrations in fasting adults declined from NHANES 1999-2000 to 2009-2010. Am J Clin Nutr 2017; 105:1063-1069. [PMID: 28381474 PMCID: PMC5708855 DOI: 10.3945/ajcn.116.141622] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2016] [Accepted: 03/06/2017] [Indexed: 01/20/2023] Open
Abstract
Background: The consumption of trans fatty acids (TFAs) is associated with an increased risk of cardiovascular disease, and reducing their consumption is a major public health objective. Food intake studies have provided estimates for TFA concentrations in the US population; however, there is a need for data on TFA blood concentrations in the population.Objective: The objective of this study was to determine plasma TFA concentrations in a nationally representative group of fasted adults in the US population in NHANES samples from 1999-2000 and 2009-2010.Design: Four major TFAs [palmitelaidic acid (C16:1n-7t), trans vaccenic acid (C18:1n-7t), elaidic acid (C18:1n-9t), and linoelaidic acid (C18:2n-6t,9t)] were measured in plasma in 1613 subjects from NHANES 1999-2000 and 2462 subjects from NHANES 2009-2010 by gas chromatography-mass spectrometry. Geometric means and distribution percentiles were calculated for each TFA and their sum by age, sex, and race/ethnicity (non-Hispanic white, non-Hispanic black, Mexican American), and covariate-adjusted geometric means were computed by using a model that included these demographic and other dietary factors, as well as survey year and any significant interaction terms.Results: These nationally representative data for the adult US population show that TFA concentrations were 54% lower in NHANES 2009-2010 than in NHANES 1999-2000. Covariate-adjusted geometric means for the sum of the 4 TFAs were 81.4 μmol/L (95% CI: 77.3, 85.6 μmol/L) and 37.8 μmol/L (95% CI: 36.4, 39.4 μmol/L) in NHANES 1999-2000 and 2009-2010, respectively. Even with the large decline in TFA concentrations, differences between demographic subgroups were comparable in the 2 surveys.Conclusion: The results indicate an overall reduction in TFA concentrations in the US population and provide a valuable baseline to evaluate the impact of the recent regulation categorizing TFAs as food additives.
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Affiliation(s)
- Hubert W Vesper
- Division of Laboratory Sciences, National Center for Environmental Health,
| | - Samuel P Caudill
- Division of Laboratory Sciences, National Center for Environmental Health
| | - Heather C Kuiper
- Division of Laboratory Sciences, National Center for Environmental Health
| | - Quanhe Yang
- Division of Heart Disease and Stroke Prevention, National Center for Chronic Disease and Health Promotion, and
| | - Namanjeet Ahluwalia
- Division of Health Nutrition Examination Surveys, National Center for Health Statistics, CDC, Atlanta, GA
| | - David A Lacher
- Division of Health Nutrition Examination Surveys, National Center for Health Statistics, CDC, Atlanta, GA
| | - James L Pirkle
- Division of Laboratory Sciences, National Center for Environmental Health
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46
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Travison TG, Vesper HW, Orwoll E, Wu F, Kaufman JM, Wang Y, Lapauw B, Fiers T, Matsumoto AM, Bhasin S. Harmonized Reference Ranges for Circulating Testosterone Levels in Men of Four Cohort Studies in the United States and Europe. J Clin Endocrinol Metab 2017; 102:1161-1173. [PMID: 28324103 PMCID: PMC5460736 DOI: 10.1210/jc.2016-2935] [Citation(s) in RCA: 163] [Impact Index Per Article: 23.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/10/2016] [Accepted: 11/18/2016] [Indexed: 02/04/2023]
Abstract
Background Reference ranges for testosterone are essential for making a diagnosis of hypogonadism in men. Objective To establish harmonized reference ranges for total testosterone in men that can be applied across laboratories by cross-calibrating assays to a reference method and standard. Population The 9054 community-dwelling men in cohort studies in the United States and Europe: Framingham Heart Study; European Male Aging Study; Osteoporotic Fractures in Men Study; and Male Sibling Study of Osteoporosis. Methods Testosterone concentrations in 100 participants in each of the four cohorts were measured using a reference method at Centers for Disease Control and Prevention (CDC). Generalized additive models and Bland-Altman analyses supported the use of normalizing equations for transformation between cohort-specific and CDC values. Normalizing equations, generated using Passing-Bablok regression, were used to generate harmonized values, which were used to derive standardized, age-specific reference ranges. Results Harmonization procedure reduced intercohort variation between testosterone measurements in men of similar ages. In healthy nonobese men, 19 to 39 years, harmonized 2.5th, 5th, 50th, 95th, and 97.5th percentile values were 264, 303, 531, 852, and 916 ng/dL, respectively. Age-specific harmonized testosterone concentrations in nonobese men were similar across cohorts and greater than in all men. Conclusion Harmonized normal range in a healthy nonobese population of European and American men, 19 to 39 years, is 264 to 916 ng/dL. A substantial proportion of intercohort variation in testosterone levels is due to assay differences. These data demonstrate the feasibility of generating harmonized reference ranges for testosterone that can be applied to assays, which have been calibrated to a reference method and calibrator.
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Affiliation(s)
| | - Hubert W. Vesper
- Centers for Disease Control and Prevention, Atlanta, Georgia 30341
| | - Eric Orwoll
- Oregon Health and Science University, Portland, Oregon 97239
| | - Frederick Wu
- Andrology Research Unit, Centre for Endocrinology and Diabetes, Manchester Academic Health Science Centre, University of Manchester, Manchester M13 9WL, United Kingdom
| | | | - Ying Wang
- Oregon Health and Science University, Portland, Oregon 97239
| | | | - Tom Fiers
- Department of Clinical Chemistry, Ghent University Hospital, Ghent B-9000, Belgium
| | - Alvin M. Matsumoto
- Geriatric Research, Education, and Clinical Center, VA Puget Sound Health Care System, Division of Gerontology and Geriatric Medicine, Department of Medicine, University of Washington School of Medicine, Seattle, Washington 98108
| | - Shalender Bhasin
- Research Program in Men’s Health, Aging, and Metabolism, Boston Claude D. Pepper Older Americans Independence Center, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts 02115
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Legro RS, Kunselman AR, Stetter CM, Gnatuk CL, Estes SJ, Brindle E, Vesper HW, Botelho JC, Lee PA, Dodson WC. Normal Pubertal Development in Daughters of Women With PCOS: A Controlled Study. J Clin Endocrinol Metab 2017; 102:122-131. [PMID: 27778640 PMCID: PMC5413094 DOI: 10.1210/jc.2016-2707] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/15/2016] [Accepted: 10/21/2016] [Indexed: 11/19/2022]
Abstract
CONTEXT Daughters of women with polycystic ovary syndrome (PCOS) are thought to be at increased risk for developing stigmata of the syndrome, but the ontogeny during puberty is uncertain. OBJECTIVE We phenotyped daughters (n = 76) of mothers with PCOS and daughters (n = 80) from control mothers for reproductive and metabolic parameters characteristic of PCOS. DESIGN, SETTING, AND PARTICIPANTS We performed a matched case/control study at Penn State Hershey Medical Center that included non-Hispanic, white girls 4 to 17 years old. INTERVENTION We obtained birth history, biometric, ovarian ultrasounds, whole-body dual-energy X-ray absorptiometry scan for body composition, 2-hour glucose challenged salivary insulin levels, and two timed urinary collections (12 hours overnight and 3 hours in the morning) for gonadotropins and sex steroids. MAIN OUTCOME MEASURES We measured integrated urinary levels of adrenal (dehydroepiandrosterone sulfate) and ovarian [testosterone (TT)] steroids. Other endpoints included integrated salivary insulin levels and urinary luteinizing hormone levels. RESULTS There were no differences in detection rates or mean levels for gonadotropins and sex steroids in timed urinary collections between PCOS daughters and control daughters, nor were there differences in integrated salivary insulin levels. Results showed that 69% of Tanner 4/5 PCOS daughters vs 31% of control daughters had hirsutism defined as a Ferriman-Gallwey score >8 (P = 0.04). There were no differences in body composition as determined by dual-energy X-ray absorptiometry between groups in the three major body contents (i.e., bone, lean body mass, and fat) or in ovarian volume between groups. CONCLUSIONS Matched for pubertal stage, PCOS daughters have similar levels of urinary androgens and gonadotropins as well as glucose-challenged salivary insulin levels.
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Affiliation(s)
- Richard S. Legro
- Public Health Sciences, and
- Pediatrics, Penn State College of Medicine, Hershey, Pennsylvania 17033;
| | - Allen R. Kunselman
- Pediatrics, Penn State College of Medicine, Hershey, Pennsylvania 17033;
| | - Christy M. Stetter
- Pediatrics, Penn State College of Medicine, Hershey, Pennsylvania 17033;
| | | | | | - Eleanor Brindle
- Center for Studies in Demography and Ecology, University of Washington, Seattle, Washington 98195; and
| | - Hubert W. Vesper
- Center for Studies in Demography and Ecology, University of Washington, Seattle, Washington 98195; and
| | - Julianne C. Botelho
- Clinical Chemistry Branch, Division of Laboratory Sciences, Centers for Disease Control and Prevention, Atlanta, Georgia 30329
| | - Peter A. Lee
- Pediatrics, Penn State College of Medicine, Hershey, Pennsylvania 17033;
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48
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Botelho JC, Ribera A, Cooper HC, Vesper HW. Evaluation of an Isotope Dilution HPLC Tandem Mass Spectrometry Candidate Reference Measurement Procedure for Total 17-β Estradiol in Human Serum. Anal Chem 2016; 88:11123-11129. [PMID: 27744701 DOI: 10.1021/acs.analchem.6b03220] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
The inaccuracy of 17-β estradiol (E2) measurements affects its use as a biomarker in patient care and research. Clinical and research communities called for accurate and standardized E2 measurements. Reference Measurement Procedures (RMPs), part of the CDC Hormone Standardization Program (HoSt), are essential in addressing this need and ensuring that methods are accurate and comparable across testing systems, laboratories, and over time. A candidate RMP (cRMP) was developed for the measurement of total E2 in serum using liquid chromatography-tandem mass spectrometry (LC-MS/MS) without derivatization. The cRMP meets suggested performance criteria for accuracy and precision through the use of isotope dilution, calibrator bracketing, and gravimetric measurements. The cRMP demonstrated high agreement with certified reference materials (no significant bias to BCR576, 577, and 578) and established RMPs (slope 1.00, 95% CI 1.00-1.01; intercept 0.02, 95% CI -0.01 to 0.06). The cRMP is highly precise with intra-assay, interassay, and total percent CVs of 2.7%, 1.3%, and 2.4%, respectively. A higher specificity was achieved by measuring E2 without derivatization, compared to methods using derivatization agents. The cRMP can serve as a higher-order standard for establishing measurement traceability and provides an accuracy base against which routine methods can be compared in HoSt.
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Affiliation(s)
- Julianne Cook Botelho
- Centers For Disease Control And Prevention , National Center For Environmental Health, Division of Laboratory Sciences, Clinical Chemistry Branch, 4770 Buford Highway NE, Atlanta, Georgia 30341, United States
| | - Ashley Ribera
- Centers For Disease Control And Prevention , National Center For Environmental Health, Division of Laboratory Sciences, Clinical Chemistry Branch, 4770 Buford Highway NE, Atlanta, Georgia 30341, United States
| | - Hans C Cooper
- Centers For Disease Control And Prevention , National Center For Environmental Health, Division of Laboratory Sciences, Clinical Chemistry Branch, 4770 Buford Highway NE, Atlanta, Georgia 30341, United States
| | - Hubert W Vesper
- Centers For Disease Control And Prevention , National Center For Environmental Health, Division of Laboratory Sciences, Clinical Chemistry Branch, 4770 Buford Highway NE, Atlanta, Georgia 30341, United States
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49
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Sturgeon CM, Sprague S, Almond A, Cavalier E, Fraser WD, Algeciras-Schimnich A, Singh R, Souberbielle JC, Vesper HW. Perspective and priorities for improvement of parathyroid hormone (PTH) measurement - A view from the IFCC Working Group for PTH. Clin Chim Acta 2016; 467:42-47. [PMID: 27746210 DOI: 10.1016/j.cca.2016.10.016] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2016] [Revised: 10/11/2016] [Accepted: 10/12/2016] [Indexed: 11/15/2022]
Abstract
Parathyroid hormone (PTH) measurement in serum or plasma is a necessary tool for the exploration of calcium/phosphate disorders, and is widely used as a surrogate marker to assess skeletal and mineral disorders associated with chronic kidney disease (CKD), referred to as CKD-bone mineral disorders (CKD-MBD). CKD currently affects >10% of the adult population in the United States and represents a major health issue worldwide. Disturbances in mineral metabolism and fractures in CKD patients are associated with increased morbidity and mortality. Appropriate identification and management of CKD-MBD is therefore critical to improving clinical outcome. Recent increases in understanding of the complex pathophysiology of CKD, which involves calcium, phosphate and magnesium balance, and is also influenced by vitamin D status and fibroblast growth factor (FGF)-23 production, should facilitate such improvement. Development of evidence-based recommendations about how best to use PTH is limited by considerable method-related variation in results, of up to 5-fold, as well as by lack of clarity about which PTH metabolites these methods recognise. This makes it difficult to compare PTH results from different studies and to develop common reference intervals and/or decision levels for treatment. The implications of these method-related differences for current clinical practice are reviewed here. Work being undertaken by the International Federation of Clinical Chemistry and Laboratory Medicine (IFCC) to improve the comparability of PTH measurements worldwide is also described.
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Affiliation(s)
- Catharine M Sturgeon
- C/o Department of Laboratory Medicine, Royal Infirmary of Edinburgh, Edinburgh EH16 4SA, UK.
| | - Stuart Sprague
- C/o Department of Laboratory Medicine, Royal Infirmary of Edinburgh, Edinburgh EH16 4SA, UK
| | - Alison Almond
- C/o Department of Laboratory Medicine, Royal Infirmary of Edinburgh, Edinburgh EH16 4SA, UK
| | - Etienne Cavalier
- C/o Department of Laboratory Medicine, Royal Infirmary of Edinburgh, Edinburgh EH16 4SA, UK
| | - William D Fraser
- C/o Department of Laboratory Medicine, Royal Infirmary of Edinburgh, Edinburgh EH16 4SA, UK
| | | | - Ravinder Singh
- C/o Department of Laboratory Medicine, Royal Infirmary of Edinburgh, Edinburgh EH16 4SA, UK
| | | | - Hubert W Vesper
- C/o Department of Laboratory Medicine, Royal Infirmary of Edinburgh, Edinburgh EH16 4SA, UK
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- C/o Department of Laboratory Medicine, Royal Infirmary of Edinburgh, Edinburgh EH16 4SA, UK
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50
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Nakamura M, Iso H, Kitamura A, Imano H, Noda H, Kiyama M, Sato S, Yamagishi K, Nishimura K, Nakai M, Vesper HW, Teramoto T, Miyamoto Y. Comparison between the triglycerides standardization of routine methods used in Japan and the chromotropic acid reference measurement procedure used by the CDC Lipid Standardization Programme. Ann Clin Biochem 2016; 53:632-639. [PMID: 26680645 DOI: 10.1177/0004563215624461] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background The US Centers for Disease Control and Prevention ensured adequate performance of the routine triglycerides methods used in Japan by a chromotropic acid reference measurement procedure used by the Centers for Disease Control and Prevention lipid standardization programme as a reference point. We examined standardized data to clarify the performance of routine triglycerides methods. Methods The two routine triglycerides methods were the fluorometric method of Kessler and Lederer and the enzymatic method. The methods were standardized using 495 Centers for Disease Control and Prevention reference pools with 98 different concentrations ranging between 0.37 and 5.15 mmol/L in 141 survey runs. The triglycerides criteria for laboratories which perform triglycerides analyses are used: accuracy, as bias ≤5% from the Centers for Disease Control and Prevention reference value and precision, as measured by CV, ≤5%. Results The correlation of the bias of both methods to the Centers for Disease Control and Prevention reference method was: y (%bias) = 0.516 × (Centers for Disease Control and Prevention reference value) -1.292 ( n = 495, R2 = 0.018). Triglycerides bias at medical decision points of 1.13, 1.69 and 2.26 mmol/L was -0.71%, -0.42% and -0.13%, respectively. For the combined precision, the equation y (CV) = -0.398 × (triglycerides value) + 1.797 ( n = 495, R2 = 0.081) was used. Precision was 1.35%, 1.12% and 0.90%, respectively. It was shown that triglycerides measurements at Osaka were stable for 36 years. Conclusions The epidemiologic laboratory in Japan met acceptable accuracy goals for 88.7% of all samples, and met acceptable precision goals for 97.8% of all samples measured through the Centers for Disease Control and Prevention lipid standardization programme and demonstrated stable results for an extended period of time.
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Affiliation(s)
- Masakazu Nakamura
- 1 Lipid Reference Laboratory, Department of Preventive Cardiology, National Cerebral and Cardiovascular Center, Osaka, Japan
| | - Hiroyasu Iso
- 2 Public Health, Department of Social Medicine, Graduate School of Medicine, Osaka University, Osaka, Japan
| | - Akihiko Kitamura
- 2 Public Health, Department of Social Medicine, Graduate School of Medicine, Osaka University, Osaka, Japan
| | - Hironori Imano
- 2 Public Health, Department of Social Medicine, Graduate School of Medicine, Osaka University, Osaka, Japan
| | - Hiroyuki Noda
- 2 Public Health, Department of Social Medicine, Graduate School of Medicine, Osaka University, Osaka, Japan
| | - Masahiko Kiyama
- 3 Osaka Center for Cancer and Cardiovascular Disease Prevention, Osaka, Japan
| | - Shinichi Sato
- 4 Chiba Prefectural Institute of Public Health/Osaka Prefecture University, Institution of Public Nutrition Practice, Chiba, Japan
| | - Kazumasa Yamagishi
- 5 Department of Public Health Medicine, Faculty of Medicine, University of Tsukuba, Ibaraki, Japan
| | - Kunihiro Nishimura
- 6 Department of Statistics and Data Analysis, Center for Cerebral and Cardiovascular Disease Information, National Cerebral and Cardiovascular Center, Osaka, Japan
| | - Michikazu Nakai
- 6 Department of Statistics and Data Analysis, Center for Cerebral and Cardiovascular Disease Information, National Cerebral and Cardiovascular Center, Osaka, Japan
| | - Hubert W Vesper
- 7 Division of Laboratory Sciences, National Center for Environmental Health, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Tamio Teramoto
- 8 Teikyo Academic Research Center, Teikyo University, Tokyo, Japan
| | - Yoshihiro Miyamoto
- 9 Department of Preventive Cardiology, National Cerebral and Cardiovascular Center, Osaka, Japan
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