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Short-term biological variation of serum glial fibrillary acidic protein

  • Silje Hovden Christensen , Claus Vinter Bødker Hviid , Anne Tranberg Madsen ORCID logo , Tina Parkner and Anne Winther-Larsen EMAIL logo
Published/Copyright: August 15, 2022
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Clinical Chemistry and Laboratory Medicine (CCLM)
From the journal Clinical Chemistry and Laboratory Medicine (CCLM) Volume 60 Issue 11

Abstract

Objectives

Serum glial fibrillary acidic protein (GFAP) is an emerging biomarker for intracerebral diseases and is approved for clinical use in traumatic brain injury. GFAP is also being investigated for several other applications, where the GFAP changes are not always outstanding. It is thus essential for the interpretation of GFAP to distinguish clinical relevant changes from natural occurring biological variation. This study aimed at estimating the biological variation of serum GFAP.

Methods

Apparently healthy subjects (n=33) had blood sampled for three consecutive days. On the second day, blood was also drawn every third hour from 9 AM to 9 PM. Serum GFAP was measured by Single Molecule Array (Simoa™). Components of biological variation were estimated in a linear mixed-effects model.

Results

The overall median GFAP value was 92.5 pg/mL (range 34.4–260.3 pg/mL). The overall within– (CVI) and between-subject variations (CVG) were 9.7 and 39.5%. The reference change value was 36.9% for an increase. No day-to-day variation was observed, however semidiurnal variation was observed with increasing GFAP values between 9 AM and 12 PM (p<0.00001) and decreasing from 12 to 9 PM (p<0.001).

Conclusions

Serum GFAP exhibits a relatively low CVI but a considerable CVG and a marked semidiurnal variation. This implies caution on the timing of blood sampling and when interpreting GFAP in relation to reference intervals, especially in conditions where only small GFAP differences are observed.

Keywords: biological variation; biomarkers; depressive disorder; glial fibrillary acidic protein; individual; nervous system diseases
Corresponding author: Anne Winther-Larsen, MD, PhD, Associated Professor, Department of Clinical Biochemistry, Aarhus University Hospital, Palle Juul-Jensens Boulevard 99, 8200, Aarhus N, Aarhus, Denmark; and Department of Clinical Medicine, Aarhus University, Aarhus, Denmark, Phone: +0045 7844 0000, E-mail:

Funding source: Dagmar Marshalls Fond

Funding source: Harboefonden

Acknowledgments

The authors wish to thank the biomedical laboratory technicians at the research department of the Department of Clinical Biochemistry, Aarhus University Hospital.

  1. Research funding: The work was supported by Harboefonden and Dagmar Marshalls Fond. The funders did not have any role in the study design, data collection, data analysis, interpretation, or writing of the report.

  2. Author contributions: All authors have accepted responsibility for the entire content of this manuscript and approved its submission.

  3. Competing interests: Authors state no conflicts of interest.

  4. Informed consent: Informed consent was obtained from all individuals included in this study.

  5. 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 Central Denmark Region Committees on Biomedical Research Ethics (1-10-72-452-17).

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Supplementary Material

The online version of this article offers supplementary material (https://doi.org/10.1515/cclm-2022-0480).

Received: 2022-05-17
Accepted: 2022-07-29
Published Online: 2022-08-15
Published in Print: 2022-10-26

© 2022 Walter de Gruyter GmbH, Berlin/Boston

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https://doi.org/10.1515/cclm-2022-0480
Keywords for this article
biological variation; biomarkers; depressive disorder; glial fibrillary acidic protein; individual; nervous system diseases

Articles in the same Issue

  1. Frontmatter
  2. Editorial
  3. Measuring FGF23 in clinical practice: dream or reality?
  4. Reviews
  5. Fibroblast growth factor 23: translating analytical improvement into clinical effectiveness for tertiary prevention in chronic kidney disease
  6. Pursuing appropriateness of laboratory tests: a 15-year experience in an academic medical institution
  7. General Clinical Chemistry and Laboratory Medicine
  8. Moving average quality control of routine chemistry and hematology parameters – a toolbox for implementation
  9. Practical application of European biological variation combined with Westgard Sigma Rules in internal quality control
  10. Total bilirubin assay differences may cause inconsistent treatment decisions in neonatal hyperbilirubinaemia
  11. Early predictors of abnormal MRI patterns in asphyxiated infants: S100B protein urine levels
  12. Interlaboratory comparison study of immunosuppressant analysis using a fully automated LC-MS/MS system
  13. Analytical evaluation and bioclinical validation of new aldosterone and renin immunoassays
  14. Improving clinical performance of urine sediment analysis by implementation of intelligent verification criteria
  15. Clinical evaluation of the OC-Sensor Pledia calprotectin assay
  16. Serous body fluid evaluation using the new automated haematology analyser Mindray BC-6800Plus
  17. Analysis of cryoproteins with a focus on cryofibrinogen: a study on 103 patients
  18. Reference Values and Biological Variations
  19. Within-subject biological variation estimates using an indirect data mining strategy. Spanish multicenter pilot study (BiVaBiDa)
  20. Short-term biological variation of serum glial fibrillary acidic protein
  21. Reference ranges for GDF-15, and risk factors associated with GDF-15, in a large general population cohort
  22. Serum GFAP – reference interval and preanalytical properties in Danish adults
  23. Determination of pediatric reference limits for 10 commonly measured autoantibodies
  24. Hematology and Coagulation
  25. Arterial and venous blood sampling is equally applicable for coagulation and fibrinolysis analyses
  26. Infectious Diseases
  27. Free urinary sialic acid levels may be elevated in patients with pneumococcal sepsis
  28. Letters to the Editor
  29. Thyroid stimulating hormone: biased estimate of allowable bias
  30. Letter to the Editor relating to Clin Chem Lab Med 2022;60(9):1365–72
  31. Reply to the Letter of Sun et al. [1] relating to Clin Chem Lab Med 2022;60(9):1365–72
  32. Prognostic significance of smudge cell percentage in chronic lymphocytic leukemia. Facts or artifacts? Methodological considerations and literature review
  33. Detection of a monoclonal component after pediatric liver transplantation: a case report
  34. Reporting magnesium critical results: clinical impact on pregnant women and neonates
  35. Congress Abstracts
  36. 54th National Congress of the Italian Society of Clinical Biochemistry and Clinical Molecular Biology (SIBioC – Laboratory Medicine)
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