LBPC-PPC, Univ Montpellier, CHU Montpellier, INM INSERM, Montpellier, France.
Department of Biochemistry and Hormonology, Univ Montpellier, CHU Montpellier, INSERM, Montpellier, France.
Clin Chem Lab Med. 2023 Nov 24;62(5):881-890. doi: 10.1515/cclm-2023-0312. Print 2024 Apr 25.
Blood microsampling, particularly dried blood spots (DBSs), is an attractive minimally-invasive approach that is well suited for home sampling and predictive medicine associated with longitudinal follow-up of the elderly. However, diagnostic quantification of biomarkers from DBS poses a major challenge. Clinical mass spectrometry can reliably quantify blood proteins in various research projects. Our goal here was to use mass spectrometry of DBS in a real-world clinical setting and compared it to the standard immunoassay method. We also sought to correlate DBS mass spectrometry measurements with clinical indices.
A clinical trial of diagnostic equivalence was conducted to compare conventional venous samples quantified by immunoassay and DBSs quantified by mass spectrometry in an elderly population. We assayed three protein biomarkers of nutritional and inflammatory status: prealbumin (transthyretin), C-reactive protein, and transferrin.
The analysis of DBSs showed satisfactory variability and low detection limits. Statistical analysis confirmed that the two methods give comparable results at clinical levels of accuracy. In conclusion, we demonstrated, in a real-life setting, that DBSs can be used to measure prealbumin, CRP and transferrin, which are commonly used markers of nutritional status and inflammation in the elderly. However, there was no correlation with patient frailty for these proteins.
Early detection and regular monitoring of nutritional and inflammatory problems using DBS appear to be clinically feasible. This could help resolve major public health challenges in the elderly for whom frailty leads to serious risks of health complications.
血液微采样，特别是干血斑（DBS），是一种有吸引力的微创方法，非常适合家庭采样和与老年人纵向随访相关的预测医学。然而，从 DBS 中诊断性地定量生物标志物是一个主要挑战。临床质谱可以在各种研究项目中可靠地定量血液蛋白。我们的目标是在真实的临床环境中使用 DBS 的质谱，并将其与标准免疫测定方法进行比较。我们还试图将 DBS 质谱测量值与临床指数相关联。
进行了一项诊断等效性临床试验，以比较免疫测定定量的常规静脉样本和老年人 DBS 定量的质谱。我们测定了三种营养和炎症状态的蛋白质生物标志物：前白蛋白（转甲状腺素）、C 反应蛋白和转铁蛋白。
DBS 的分析显示出令人满意的可变性和低检测限。统计分析证实，两种方法在临床准确性水平上给出了可比的结果。总之，我们在现实环境中证明，DBS 可用于测量前白蛋白、CRP 和转铁蛋白，这些蛋白通常用于评估老年人的营养状况和炎症。然而，这些蛋白与患者虚弱程度之间没有相关性。
使用 DBS 早期检测和定期监测营养和炎症问题在临床上似乎是可行的。这有助于解决老年人面临的重大公共卫生挑战，因为虚弱会导致严重的健康并发症风险。
