Assessment of urine sample quality by the simultaneous measurement of urinary γ-glutamyltransferase and lactate dehydrogenase enzyme activities: possible application to unravel cheating in drugs of abuse testing
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Anna Friess
Abstract
Objectives
Evaluation of the simultaneous measurement of urinary γ-glutamyltransferase (γGT) and lactate dehydrogenase (LDH) to discriminate fresh from previously frozen specimens in urine drug monitoring.
Methods
Two widely available photometric tests (Siemens Healthineers Atellica) were used to determine the range of urinary γGT and LDH excretion and to study the decay in urinary enzyme activity under various storage conditions (room temperature, 4–8 °C, −18 °C, −80 °C). From these data, cut-off values were established and evaluated in split (fresh/frozen) specimens.
Results
Both assays allow robust, reliable, and simultaneous determination of urinary γGT and LDH. In healthy subjects, the 95% reference intervals for enzyme activity in native urine were γGT: 24.4–100.4 U/g Crea (creatinine) and LDH: 2.5–45.8 U/g Crea. Frozen storage for at least 7 days at −18 °C resulted in a loss of activity to less than 50% in both enzymes. Cut-offs for frozen samples were γGT≤33.2 U/g Crea and LDH≤ 8.4 U/g Crea. When applied to 100 sample pairs (fresh/frozen), 86.5% (173/200) of the measurements were conclusive and the combination of concordant enzyme measurements (low γGT/low LDH or high γGT/high LDH) was able to predict the mode of storage with a sensitivity of 96.3% and a specificity of 96.7%.
Conclusions
The additional measurements of urinary γGT and LDH can be used to detect previously frozen urine specimens. A simple protocol is proposed to provide additional information on sample quality when deceit is suspected. The procedure can be easily integrated into the standard workflow of urinary drug monitoring.
Acknowledgments
The support in sample collection by the staff of the medical practice, G. Reuchlin and M. Kampmeyer, is highly appreciated.
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Research funding: None declared.
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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: Authors state no conflict of interest.
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Informed consent: Not applicable.
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Ethical approval: Research involving human subjects complied with all relevant national regulations, institutional policies and is in accordance with the tenets of the Helsinki Declaration (as revised in 2013) and has been approved by the authors’ Institutional Review Board (University of Tuebingen Ethics Board) as project 590/2019BO1.
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© 2022 Walter de Gruyter GmbH, Berlin/Boston
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Articles in the same Issue
- Frontmatter
- Editorial
- Transdermal measurement of cardiac troponins: the future is now
- Reviews
- Perinatal presepsin assessment: a new sepsis diagnostic tool?
- Hypertriglyceridemia, a causal risk factor for atherosclerosis, and its laboratory assessment
- Opinion Paper
- The novelties of the regulation on health technology assessment, a key achievement for the European union health policies
- General Clinical Chemistry and Laboratory Medicine
- Performance of four regression frameworks with varying precision profiles in simulated reference material commutability assessment
- Comparison of six regression-based lot-to-lot verification approaches
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- Evaluation of a pneumatic tube system carrier prototype with fixing mechanism allowing for automated unloading
- Analytical performance of eight enzymatic assays for ethanol in serum evaluated by data from the Belgian external quality assessment scheme
- Vitamin D metabolism in living kidney donors before and after organ donation
- Validation of steroid ratios for random urine by mass spectrometry to detect 5α-reductase deficiency in Vietnamese children
- Evaluation of serum neurofilament light in the early management of mTBI patients
- Assessment of urine sample quality by the simultaneous measurement of urinary γ-glutamyltransferase and lactate dehydrogenase enzyme activities: possible application to unravel cheating in drugs of abuse testing
- Reference Values and Biological Variations
- Age and sex specific reference intervals of 13 hematological analytes in Chinese children and adolescents aged from 28 days up to 20 years: the PRINCE study
- Cancer Diagnostics
- Prostate health index (PHI) as a reliable biomarker for prostate cancer: a systematic review and meta-analysis
- A comparison of the faecal haemoglobin concentrations and diagnostic accuracy in patients suspected with colorectal cancer and serious bowel disease as reported on four different faecal immunochemical test systems
- Circulating cell-free DNA undergoes significant decline in yield after prolonged storage time in both plasma and purified form
- Cardiovascular Diseases
- Analytical and clinical performance evaluation of a new high-sensitivity cardiac troponin I assay
- Infectious Diseases
- Results of a SARS-CoV-2 virus genome detection external quality assessment round focusing on sensitivity of assays and pooling of samples
- Letters to the Editors
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- Biological variation of serum cholinesterase catalytic concentrations
- Three-month ad interim analysis of total anti-SARS-CoV-2 antibodies in healthy recipient of a single BNT162b2 vaccine booster
- Fibrin strands in peripheral blood smear: the COVID-19 era
- Fragments of alpha-1-antitrypsin in patients with severe COVID-19 and bacterial pulmonary sepsis
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