25-OH Vitamin D Düzeyi Ölçümünde Radyoopak Madde İnterferansının Deneysel Araştırılması

Amaç: D vitamini eksikliği insanların kapalı alanlarda yaşama eğiliminden dolayı toplumda sıklıkla görülmektedir. Eksikliğin tespiti için son zamanlarda immunassay yöntemler terk edilerek referans metod olan LC-MS/MS ölçüm tekniği kullanılmaktadır. Fakat bu yöntemde serum matriks etkisi nedeniyle meydana gelen interferans yanlış sonuçlara neden olabilmektedir. Bu çalışmada kontrastlı görüntüleme tekniklerinde kullanılan radyoopak maddelerin 25OH vitamin D (25[OH]D) ölçümü sırasında oluşabilecek interferans etkisinin araştırılması amaçlanmıştır.Materyal ve Metod: Çalışmada 100 uL 25[OH]D kontrol solüsyonu üzerine 50 uL yedi farklı radyoopak madde eklenerek LC-MS/MS yöntemi ile 25[OH]D ölçümü yapıldı. Yapılan interferans çalışması ile elde edilen hedef değerden sapma miktarları (bias) kaydedildi.Bulgular: 7 farklı radyoopak madde (RM1-RM7) %5.14 - %81.08 arasında değişen oranlarda hedef değerden sapmaya neden oldu. %81.08 ile en fazla sapma gadodiamid (287 mg/mL) içeren RM6 ticari ürününde meydana geldi. Gadobutrol, 604.72 mg/mL (RM1) ioheksol, 755 mg/mL (RM2), gadodiamid, 287 mg/mL (RM5) içerikli radyoopak maddeler sırasıyla %5.11, %11.08, %10.21 oranlarında daha düşük sapmaya neden oldu.Sonuç: 25[OH]D konsantrasyonu doğru ölçülmezse osteomalazinin atlanmasına ve buna bağlı komplikasyonlara neden olabilir. Radyoopak madde interferansına maruz kalmamak için kan alma işlemi kontrastlı görüntüleme öncesi yapılmalıdır. Bunu sağlamanın mümkün olmadığı durumlarda hatalı yüksek sonuçlarla karşılaşmamak için hastanelerde gadobutrol, 604.72 mg/mL (RM1) ioheksol, 755 mg/mL (RM2), gadodiamid, 287 mg/mL (RM5) etken madde içeren radyoopak maddelerinin kullanımı tercih edilmelidir. Hastanelere radyoopak madde temin ederken interferans çalışmalarına göre ürün kabülünün yapılması laboratuvar hata oranlarını azaltmada katkı sağlayacaktır.

Anahtar Kelimeler:

Radyoopak madde, 25-OH vitamin D, interferans, LC-MS/MS

Experimental Research of Interference Associated With Radiopaque Material on 25-OH Vitamin D Blood Level

Background: Vitamin D deficiency is frequently seen in society because of the tendency of people to live in closed areas. Recently, immunoassay methods have been abandoned and LC-MS/MS measurement technique is used in order to determine Vitamin D deficiency. However, interference caused by the serum matrix effect in LC-MS/MS method may cause incorrect results. The aim of this study was to investigate the interference due to radiopaque substances used in contrast imaging techniques during 25-OH vitamin D (25[OH]D) measurement.Material and Methods: 50 uL of seven different was added to 100 uL of 25[OH]D control solution. 25[OH]D concentrations from every mixture were measured by LC-MS/MS method. The amounts of deviation (bias) were calculated.Results: Every radiopaque substance (RM1-RM7) caused different deviation from the target values (5.14% to 81.08%). The reason of the highest deviation (81.08%) was from the RM6 commercial product containing gadodiamide (287 mg / mL). Radiopaque substances containing gadobutrol, 604.72 mg / mL (RM1) iohexol, 755 mg / mL (RM2), gadodiamide, 287 mg / mL (RM5) showed lower deviation (5.11%, 11.08%, 10.21%)Conclusions: If the concentration of 25[OH]D is not measured correctly, it may cause chronic complications associated with osteomalacia . In order to avoid to the interferences, the phlebotomy should be performed before radiocontrast imaging. In hospitals, the radiopaque materials containing gadobutrol, 604.72 mg/mL (RM1) ioheksol, 755 mg/mL (RM2), gadodiamid, 287 mg/mL (RM5) can be preferred to reduce the risk of the similar interference.While providing radiopaque substances to hospitals from the drug companies, it could be suggestion to investigate the interferences for these like drugs

Keywords:

Radiopaque substance, 25-OH vitamin D, interference, LC-MS/MS,

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