Liu Zhaoyang, Dong Jun, Li Hongxia, Yang Ruiyue, Shao Zhiyu, Wang Siming
Beijing Hospital,National Center of Gerontology,Beijing Geriatrics Institute of National Health Commission,Key Laboratory of Geriatrics of National Health Commission,Institute of Geriatric Medicine,Chinese Academy of Medical Sciences.
Se Pu. 2023 Feb;41(2):131-141. doi: 10.3724/SP.J.1123.2022.06025.
Alcohol intake is an important risk factor for cardiovascular disease, liver disease, and diabetes. The accurate and objective evaluation of alcohol intake is important for disease prevention and intervention, as well as alcohol intake monitoring. Phosphatidylethanol (PEth) is a potential clinical biomarker of alcohol consumption. Monitoring PEth levels can provide an objective and quantitative basis for alcohol intake studies. Unlike other current alcohol biomarkers, PEth can only be produced in the presence of alcohol. Therefore, PEth is highly specific for alcohol intake and not affected by confounding factors, such as age, gender, hypertension, kidney disease, liver disease, and other comorbidities. Because of its long half-life and high specificity for alcohol intake, PEth may be used as a tool for monitoring drinking behavior in the clinical, transportation, and other fields. Given rapid developments in mass spectrometry technology over the past decade, liquid chromatography-tandem mass spectrometry (LC-MS/MS) has become the preferred method for PEth detection. However, most current LC-MS/MS methods focus on the determination of one or several PEth homologs, and the number of PEth homologs that can be determined simultaneously is relatively limited. Moreover, the detection capacity of the available methods remains insufficient, and their analytical sensitivity for some PEth homologs must be further improved. In this study, a novel LC-MS/MS method based on an intelligent scheduled time-zone negative multiple reaction monitoring acquisition technology (Scheduled-MRM) was developed. The technology monitors two ion channels in each PEth to ensure reliable results and can quantify 18 PEth homologs in human whole blood simultaneously. Methanol-methyl -butyl ether-water was used as the extraction system. An XBridge C18 column (100 mm×2.1 mm, 3.5 μm) was selected for gradient elution with 2.5 mmol/L ammonium acetate isopropanol solution and 2.5 mmol/L ammonium acetate aqueous solution-acetonitrile (50∶50, v/v) as the mobile phases. Negative electronic spray ionization in scheduled-MRM mode was applied for MS/MS detection. The method was validated to have a linear range of 10-2500 ng/mL with correlation coefficients greater than 0.9999. The limits of detection and quantification were 0.7-2.8 and 2.2-9.4 ng/mL, respectively, and the spiked recoveries ranged from 91.0% to 102.2%. The method was confirmed to be simple, rapid, and precise, and subsequently validated for the measurement of 18 PEth homologs in human blood. Scheduled-MRM can assign a suitable scan time to each ion channel and effectively reduce the number of concurrent ion pairs monitored per unit time. This technology overcomes the problem of insufficient dwell time caused by an excessive number of ion channels, thereby avoiding the redundant monitoring of non-retention times. Scheduled-MRM significantly improved the detection sensitivity, data acquisition quality, and signal response of the proposed method. Whole blood samples from 359 volunteers with regular drinking habits were analyzed using this method. The total PEth concentrations ranged from 51.13 ng/mL to 2.89 μg/mL, with a mean of 363.16 ng/mL. PEth 16∶0/18∶1 and 16∶0/18∶2 were the two most abundant homologs, with mean concentrations of 74.21 and 48.75 ng/mL, accounting for approximately 20.43% and 13.42%, respectively, of the total PEth. Spearman correlation analyses showed that the PEth homologs correlated well with each other, -glutamyltransferase, a clinically available biological marker of alcohol, and other clinical biochemical parameters related to liver and kidney function. Overall, the method was demonstrated to be sensitive, precise, and accurate; thus, it may be an effective tool for monitoring alcohol intake in the clinical and other fields.
酒精摄入是心血管疾病、肝脏疾病和糖尿病的重要风险因素。准确客观地评估酒精摄入量对于疾病预防、干预以及酒精摄入监测都很重要。磷脂酰乙醇(PEth)是酒精消费的一种潜在临床生物标志物。监测PEth水平可为酒精摄入研究提供客观定量依据。与其他当前的酒精生物标志物不同,PEth仅在有酒精存在时产生。因此,PEth对酒精摄入具有高度特异性,不受年龄、性别、高血压、肾脏疾病、肝脏疾病和其他合并症等混杂因素影响。由于其半衰期长且对酒精摄入具有高特异性,PEth可作为临床、交通等领域监测饮酒行为的工具。鉴于过去十年质谱技术的快速发展,液相色谱 - 串联质谱(LC-MS/MS)已成为PEth检测的首选方法。然而,当前大多数LC-MS/MS方法专注于一种或几种PEth同系物的测定,同时可测定的PEth同系物数量相对有限。此外,现有方法的检测能力仍不足,对某些PEth同系物的分析灵敏度还需进一步提高。在本研究中,开发了一种基于智能定时分区负多重反应监测采集技术(Scheduled-MRM)的新型LC-MS/MS方法。该技术监测每个PEth中的两个离子通道以确保结果可靠,并且能够同时定量人全血中的18种PEth同系物。使用甲醇 - 甲基 - 丁基醚 - 水作为萃取系统。选用XBridge C18柱(100 mm×2.1 mm,3.5μm),以2.5 mmol/L醋酸铵异丙醇溶液和2.5 mmol/L醋酸铵水溶液 - 乙腈(50∶50,v/v)作为流动相进行梯度洗脱。在Scheduled-MRM模式下采用负电喷雾电离进行MS/MS检测。该方法经验证线性范围为10 - 2500 ng/mL,相关系数大于0.9999。检测限和定量限分别为0.7 - 2.8 ng/mL和2.2 - 9.4 ng/mL,加标回收率在91.0%至102.2%之间。该方法被证实简单、快速且精确,随后在人血中18种PEth同系物的测定中得到验证。Scheduled-MRM可为每个离子通道分配合适的扫描时间,并有效减少单位时间内同时监测的离子对数量。该技术克服了离子通道过多导致驻留时间不足的问题,从而避免了对非保留时间的冗余监测。Scheduled-MRM显著提高了所提方法的检测灵敏度、数据采集质量和信号响应。使用该方法对359名有规律饮酒习惯的志愿者的全血样本进行了分析。总PEth浓度范围为51.13 ng/mL至2.89μg/mL,平均值为363.16 ng/mL。PEth 16∶0/18∶1和16∶0/18∶2是两种含量最高的同系物,平均浓度分别为74.21和48.75 ng/mL,分别约占总PEth的20.43%和13.42%。Spearman相关性分析表明,PEth同系物之间、与γ-谷氨酰转移酶(一种临床上可用的酒精生物标志物)以及其他与肝脏和肾脏功能相关的临床生化参数之间具有良好的相关性。总体而言,该方法被证明灵敏、精确且准确;因此,它可能是临床和其他领域监测酒精摄入的有效工具。