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      Assessment of the Trueness and Inter-Laboratory Precision of Routine Uric Acid Assays Using 4 Frozen Pooled Serum Samples Measured by the Japan Society of Clinical Chemistry's HPLC Method

      research-article
      , Ph.D. 1 , , M.S. 2 , , M.S. 1 ,
      Annals of Laboratory Medicine
      The Korean Society for Laboratory Medicine
      Uric acid, HPLC, Standardization

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          Abstract

          Background

          Reference procedures are required for evaluating the accuracy of routine analytical systems for uric acid (UA). External quality assessment (EQA) for UA has only been conducted with quality controls in China, and the results have not been published. This study was designed to investigate both the trueness and inter-laboratory precision of UA measurements among routine analytical systems using a candidate reference method.

          Methods

          We performed the HPLC method recommended by the Japan Society of Clinical Chemistry (JSCC). Next, we evaluated its analytical performance and validated its trueness. The performance of 4 routine analytical systems (5 instruments per system, n=20) for UA was assessed by using 4 frozen pooled serum samples measured by the HPLC method according to biologically relevant quality goals.

          Results

          Within-run, between-run, inter-day, and total CV of the method were less than 0.3%, 0.4%, 1.8%, and 2.6%, respectively. The UA measurements were consistent with the target values of standard reference material (SRM) 909b, the sixth ring trial for Reference Laboratories (RELA-2008) specimen, and national primary reference materials. The 4 frozen pooled serum samples were homogeneous, stable, and commutable. All routine systems achieved the desirable performance goal (total error <11.9%).

          Conclusions

          We successfully reproduced the JSCC's HPLC method, which was simple, specific, precise, and accurate. We recommend this method as a reference method for UA measurement in human serum. Four routine analytical systems for UA measurement had acceptable traceability, and their UA results showed good concordance.

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          Most cited references31

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          Proposals for setting generally applicable quality goals solely based on biology.

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            Hyperuricemia and gout in thyroid endocrine disorders.

            A significant correlation between thyroid function and purine nucleotide metabolism has been established in hypothyroidism. On the contrary, the relationship between hyperthyroidism and purine metabolism is more controversial. The present study evaluates the prevalence of hyperuricemia and gout in patients affected by primary hypothyroidism and hyperthyroidism. We studied 28 patients with primary hypothyroidism and 18 patients with primary hyperthyroidism, all hospitalized because of endocrine dysfunction. All underwent a series of clinical, biochemical and instrumental evaluations; in particular, thyroid-stimulatin hormone (TSH), free thyroxine (fT4), blood urea, serum creatinine, creatinine clearance, serum and urinary uric acid levels were measured. In comparison to the prevalence reported in the general population, a significant increase of both hyperuricemia and gout was found in the hypothyroid patients, and of hyperuricemia in the hyperthyroid patients. In hyperthyroidism the hyperuricemia is due to the increased urate production, while in hypothyroidism the hyperuricemia is secondary to a decreased renal plasma flow and impaired glomerular filtration. Ourfindings confirm the data in the literature concerning the high prevalence of hyperuricemia and gout in hypothyroidism. It shows that hyperthyroidism can cause a significant increase in serum uric acid, as well, although lower than the hyperuricemia due to thyroid hormone deficiency.
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              Determination of serum uric acid using high-performance liquid chromatography (HPLC)/isotope dilution mass spectrometry (ID-MS) as a candidate reference method

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                Author and article information

                Journal
                Ann Lab Med
                Ann Lab Med
                ALM
                Annals of Laboratory Medicine
                The Korean Society for Laboratory Medicine
                2234-3806
                2234-3814
                March 2014
                13 February 2014
                : 34
                : 2
                : 104-110
                Affiliations
                [1 ]Department of Clinical Laboratory, Peking University First Hospital, Beijng, China.
                [2 ]Department of Clinical Laboratory, Tsinghua University First Hospital, Beijng, China.
                Author notes
                Corresponding author: Guobing Xu. Department of Clinical Laboratory, Peking University First Hospital, No.8 Xishiku Street, Xicheng District, Beijing 100034, China. Tel: +86-10-88196859, Fax: +86-10-66551785, 15810465161@ 123456163.com
                Article
                10.3343/alm.2014.34.2.104
                3948822
                f6e8a1e7-50d9-45bb-92d1-eab8490621eb
                © The Korean Society for Laboratory Medicine.

                This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License ( http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 29 July 2013
                : 19 December 2013
                : 22 January 2014
                Funding
                Funded by: Capital Medical Development
                Award ID: 2009-1012
                Categories
                Original Article
                Clinical Chemistry

                Clinical chemistry
                uric acid,hplc,standardization
                Clinical chemistry
                uric acid, hplc, standardization

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