Recalibration of blood analytes over 25 years in the Atherosclerosis Risk in Communities Study: Impact of recalibration on chronic kidney disease prevalence and incidence

Christina M. Parrinello, Morgan E. Grams, David Couper, Christie M. Ballantyne, Ron C. Hoogeveen, John H. Eckfeldt, Elizabeth Selvin, Josef Coresh

Research output: Contribution to journalArticle

35 Citations (Scopus)

Abstract

BACKGROUND: Equivalence of laboratory tests over time is important for longitudinal studies. Even a small systematic difference (bias) can result in substantial misclassification. METHODS: We selected 200 Atherosclerosis Risk in Communities Study participants attending all 5 study visits over 25 years. Eight analytes were remeasured in 2011-2013 from stored blood samples from multiple visits: creatinine, uric acid, glucose, total cholesterol, HDL cholesterol, LDL cholesterol, triglycerides, and high-sensitivity C-reactive protein. Original values were recalibrated to remeasured values with Deming regression. Differences >10% were considered to reflect substantial bias, and correction equations were applied to affected analytes in the total study population. We examined trends in chronic kidney disease (CKD) pre- and postrecalibration. RESULTS: Repeat measures were highly correlated with original values [Pearson r > 0.85 after removing outliers (median 4.5% of paired measurements)], but 2 of 8 analytes (creatinine and uric acid) had differences >10%. Original values of creatinine and uric acid were recalibrated to current values with correction equations. CKD prevalence differed substantially after recalibration of creatinine (visits 1, 2, 4, and 5 prerecalibration: 21.7%, 36.1%, 3.5%, and 29.4%, respectively; postrecalibration: 1.3%, 2.2%, 6.4%, and 29.4%). For HDL cholesterol, the current direct enzymatic method differed substantially from magnesium dextran precipitation used during visits 1-4. CONCLUSIONS: Analytes remeasured in samples stored for approximately 25 years were highly correlated with original values, but 2 of the 8 analytes showed substantial bias at multiple visits. Laboratory recalibration improved reproducibility of test results across visits and resulted in substantial differences in CKD prevalence. We demonstrate the importance of consistent recalibration of laboratory assays in a cohort study.

Original languageEnglish (US)
Pages (from-to)938-947
Number of pages10
JournalClinical Chemistry
Volume61
Issue number7
DOIs
StatePublished - Jul 1 2015
Externally publishedYes

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Chronic Renal Insufficiency
Creatinine
Atherosclerosis
Blood
Uric Acid
Incidence
HDL Cholesterol
Cholesterol
Dextrans
Reproducibility of Results
C-Reactive Protein
LDL Cholesterol
Magnesium
Longitudinal Studies
Assays
Triglycerides
Cohort Studies
Glucose
Population

ASJC Scopus subject areas

  • Clinical Biochemistry
  • Biochemistry, medical
  • Medicine(all)

Cite this

Recalibration of blood analytes over 25 years in the Atherosclerosis Risk in Communities Study : Impact of recalibration on chronic kidney disease prevalence and incidence. / Parrinello, Christina M.; Grams, Morgan E.; Couper, David; Ballantyne, Christie M.; Hoogeveen, Ron C.; Eckfeldt, John H.; Selvin, Elizabeth; Coresh, Josef.

In: Clinical Chemistry, Vol. 61, No. 7, 01.07.2015, p. 938-947.

Research output: Contribution to journalArticle

Parrinello, Christina M. ; Grams, Morgan E. ; Couper, David ; Ballantyne, Christie M. ; Hoogeveen, Ron C. ; Eckfeldt, John H. ; Selvin, Elizabeth ; Coresh, Josef. / Recalibration of blood analytes over 25 years in the Atherosclerosis Risk in Communities Study : Impact of recalibration on chronic kidney disease prevalence and incidence. In: Clinical Chemistry. 2015 ; Vol. 61, No. 7. pp. 938-947.
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abstract = "BACKGROUND: Equivalence of laboratory tests over time is important for longitudinal studies. Even a small systematic difference (bias) can result in substantial misclassification. METHODS: We selected 200 Atherosclerosis Risk in Communities Study participants attending all 5 study visits over 25 years. Eight analytes were remeasured in 2011-2013 from stored blood samples from multiple visits: creatinine, uric acid, glucose, total cholesterol, HDL cholesterol, LDL cholesterol, triglycerides, and high-sensitivity C-reactive protein. Original values were recalibrated to remeasured values with Deming regression. Differences >10{\%} were considered to reflect substantial bias, and correction equations were applied to affected analytes in the total study population. We examined trends in chronic kidney disease (CKD) pre- and postrecalibration. RESULTS: Repeat measures were highly correlated with original values [Pearson r > 0.85 after removing outliers (median 4.5{\%} of paired measurements)], but 2 of 8 analytes (creatinine and uric acid) had differences >10{\%}. Original values of creatinine and uric acid were recalibrated to current values with correction equations. CKD prevalence differed substantially after recalibration of creatinine (visits 1, 2, 4, and 5 prerecalibration: 21.7{\%}, 36.1{\%}, 3.5{\%}, and 29.4{\%}, respectively; postrecalibration: 1.3{\%}, 2.2{\%}, 6.4{\%}, and 29.4{\%}). For HDL cholesterol, the current direct enzymatic method differed substantially from magnesium dextran precipitation used during visits 1-4. CONCLUSIONS: Analytes remeasured in samples stored for approximately 25 years were highly correlated with original values, but 2 of the 8 analytes showed substantial bias at multiple visits. Laboratory recalibration improved reproducibility of test results across visits and resulted in substantial differences in CKD prevalence. We demonstrate the importance of consistent recalibration of laboratory assays in a cohort study.",
author = "Parrinello, {Christina M.} and Grams, {Morgan E.} and David Couper and Ballantyne, {Christie M.} and Hoogeveen, {Ron C.} and Eckfeldt, {John H.} and Elizabeth Selvin and Josef Coresh",
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T1 - Recalibration of blood analytes over 25 years in the Atherosclerosis Risk in Communities Study

T2 - Impact of recalibration on chronic kidney disease prevalence and incidence

AU - Parrinello, Christina M.

AU - Grams, Morgan E.

AU - Couper, David

AU - Ballantyne, Christie M.

AU - Hoogeveen, Ron C.

AU - Eckfeldt, John H.

AU - Selvin, Elizabeth

AU - Coresh, Josef

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Y1 - 2015/7/1

N2 - BACKGROUND: Equivalence of laboratory tests over time is important for longitudinal studies. Even a small systematic difference (bias) can result in substantial misclassification. METHODS: We selected 200 Atherosclerosis Risk in Communities Study participants attending all 5 study visits over 25 years. Eight analytes were remeasured in 2011-2013 from stored blood samples from multiple visits: creatinine, uric acid, glucose, total cholesterol, HDL cholesterol, LDL cholesterol, triglycerides, and high-sensitivity C-reactive protein. Original values were recalibrated to remeasured values with Deming regression. Differences >10% were considered to reflect substantial bias, and correction equations were applied to affected analytes in the total study population. We examined trends in chronic kidney disease (CKD) pre- and postrecalibration. RESULTS: Repeat measures were highly correlated with original values [Pearson r > 0.85 after removing outliers (median 4.5% of paired measurements)], but 2 of 8 analytes (creatinine and uric acid) had differences >10%. Original values of creatinine and uric acid were recalibrated to current values with correction equations. CKD prevalence differed substantially after recalibration of creatinine (visits 1, 2, 4, and 5 prerecalibration: 21.7%, 36.1%, 3.5%, and 29.4%, respectively; postrecalibration: 1.3%, 2.2%, 6.4%, and 29.4%). For HDL cholesterol, the current direct enzymatic method differed substantially from magnesium dextran precipitation used during visits 1-4. CONCLUSIONS: Analytes remeasured in samples stored for approximately 25 years were highly correlated with original values, but 2 of the 8 analytes showed substantial bias at multiple visits. Laboratory recalibration improved reproducibility of test results across visits and resulted in substantial differences in CKD prevalence. We demonstrate the importance of consistent recalibration of laboratory assays in a cohort study.

AB - BACKGROUND: Equivalence of laboratory tests over time is important for longitudinal studies. Even a small systematic difference (bias) can result in substantial misclassification. METHODS: We selected 200 Atherosclerosis Risk in Communities Study participants attending all 5 study visits over 25 years. Eight analytes were remeasured in 2011-2013 from stored blood samples from multiple visits: creatinine, uric acid, glucose, total cholesterol, HDL cholesterol, LDL cholesterol, triglycerides, and high-sensitivity C-reactive protein. Original values were recalibrated to remeasured values with Deming regression. Differences >10% were considered to reflect substantial bias, and correction equations were applied to affected analytes in the total study population. We examined trends in chronic kidney disease (CKD) pre- and postrecalibration. RESULTS: Repeat measures were highly correlated with original values [Pearson r > 0.85 after removing outliers (median 4.5% of paired measurements)], but 2 of 8 analytes (creatinine and uric acid) had differences >10%. Original values of creatinine and uric acid were recalibrated to current values with correction equations. CKD prevalence differed substantially after recalibration of creatinine (visits 1, 2, 4, and 5 prerecalibration: 21.7%, 36.1%, 3.5%, and 29.4%, respectively; postrecalibration: 1.3%, 2.2%, 6.4%, and 29.4%). For HDL cholesterol, the current direct enzymatic method differed substantially from magnesium dextran precipitation used during visits 1-4. CONCLUSIONS: Analytes remeasured in samples stored for approximately 25 years were highly correlated with original values, but 2 of the 8 analytes showed substantial bias at multiple visits. Laboratory recalibration improved reproducibility of test results across visits and resulted in substantial differences in CKD prevalence. We demonstrate the importance of consistent recalibration of laboratory assays in a cohort study.

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