|
|
||||||||
Department of Population Medicine and Diagnostic Sciences, College of Veterinary Medicine, Cornell University, Ithaca, NY 14853
Corresponding author: Tracy Stokol; e-mail: ts23{at}cornell.edu.
| ABSTRACT |
|---|
|
|
|---|
Key Words: NEFA and BHBA concentration dairy cow storage and temperature stability anticoagulant
Abbreviation key: SST = serum separator tube
| INTRODUCTION |
|---|
|
|
|---|
During states of negative energy balance, lipolysis of adipose tissue liberates NEFA, which are used by the liver and mammary gland for energy and milk production, respectively. However, if NEFA delivery exceeds NEFA use, they are esterified and converted to triglycerides or metabolized to ketone bodies, particularly BHBA, within the liver. Triglycerides accumulate within hepatocytes and cause liver dysfunction and ketosis (Drackley, 1999; Herdt, 2000). Thus, high prepartum NEFA (>0.4 mmol/L) and postpartum BHBA (>1.40 mmol/L) concentrations in a proportion (>10%) of tested animals are considered biomarkers of negative energy balance and subclinical ketosis in the herd, respectively (Duffield, 2000; Oetzel, 2004). ß-Hydroxybutyrate is typically measured in serum samples, whereas NEFA can be measured in serum or EDTA plasma. It is advantageous to dairy practitioners to collect only one sample (serum) for these tests, because both tests are included in postcalving metabolic profiles (NEFA and Metabolic Profile Sample Handling Guidelines, Nutrition Laboratory, University of Michigan). In human patients, BHBA concentrations are unaffected by storage temperature and time (Custer et al., 1983); however, NEFA are far less stable. Nonesterified fatty acid values are affected by anticoagulants, and increase with time, particularly at higher storage temperatures (Rogiers, 1978; Gleeson, 1987; McGann and Hodson, 1991; Menendez et al., 2001). The current protocol for blood sampling for NEFA testing is to collect blood into gel and clot activator or serum separator tubes (SST), allow the blood to clot, centrifuge the sample, transfer the serum into another tube, then ship the serum chilled or frozen overnight for analysis (NEFA and Metabolic Profile Sample Handling Guidelines). A previous study in dairy cows showed that NEFA concentrations were slightly higher in EDTA plasma than in serum in 8 of 10 cows (Brookes et al., 1984). However, to our knowledge, there have been no published reports on the effect of other anticoagulants (e.g., heparin), use of SST, or other pre-analytical variables, including delayed separation of serum or plasma from cells, storage temperature, and duration of storage, on NEFA and BHBA concentrations in dairy cows.
We performed this study to provide recommendations to dairy practitioners and researchers on how best to collect and store samples for NEFA and BHBA concentrations to obtain accurate results. We hypothesized that both analytes would be unaffected by anticoagulants or use of SST and would be most stable if separated from cells and stored cool until analysis. The objectives of this study were to determine if NEFA and BHBA concentrations are influenced by: 1) use of anticoagulants and SST; 2) delays in separating serum or plasma from cells; 3) maintaining samples at 24°C or 4°C after collection; 4) storing samples for up to 72 h at these temperatures; and 5) frozen storage.
| MATERIALS AND METHODS |
|---|
|
|
|---|
To determine if collecting blood into SST affected serum NEFA and BHBA concentrations, blood samples were collected from 18 periparturient cows from a single herd into SST and nonanticoagulant tubes. Samples were kept cool (4°C) and the serum was separated from cells and analyzed within 4 to 6 h after collection.
For assessing NEFA and BHBA concentrations in serum after freezethawing, blood samples were collected from 30 periparturient cows (18 and 12 each from 2 herds) into nonanticoagulant tubes, separated immediately from cells, and assayed to obtain baseline values. The samples were then frozen at 40°C, thawed, and assayed 24 h later (experiment 1). In a second experiment (experiment 2), blood samples were collected from 11 dry cows from a single herd into nonanti-coagulant tubes, the serum was separated from cells, and analyzed for baseline concentrations. Portions of the serum were then frozen at 40°C, then thawed, and analyzed at 7, 14, and 28 d after collection.
Analysis of NEFA and BHBA Concentrations
Nonesterified fatty acids (NEFA-C, Wako Chemicals USA, Inc., Richmond, VA; Custer et al., 1983) and BHBA (ß-HBA, Catachem Inc., Bridgeport, CT; Morris et al., 2002) concentrations were measured using colorimetric enzymatic reactions with an automated wet chemistry analyzer (Hitachi 917, Roche Diagnostics, Indianapolis, IN). The analyzer was calibrated and controls assayed daily according to manufacturers recommendations, to ensure acceptable assay performance.
Statistical Analyses
Median values in different sample types, over time, or at different temperatures were compared with a Wilcoxon signed-rank test (2 medians) or Friedman 1-way ANOVA test (>2 medians), with a Bonferroni adjustment for the numbers of pairwise comparisons. Alpha was set at P
0.05.
| RESULTS |
|---|
|
|
|---|
|
|
Effect of freezethaw.
Concentrations of NEFA did not change significantly (P = 0.366) when serum was frozen at 40°C, then thawed, and analyzed 24 h later (experiment 1, Table 2
). Minor changes occurred in NEFA concentrations when serum was stored frozen for up to 1 mo (experiment 2, Table 2
).
|
|
|
Effect of freezethaw.
Concentrations of BHBA did not change significantly (P = 0.640) when serum was frozen for 24 h at 40°C, then thawed (experiment 1, Table 2
). Similarly, BHBA concentrations were stable when serum was frozen at 40°C for 1 mo after collection (P = 0.210) (experiment 2, Table 2
).
| DISCUSSION |
|---|
|
|
|---|
Previous studies in human patients using the same analytical technique have shown that NEFA concentrations are higher (4 to 10%) in serum than in EDTA plasma (McGann and Hodson, 1991; Menendez et al., 2001). In our study, NEFA concentrations were similarly higher (by 5%) in serum, although this was not significant or clinically relevant. Higher values in serum have been attributed to activation of de-esterifying enzymes (e.g., lecithinases) or lipolytic enzymes during clotting or possible EDTA inhibition of the reaction (McGann and Hodson, 1991). In contrast, NEFA concentrations were higher (albeit not significantly) in EDTA plasma compared with serum in sheep (Morris et al., 2002), and in a previous study in 10 dairy cows (Brookes et al., 1984). A reason for the discrepancies between these results and our data is not readily apparent, but could be related to differences in sample handling and processing, because the same analytical technique was used for these 3 studies. ß-Hydroxybutyrate concentrations were similar regardless of sample type, as has been reported previously for ovine blood (Morris et al., 2002). In contrast, BHBA values were influenced by anticoagulants in human samples, with lower values seen after exogenous addition of EDTA or sodium fluoride/potassium oxalate, but not lithium heparin (Custer et al., 1983).
Nonesterified fatty acid concentrations were stable at 4°C, regardless of anticoagulant, for 24 h in whole blood and for 72 h in separated plasma or serum. Similarly, NEFA concentrations did not change significantly over 48 h in human serum or plasma kept at 4°C (Menendez et al., 2001). Our results are in contrast to that reported for ovine blood, where serum NEFA concentrations increased significantly by 20% over 72 h at 4°C (Morris et al., 2002). Nonesterified fatty acid concentrations were consistently higher in all samples, regardless of anticoagulant, when stored at 24°C. Significant increases were apparent after about 24 h of storage at 24°C in whole blood or anticoagulated plasma. Similar findings were reported previously in human subjects (McGann and Hodson, 1991; Menendez et al., 2001), although the increases were much greater in serum and EDTA plasma (30 to 75%) than that seen in our study (20 to 21%). It is interesting that NEFA concentrations were less stable in heparinized plasma; concentrations increased by 62% within 72 h of storage at 24°C. Similar results have been reported previously for human patients in some studies (Gleeson, 1987). Heparin also produced the largest variation in baseline NEFA concentrations (Figure 1
). Therefore, heparin should be avoided as an anticoagulant for collecting blood samples for NEFA testing in dairy cows. The increase in NEFA concentrations at higher storage temperatures has been attributed to spontaneous or enzyme (lipoprotein lipase, lecithinase)-catalyzed hydrolysis of esterified fats (McGann and Hodson, 1991). This process may be accelerated in heparinized samples (Gleeson, 1987), although addition of exogenous heparin to human samples after collection in vitro did not affect NEFA concentrations when measured using the same enzymatic method used in our study (McGann and Hodson, 1991) or gas chromatography (Rogiers, 1978). Heparin does activate lipoprotein lipase; however, this enzyme is attached to capillary endothelium and is only released after intravenous boluses of heparin (Watson et al., 1995). It must be noted that, although the increases in NEFA concentrations with storage at 24°C were significant, none were of sufficient magnitude to alter result interpretation; that is, the proportion of cows with NEFA concentrations < 0.4 mmol/L was the same (10%) at all time points, regardless of storage temperature or anticoagulant. Nonesterified fatty acid concentrations were also stable with frozen storage, as reported previously for human (Gleeson, 1987; McGann and Hodson, 1991; Menendez et al., 2001) and ovine (Morris et al., 2002) blood.
Delayed separation (up to 24 h) of serum or plasma from cells did not affect NEFA concentrations when whole blood was stored at 4°C. Similarly, NEFA concentrations were stable when EDTA- or heparin-anticoagulated samples were stored as whole blood for 24 h at 24°C. In contrast, NEFA concentrations were significantly higher in nonanticoagulated whole blood stored at 24°C for 24 h compared with separated serum. These data are similar to those reported for human patients, in which a 24-h delay in separation increased NEFA concentrations when samples were stored at 24 but not 4°C. These increases were marked (31 to 36%) in heparin- and nonanticoagulated blood samples, but minimal in EDTA-anticoagulated samples (9%) (McGann and Hodson, 1991). These results emphasize the importance of keeping blood cool at all times after sample collection for NEFA testing.
Serum obtained from SST yielded slightly, but significantly, higher NEFA concentrations than serum obtained from nonanticoagulant tubes. The reason for this is unclear; however, it may be an artifact of the silicone gel, because the tubes were handled identically. Serum separator tubes are often favored by large-animal practitioners because they hasten clotting and facilitate serum collection by lay staff. However, although the changes were small (median difference of 0.02 mmol/L) and unlikely to be relevant, we recommend that SST not be used for NEFA evaluation. In our experience, serum in these SST is often not removed from the clot (and placed in a separate tube), because it is assumed that the silicone barrier prevents cell-associated artifacts in biochemical parameters (e.g., hypoglycemia from glucose consumption by cells) from occurring. However, these artifacts still occur (T. Stokol, personal observations, 2005). Furthermore, if samples left in SST freeze (intentionally or inadvertently during winter), the ensuing hemolysis will cause artifactually high NEFA concentrations, substantially affecting interpretation of results (T. Stokol and D. V. Nydam, unpublished results, 2005; Morris et al., 2002). Therefore, these tubes provide little advantage over regular non-anticoagulant tubes.
In contrast to NEFA, BHBA concentrations were stable under all storage conditions tested. ß-Hydroxybutyrate concentrations were similarly stable in sodium fluoride-anticoagulated ovine plasma frozen for 180 d at 20 or 80°C (Morris et al., 2002), and in human blood stored as whole blood (nonanticoagulated or fluoride/oxalate-anticoagulated) or separated plasma or serum for 7 d at 4 or 24°C (Custer et al., 1983). It is noted that the NEFA and BHBA concentrations in our cohort of peripartum cows were not high. It is possible that there would be more variation in the concentrations of these analytes due to anticoagulants or storage in samples with higher baseline values.
| CONCLUSIONS |
|---|
|
|
|---|
Cornell University recently changed its supplier of the BHBA reagent from Catechem Inc. to Randox Laboratories (Antrim, UK). The enzymatic method for detecting BHBA is the same for both suppliers. In a preliminary trial, we collected blood from 10 periparturient dairy cows into nonanticoagulant tubes and compared serum BHBA concentrations with the 2 reagents. The median BHBA concentrations were stable with both reagents in separated serum samples maintained at 4 or 24°C for 72 h.
| ACKNOWLEDGEMENTS |
|---|
|
|
|---|
Received for publication March 31, 2005. Accepted for publication May 13, 2005.
| REFERENCES |
|---|
|
|
|---|
This article has been cited by other articles:
![]() |
M. Iwersen, U. Falkenberg, R. Voigtsberger, D. Forderung, and W. Heuwieser Evaluation of an electronic cowside test to detect subclinical ketosis in dairy cows J Dairy Sci, June 1, 2009; 92(6): 2618 - 2624. [Abstract] [Full Text] [PDF] |
||||
![]() |
G. R. Oetzel, K. M. Emery, W. P. Kautz, and J. E. Nocek Direct-Fed Microbial Supplementation and Health and Performance of Pre- and Postpartum Dairy Cattle: A Field Trial J Dairy Sci, April 1, 2007; 90(4): 2058 - 2068. [Abstract] [Full Text] [PDF] |
||||
![]() |
T. Stokol and D. V. Nydam Effect of Hemolysis on Nonesterified Fatty Acid and {beta}-hydroxybutyrate Concentrations in Bovine Blood J Vet Diagn Invest, September 1, 2006; 18(5): 466 - 469. [Abstract] [Full Text] [PDF] |
||||
| ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |