The Preanalytical Process Matters: Impact of Blood Collection Tubes on the Measurement of Vitamin D Using Liquid Chromatography Tandem Mass Spectrometry.

Abstract

Background: Liquid chromatography tandem mass spectrometry (LC-MS/MS) is a highly sensitive analytical tool that has become the gold standard for measuring the concentrations of some steroidal hormones and therapeutic drugs in blood. However, the application of this technology in different clinical laboratories faces challenges related to the preanalytical process. In this study, we investigated how the materials used in blood collection tubes affect the measurement of serum 25-hydroxyvitamin D [25(OH)D] by LC-MS/MS.

Methods: Serum samples were collected in 20 different blood collection tubes made by various manufacturers. The samples were processed under controlled conditions to simulate clinical practice, followed by measurement using an LC-MS/MS system. The data were compared with measurements obtained from a chemiluminescent enzyme immunoassay.

Results: Significant variability in measurement outcomes was observed depending on the type of blood collection tube used. Specific blood collection tubes from a manufacturer that employed specific separator gels exhibited interference, as indicated by broad peaks in chromatograms. This interference complicated the quantification of 25(OH)D. The interference was consistent across multiple samples, indicating a systemic problem related to the materials used in the blood collection tubes.

Conclusions: These findings highlight the need to evaluate blood collection tubes from various manufacturers prior to the clinical implementation of LC-MS/MS measurements. Because LC-MS/MS has unique potential error sources, our results indicate the importance in utilizing LC-MS/MS international standards to ensure accurate and reliable results in clinical laboratories.