Assessing an aflatoxin exposure biomarker: Exploring the interchangeability and correlation between venous and capillary blood samples
Assessing an aflatoxin exposure biomarker: Exploring the interchangeability and correlation between venous and capillary blood samples
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DOI：
10.1016/j.envres.2022.114396
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发表时间：
2022-09-26
影响因子：
8.3
通讯作者：
Mehta，Saurabh
中科院分区：
文献类型：
--
作者：
Srinivasan，Balaji;Ghosh，Shibani;Mehta，Saurabh
饮食中接触黄曲霉毒素除了是一种已知的致癌物质外，还被认为是对儿童营养和生长的潜在威胁。因此，准确评估高危个体血液中黄曲霉毒素浓度的能力对于为世界各地的公共卫生政策和实地计划提供信息非常重要。静脉血经常被用来量化暴露的生物标志物，如黄曲霉毒素FB1-赖氨酸加合物。然而，静脉采血方法是侵入性的，需要训练有素的工作人员，这使得这种方法的实施具有挑战性，特别是在资源有限的环境中。相比之下，通过指刺采集毛细血管血侵入性较小，并有可能在需要时监测中应用。本探索性研究的目的是探讨毛细血管血样和静脉血样在AFB1-赖氨酸加合物浓度定量中的相关性和互换性。从乌干达北部36名育龄妇女(16-49岁)采集了72份静脉和毛细血管血样。所有样品均采用高效液相色谱-荧光检测法进行分析。用回归分析和Bland-Altman分析比较AFB1-赖氨酸在静脉和毛细血管样本对之间的浓度。白蛋白归一化黄曲霉毒素B_1-赖氨酸数据偏倚为−0.023 pg/mg白蛋白，对数变换数据的95%符合限为0.51~−0.56pg/mg白蛋白。白蛋白标准化静脉血和毛细血管AFB1-赖氨酸浓度呈正相关，相关系数为0.71(p<0.0001)。由于缺乏任何可接受的黄曲霉毒素暴露的临床分界值，使得统计分析和方法比较的“可接受”限值的定义具有挑战性。我们的数据表明，静脉和毛细血管样本中白蛋白标准化的AFB1-赖氨酸浓度之间存在正相关，但基于Bland-Altman分析的一致性和互换性相对较弱。
Exposure to dietary aflatoxins has been recognized as a potential threat to child nutrition and growth, in addition to being a known carcinogen. The ability to accurately assess concentration of aflatoxin in the blood of at-risk individuals is therefore very important to inform public health policies and on-the-ground programs around the world. Venous blood is frequently used to quantify biomarkers of exposure such as AFB1-lysine adducts. However, venous blood collection methods are invasive, requiring highly trained staff, which makes this method challenging to implement, especially in resource-limited settings. In contrast, capillary blood collection by fingerprick is less invasive and has the potential for application in point-of-need monitoring. The aim of this exploratory study was to investigate the correlation and interchangeability of capillary and venous human blood samples in the quantification of AFB1-lysine adduct concentration. A total of 72 venous and capillary blood samples were collected from 36 women of reproductive age (16–49 years) in northern Uganda. All sample specimens were analyzed using high-performance liquid chromatography with fluorescence detection. Regression analysis and Bland–Altman analysis were performed to compare AFB1-lysine concentrations between venous and capillary sample pairs. Bland-Altman analysis of albumin-normalized AFB1-lysine data-bias was −0.023 pg/mg-albumin and the 95% limits of agreement were 0.51 to −0.56 pg/mg-albumin for log-transformed data. There was a positive correlation between albumin-normalized venous and capillary AFB1-lysine concentrations withrof 0.71 (p < .0001). A lack of any accepted clinical cutoff for aflatoxin exposure makes definition of an ‘acceptable’ limit for statistical analysis and comparison of methods challenging. Our data suggests a positive correlation between albumin-normalized AFB1-lysine concentrations in venous and capillary sample pairs, but relatively weak agreement and interchangeability based on Bland-Altman analysis.