Quality assurance programs for vitamin A and E in serum: are we doing enough to assess laboratory performance?
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Michael Fitzpatrick
,
Trisha Andersen
Abstract
Objectives
Monitoring serum vitamin A (retinol) and vitamin E (α-tocopherol) concentrations is common practice for assessing nutritional status. Measurement of these vitamins can be challenging due to several factors. Whilst the RCPAQAP Vitamins: Serum Program assists participating laboratories in harmonisation, the materials provided do not contain the analogues of retinol and α-tocopherol that may be present in real patient samples. We aimed to assess participants’ capacity to accurately report retinol and α-tocopherol in the presence of the vitamin E analogues tocopherol acetate and γ-tocopherol.
Methods
A supplementary series of a control sample and three matched spiked samples were distributed to each laboratory participating in the Program. Retinol and α-tocopherol results for each spiked sample were compared to the results of the control sample submitted by each participant. Acceptability of retinol and α-tocopherol results was determined based on the RCPAQAP allowable performance specifications (APS).
Results
Thirteen participants returned results for the supplementary sample series. Interference from α-tocopherol acetate was observed with results below the APS in 30 % (n=4) of laboratories for retinol quantification and in 23 % (n=3) for α-tocopherol quantification. One laboratory returned results above the APS for α-tocopherol when γ-tocopherol was present.
Conclusions
This supplementary sample series has shown that the presence of vitamin E analogues can lead to the over or under estimation of nutritional status by some participants. Affected laboratories are encouraged to review their analytical procedures. To further assess laboratory competence, EQA providers should consider using patient samples or spiked challenge samples.
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Research ethics: Not applicable.
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Informed consent: Not applicable.
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Author contributions: All authors have accepted responsibility for the entire content of this manuscript and approved its submission.
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Competing interests: The authors state no conflict of interest.
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Research funding: All funding was provided by RCPAQAP.
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Data availability: All data not presented in the manuscript is available for reviewby request. Please contact the corresponding author.
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© 2023 Walter de Gruyter GmbH, Berlin/Boston
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Artikel in diesem Heft
- Frontmatter
- Editorial
- Rapid rule-in and rule-out protocols of acute myocardial infarction using hs-cTnI and hs-cTnT methods
- Reviews
- A guide to conducting systematic reviews of clinical laboratory tests
- Improving diagnosis and treatment of hypomagnesemia
- Opininon Paper
- Documenting and validating metrological traceability of serum alanine aminotransferase measurements: a priority for medical laboratory community for providing high quality service in hepatology
- EFLM Paper
- Assessing the status of European laboratories in evaluating biomarkers for chronic kidney diseases (CKD) and recommendations for improvement: insights from the 2022 EFLM Task Group on CKD survey
- General Clinical Chemistry and Laboratory Medicine
- Bland and Altman agreement method: to plot differences against means or differences against standard? An endless tale?
- Assessment of three equations to calculate plasma LDL cholesterol concentration in fasting and non-fasting hypertriglyceridemic patients
- Validation of metrological traceability of the new generation of Abbott Alinity alkaline phosphatase assay
- Quality assurance programs for vitamin A and E in serum: are we doing enough to assess laboratory performance?
- A supervised machine-learning approach for the efficient development of a multi method (LC-MS) for a large number of drugs and subsets thereof: focus on oral antitumor agents
- Performance evaluation of alternate ESR measurement method using BC-780 automated hematology analyzer: a comparison study with the Westergren reference method
- Total error in lymphocyte subpopulations by flow cytometry-based in state of the art using Spanish EQAS data
- Development and multi-center validation of a fully automated digital immunoassay for neurofilament light chain: toward a clinical blood test for neuronal injury
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- Evaluation of the analytical and clinical performance of a new high-sensitivity cardiac troponin I assay: hs-cTnI (CLIA) assay
- Hemodialysis and biomarkers of myocardial infarction – a cohort study
- Letters to the Editor
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- Blood collection in heparin vs. EDTA results in an inflammasome-independent increase in monocyte distribution width at 4 h
- Week-to-week within-subject and between-subject biological variation of copeptin
- The effect of unintended shortage in technical resources on the quality of endpoint clinical laboratory diagnosis
- Epigenetic signatures of cfDNA enable a topological assignment of tissue damage
- Six Sigma driven QC in antibody testing for infectious diseases
- Extensive analytical evaluation of the performances of the new DiaSys PCT assay and comparison with Elecsys B·R·A·H·M·S PCT test on Roche Cobas and B·R·A·H·M·S PCT-sensitive Kryptor
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