Within- and between-subject biological variation data for serum zinc, copper and selenium obtained from 68 apparently healthy Turkish subjects

• Published in: Clinical chemistry and laboratory medicine Vol. 60; no. 4; pp. 533 - 542
• Main Authors: Coşkun, Abdurrahman, Carobene, Anna, Aarsand, Aasne K., Aksungar, Fehime B., Serteser, Mustafa, Sandberg, Sverre, Díaz-Garzón, Jorge, Fernandez-Calle, Pilar, Karpuzoğlu, Fatma H., Coskun, Cihan, Kızılkaya, Emine, Fidan, Damla, Jonker, Niels, Uğur, Esra, Unsal, Ibrahim
• Format: Journal Article
• Language: English
• Published: Germany De Gruyter 28.03.2022; Walter De Gruyter & Company
• Subjects: Biological variation; biological variation (BV); Biological Variation, Population; Copper; copper (Cu); Estimates; Female; Females; Healthy Volunteers; Homogeneity; Humans; Inductively coupled plasma mass spectrometry; Male; Males; Mass spectrometry; Mass spectroscopy; Monitoring; Outliers (statistics); Selenium; selenium (Se); Subgroups; Trace Elements; Trace elements (nutrients); trace elements (TrEL); Variance analysis; Variation; Zinc; zinc (Zn); selenium (Se); trace elements (TrEL); zinc (Zn); biological variation (BV); copper (Cu)
• ISSN: 1434-6621; 1437-4331; 1437-4331
• DOI: 10.1515/cclm-2021-0886

Trace elements (TrEL) are nutritionally essential components in maintaining health and preventing diseases. There is a lack of reliable biological variation (BV) data for TrELs, required for the diagnosis and monitoring of TrEL disturbances. In this study, we aimed to provide updated within- and between-subject BV estimates for zinc (Zn), copper (Cu) and selenium (Se). Weekly serum samples were drawn from 68 healthy subjects (36 females and 32 males) for 10 weeks and stored at -80 °C prior to analysis. Serum Zn, Cu and Se levels were measured using inductively-coupled plasma mass spectrometry (ICP-MS). Outlier and variance homogeneity analyses were performed followed by CV-ANOVA (Røraas method) to determine BV and analytical variation estimates with 95% CI and the associated reference change values (RCV) for all subjects, males and females. Significant differences in mean concentrations between males and females were observed, with absolute and relative (%) differences for Zn at 0.5 μmol/L (3.5%), Cu 2.0 μmol/L (14.1%) and Se 0.06 μmol/L (6.0%). The within-subject BV (CV [95% CI]) estimates were 8.8% (8.2-9.3), 7.8% (7.3-8.3) and 7.7% (7.2-8.2) for Zn, Cu and Se, respectively. Within-subject biological variation (CV ) estimates derived for male and female subgroups were similar for all three TrELs. Marked individuality was observed for Cu and Se. The data of this study provides updated BV estimates for serum Zn, Cu and Se derived from a stringent protocol and state of the art methodologies. Furthermore, Cu and Se display marked individuality, highlighting that population based reference limits should not be used in the monitoring of patients.