Abstract

Abstract Background Glycerol kinase deficiency (GKD) is a rare X-linked recessive disorder biochemically characterized by hyperglycerolaemia. Adults with GKD are usually asymptomatic. However, they often present with pseudohypertriglyceridemia because most clinical triglyceride methods measure enzymatically generated glycerol from triglycerides. Currently, assays for measuring plasma glycerol are lacking. We describe a preliminary validation of glycerol measured by nuclear magnetic resonance spectroscopy (NMR). Methods Serum glycerol was measured by NMR (Numares AG, Regensberg, Germany) using a Ascend 600 NMR (Bruker, Billerica, MA). Stability and matrix effects were determined by repeat measurement of 10 freshly collected samples following various storage conditions. Normal donors were recruited for reference interval (n = 143). Analytical specificity was assessed by spiking red cell lysate, bilirubin and intralipid. Precision was assessed by measuring three pools five times for five days. Accuracy was performed by spiking known concentrations of glycerol. Accuracy was assessed using an enzymatic method (Randox Laboratories, Ltd. County Antrim, UK) on a Roche Cobas c501 (Roche Diagnostics, Indianapolis, IN) as reference. Results Measured glycerol increased over time in both serum and plasma, however, prepared samples were stable on the instrument for up to 24 hours. Measured glycerol was not impacted by hemoglobin (1000 mg/dL) or bilirubin (625 mg/dL), however, spiking Intralipid® prevented any measurement. NMR and enzymatic assays strongly correlated, with a constant bias (Table 1). Repeatability and reproducibility were <10% CV and % recovery from glycerol standard were >80% for all concentrations. Conclusion Pre-analytical stability, imprecision and accuracy were acceptable for clinical measurement of glycerol using NMR. While there is a significant systematic bias with enzymatic methods, further studies in normal and disease populations will be necessary to determine clinical impact.

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