Department of Pathology and Laboratory Medicine, University of California, Davis, 2315 Stockton Blvd, Sacramento, CA 95817, United States.
Department of Emergency Medicine, University of California, Davis, School of Medicine, Sacramento, CA 95817, United States.
Clin Biochem. 2022 Jan;99:118-121. doi: 10.1016/j.clinbiochem.2021.10.012. Epub 2021 Nov 1.
Elevated blood biotin levels may interfere with some biotin-streptavidin immunoassays, used in clinical laboratories to aid diagnosis. The objective of this study was to determine the prevalence of elevated blood biotin levels in three at risk patient cohorts, where misclassification of disease status would have a high clinical impact. This retrospective, single-center study screened residual, de-identified plasma samples (N = 700) from adult patients undergoing routine thyroid stimulating hormone (TSH) (n = 500), procalcitonin (PCT) (n = 100), or human immunodeficiency virus (HIV) (n = 100) testing using the Elecsys® BRAHMS PCT (Roche Diagnostics), Access TSH (3rd IS) (Beckman Coulter Inc), and ARCHITECT HIV Ag/Ab Combo (Abbott Laboratories) immunoassays, respectively, for elevated levels of biotin (quantified by gas chromatography-time of flight mass spectrometry). Patients taking biotin supplements were included and dosages recorded from medical records. In the overall study cohort, blood biotin levels ranged 0.1-21.3 ng/mL; 44.3% (310/700) of samples were < 1 ng/mL, 54.7% (383/700) were 1-<10 ng/mL, and 1% (7/700) were ≥ 10 ng/mL. The sub-cohorts had similar ranges of biotin levels: 0.5-21.3 ng/mL (TSH), 0.1-12.1 ng/mL (PCT), and 0.3-7.3 ng/mL (HIV). In the 44 patients (6.3% of overall study cohort) who were documented as taking biotin supplements (range of doses, 2.5-10 mg/day), blood biotin levels ranged 0.9-21.3 ng/mL; 2.3% (1/44) of samples were < 1 ng/mL, 86.4% (38/44) were 1-<10 ng/mL, and 11.4% (5/44) were ≥ 10 ng/mL. Most patients who reported taking biotin supplements had blood biotin levels ≥ 1 ng/mL and the highest blood biotin level detected was 21.3 ng/mL.
血液生物素水平升高可能会干扰一些临床实验室中用于辅助诊断的生物素-链霉亲和素免疫分析。本研究的目的是确定三个高危患者群体中血液生物素水平升高的患病率，因为疾病状态的错误分类会产生重大的临床影响。这项回顾性、单中心研究筛选了 700 份来自接受常规促甲状腺激素（TSH）（n=500）、降钙素原（PCT）（n=100）或人类免疫缺陷病毒（HIV）（n=100）检测的成年患者的剩余、去识别的血浆样本，使用 Elecsys®BRAHMS PCT（罗氏诊断）、Access TSH（3rd IS）（贝克曼库尔特公司）和 ARCHITECT HIV Ag/Ab Combo（雅培公司）免疫分析分别检测生物素水平升高（通过气相色谱-飞行时间质谱法定量）。记录了正在服用生物素补充剂的患者及其剂量的医疗记录。在整个研究队列中，血液生物素水平范围为 0.1-21.3ng/ml；44.3%（310/700）的样本<1ng/ml，54.7%（383/700）的样本为 1-<10ng/ml，1%（7/700）的样本≥10ng/ml。亚队列的生物素水平范围相似：TSH 为 0.5-21.3ng/ml，PCT 为 0.1-12.1ng/ml，HIV 为 0.3-7.3ng/ml。在 44 名（研究总队列的 6.3%）被记录为服用生物素补充剂的患者（剂量范围为 2.5-10mg/天）中，血液生物素水平范围为 0.9-21.3ng/ml；2.3%（1/44）的样本<1ng/ml，86.4%（38/44）的样本为 1-<10ng/ml，11.4%（5/44）的样本≥10ng/ml。大多数报告服用生物素补充剂的患者血液生物素水平≥1ng/ml，检测到的最高血液生物素水平为 21.3ng/ml。
