Abstract
Dried blood spot (DBS) methodology offers significant advantages over venipuncture in studies of vulnerable populations or large-scale studies, including reduced participant burden and higher response rates. Uncertainty about the validity of cardiovascular disease (CVD) risk biomarkers remains a barrier to wide-scale use. We determined the validity of DBS-derived biomarkers of CVD risk versus gold-standard assessments, and study-specific, serum-equivalency values for clinical relevance of DBS-derived values. Concurrent venipuncture serum and DBS samples (n = 150 adults) were assayed in Clinical Laboratory Improvement Amendments-certified and DBS laboratories, respectively. Time controls of DBS standard samples were assayed single-blind along with test samples. Linear regression analyses evaluated DBS-to-serum equivalency values; agreement and bias were assessed via Bland-Altman plots. Linear regressions of venipuncture values on DBS-to-serum equivalencies provided R2 values for total cholesterol, high-density lipoprotein cholesterol (HDL-C), and C-reactive protein (CRP) of 0.484, 0.118, and 0.666, respectively. Bland-Altman plots revealed minimal systematic bias between DBS-to-serum and venipuncture values; precision worsened at higher mean values of CRP. Time controls revealed little degradation or change in analyte values for HDL-C and CRP over 30 weeks. We concluded that DBS-assessed biomarkers represent a valid alternative to venipuncture assessments. Large studies using DBS should include study-specific serum-equivalency determinations to optimize individual-level sensitivity, the viability of detecting intervention effects, and generalizability in community-level primary prevention interventions.
Original language | English (US) |
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Pages (from-to) | 285-297 |
Number of pages | 13 |
Journal | Biodemography and Social Biology |
Volume | 61 |
Issue number | 3 |
DOIs | |
State | Published - Jan 1 2015 |
Funding
This work was supported by a grant from the National Institute for Occupational Safety and Health (U19 OH008861) for the Harvard School of Public Health Center for Work, Health and Well-Being. This study would not have been accomplished without the participation of Partners HealthCare System and leadership from Dennis Colling, Sree Chaguturu, and Kurt Westerman. The authors would like to thank Partners Occupational Health Services, including Marlene Freeley for her guidance, as well as Elizabeth Taylor, Elizabeth Tucker O’Day, and Terry Orechia. We also thank individuals at each of the hospitals, including Jeanette Ives Erickson and Jacqueline Somerville in Patient Care Services leadership, and Jeff Davis and Julie Celano in Human Resources. We also thank Chris Kenwood of New England Research Institutes for his statistical and programming support and Deirdre McLaren for her assistance with the production of this manuscript. This study was further supported by National Institutes of Health grants U01-AG027669, R01-HL107240, R01-HL104607, UL1-RR024153, UL1-TR000005, and T32-HL007901; additional support was provided by a Robert Wood Johnson Foundation pilot grant and Partners Occupational Health.
ASJC Scopus subject areas
- Demography
- Anthropology
- Genetics
- Ecology, Evolution, Behavior and Systematics