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1
MRC Dunn Clinical Nutrition Centre, Hills Road, Cambridge CB2 2DH, United Kingdom.
2
MRC Human Nutrition Research, Downhams Lane, Milton
Road, Cambridge CB4 1XJ, United Kingdom.
a Author for correspondence. Fax 44 1223 426617.
| Abstract |
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Method: Total body water measurements in human subjects were made by obtaining plasma, saliva, and urine samples before and after oral dosing with 1.5 mol of deuterium oxide. The enrichments of the body fluids were determined from the FTIR spectra in the range 18002800 cm-1, using a novel algorithm for estimation of instrumental response, and by IRMS for comparison.
Results: The CV (n = 5) for repeat determinations of deuterium oxide in biological fluids and calibrator solutions (4001000 µmol/mol) was found to be in the range 0.10.9%. The use of the novel algorithm instead of the integration routines supplied with the instrument gave at least a threefold increase in precision, and there was no significant difference between the results obtained with FTIR and those obtained with IRMS.
Conclusion: This improved infrared method for measuring deuterium enrichment in plasma and saliva requires no sample preparation, is rapid, and has potential value to the clinician.
© 1999 American Association for Clinical Chemistry
| Introduction |
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Other methods for the determination of deuterium (2H) in water have been proposed (7)(8)(9)(10), including infrared spectrophotometry (11)(12)(13)(14)(15)(16). This latter technique has received particular attention because of its relatively high potential sensitivity, which suggests that only a small quantity of deuterium need be administered. Unfortunately, the absorption band centered at ~2500 cm-1, attributable to excitation of the DO bond, is present as a shoulder on the band at ~2130 cm-1, which is attributable to the HO bond. If a single wavelength is monitored (as is usually done with a dispersive instrument), this leads to uncertainty in the baseline reading and consequently limits the accuracy of the technique at low enrichments. In recent years, there have been considerable advances in infrared instrumentation through the application of Fourier transform infrared (FTIR) techniques. This allows rapid monitoring of the whole of the absorption region (17)(18)(19). However, these do not appear to have been used to measure enrichment in human plasma or other body fluids. Therefore, the aim of this study was to assess the precision of the new methodology and to compare results obtained from several physiological fluids with those obtained with mass spectrometry.
| Subjects and Methods |
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treatment of samples
The saliva and plasma samples were centrifuged immediately after
collection, and the supernatants were retained. All samples were stored
frozen at -20 °C. Prior to analysis, the samples were thawed,
vortexed, and centrifuged. Preliminary work showed that the predose
urine samples were not suitable for use as background samples for
estimation of deuterium by infrared spectroscopy because of the large
variations in composition of sequential urine samples. To overcome
these variations, we freeze-dried weighed aliquots of the postdose
urine samples and then reconstituted them gravimetrically with local
tap water containing naturally occurring deuterium to provide samples
of the same constituents, but without deuterium enrichment, to act as
background samples for the postdose urine samples. Local tap water was
also analyzed [mass spectrometry value, 147.7 µmol/mol (ppm; this
value was essentially identical to values obtained from background
samples of physiological fluids, e.g., saliva and plasma)].
infrared spectroscopy
The CVs for the new method of analysis were assessed using 8, 16,
32, and 64 scans for solutions containing 200, 400, 800, and 1000
µmol/mol deuterium. Five readings were averaged to produce a single
analytical result and repeat analyses for each sample. The same
procedure was used to establish the CVs in plasma, saliva, and urine,
using 8 or 64 scans per sample. The temperature of the sample
compartment of the instrument was found to be stable (32 ±
1 °C) without thermostatic control. When not in use, the sample
holders were kept in the instrument with the instrument switched on to
maintain them at operating temperature.
The precision of the standard procedure for measuring areas under the curve, which is incorporated into the software of FTIR spectrophotometer, and a modified procedure (20) was determined using the techniques described below. The infrared spectra of aqueous samples were measured in the range 18002800 cm-1 on a Mattson Genesis series FTIR spectrophotometer (Mattson Instruments), equipped with an automated sample shuttle and a pair of matched calcium fluoride sample cells with a 0.1-mm pathlength. The specifications of the instrument were as follows: infrared ceramic emitter; detector, LaTaO3 (uncooled); beam splitter, KBr; spectral range, 5500225 cm-1; and resolution, 1 cm-1. When the matched cells were switched, the error was less than ±1 µmol/mol (SD). A sample volume of 0.2 mL is adequate for the total procedure.
Urine samples were measured using a single-sample system and a cell
near the end of its useful life because ammonia and phosphate are both
known to react with calcium fluoride, causing the crystal to become
opaque. Postdose (or calibrator) samples were read at the same time as
predose (background) samples under the same ambient conditions. Before
the spectrum of each sample was recorded, that of a background sample
with natural deuterium abundance was measured. An automatic sample
shuttle made it possible, without disturbing the spectrometer, to mimic
a double-beam system. After correction for natural abundance, the
digitized spectra were exported to a spreadsheet for subsequent
processing. Calibration was made after measurements of eight samples.
The calibration procedure involved preparation of
2H2O calibrators by gravimetric dilution of
2H2O (99.9 APE; Sigma) with local tap water.
The enrichment of these calibrations was confirmed by mass spectrometry
(see Fig. 1
for a typical calibration curve).
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ftir data handling
The infrared spectrum of D2O in water obtained from
the FTIR instrument is shown in Fig. 2
. The signal from the deuterium-oxygen bond appears as a weak
shoulder on the intense nondeuterated water band. Baseline subtraction
can be performed with unenriched water as a reference, using the sample
shuttle, but it is still difficult to determine the zero enrichment
background with any great precision. This is demonstrated in Fig. 3
, in which the zero background enrichment is subtracted from the
postdose spectrum. The line at 2500 cm-1 shows the
single frequency at which most previous workers have made measurements
(13)(16).
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To overcome this uncertainty in baseline positioning, a similar
approach to that developed in this laboratory for gas
chromatography/mass spectrometry isotope mass ratio determination was
used (20). The spectra were digitized in the region
26652415 cm-1. The sample spectrum was then compared
with the sum of the reference spectrum and its first two derivatives,
generated numerically. The inclusion of the derivative functions
allowed correction for slight spectral energy shift. Baseline
subtraction was achieved by the inclusion of a linear function of light
energy in the fitting procedure. This method compared the
spectrophotometer outputs for sample and a reference across the whole
of the relevant peak, separating the responses into that which is
common to the absorption peak itself and that which is solely a
property of the linear baselines beneath the peaks. Admixture of the
first, second, and subsequent derivatives of the observed lineshape for
the reference material allowed for nonsuperimposibility of the spectra
because of instrumental drift. The equation used is:
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is the wavenumber,
S(
) is the sample spectrum,
R(
) is the reference spectrum,
is
the ratio between the peak intensities,
is the instrumental shift
along the wavenumber axis between the sample and reference spectra, and
A and B are constants related to the slopes
and intercepts of the backgrounds of the spectra. In practice,
the n points of the digitized spectra were exported from the
spectrophotometer software directly into a spreadsheet and the
following matrix expression was solved:
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, can be obtained by
summing the first three elements of P. The
relative amounts of deuterium in the sample can then be estimated by
assuming the Beer-Lambert law to hold. In calculating the enrichment of
deuterium in salivary and plasma water, we assumed (21) (and
confirmed experimentally) that the hydration fraction of saliva was
99.5% ± 0.2% (in kg/L), and that of plasma, 94% ± 0.4%.
The hydration fraction of the urine samples was calculated from the
freeze-dried samples.
mass spectrometry
Excess sample was isotopically equilibrated with hydrogen gas for
3 days, using platinum on alumina powder as a catalyst (6).
The deuterium content of the resultant gas was compared with that of
known calibrators, using a Sira 10 (VG Instruments) equipped with a
dual inlet, and the results were converted to the SMOW/SLAP scale.
preparation of calibrators
Samples enriched in deuterium by known amounts were prepared by
the gravimetric addition of D2O (99.9%; Sigma-Aldrich) to
an aliquot of natural abundance water (Cambridge tap water) and then
adjustment to a known volume with tap water. A portion of this enriched
sample was further diluted in Cambridge tap water to give samples
enriched above natural abundance by 1000, 800, 600, 400, and 200
µmol/mol.
statistical analysis
Results were expressed as means and SD. Comparisons of results
obtained with the two methods and between different physiological
fluids collected at the same time were made using the Bland and Altman
(22) method.
ethics approval
The study was approved by the local ethics committee, and informed
written consent was obtained from all the participants.
| Results |
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The results in Table 4
show that there is close agreement between both methods for
mass spectrometry and infrared deuterium analysis when measurements
were made in plasma, saliva, and urine (none of the comparisons were
significantly different from each other; paired t-test).
There also was close agreement in the enrichment between the different
types of fluid analyzed (Table 5
) and no significant increase in the difference between methods
as deuterium enrichment increased. It was possible to analyze samples
within 30 min of receiving them (including time for centrifugation).
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| Discussion |
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This study also demonstrates good agreement between the infrared and mass spectrometry measurements of deuterium enrichment in saliva, plasma, and urine. Furthermore, the differences between plasma and salivary measurements obtained with the infrared technique were similar to those obtained with mass spectrometry. However, the dose of deuterium required to achieve a CV <1% for repeated measurements of the same sample is several fold greater with the infrared method than with mass spectrometry. On the other hand, changes in background enrichment, which may occur after the administration of intravenous fluids or the drinking of distilled water, will influence the estimation of total body water by the infrared method to a lesser extent than mass spectrometry, which usually involves measurement of smaller increments in deuterium enrichment. Furthermore, the operation of mass spectrometers requires more expertise than the operation of the infrared spectrophotometer, which can yield results shortly after the samples are obtained (plasma and saliva). A particular problem with urine analysis is the presence of variable amounts of interfering urinary substances, which makes predose urine samples less suitable for background measurements than the corresponding plasma and saliva samples. Although appropriate predose urine samples can be prepared by removing the enriched water from the urine (freeze-drying) and replacing it with tap water, the process is time-consuming and unsuitable for bedside analysis. Another problem with urine analysis is that the standard calcium fluoride cells are not suitable for prolonged and repeated use, although our preliminary studies with zinc selenide cells suggest that they are a suitable alternative because they are not "attacked" by urine. Sapphire cells may also be appropriate.
Finally, there have been reports that the use of a single-cell system
to measure enrichment of deuterium in urine (instead of the
matched-cell system for plasma and saliva measurements) could explain
the higher CV for the urinary measurements (Table 3
) and the greater
discrepancy between urinary and alternative fluid measurements when the
infrared technique is used, compared with the mass spectrometry method
(Table 5
). There have been reports of temperature dependence of the
infrared spectrum of both H2O and D2O in the
shorter wavelength 500016 000 cm-1 region
(23); therefore, some workers have used thermostatically
controlled cells (13)(16). However, because the operating
temperature was stable and the primary purpose of this work was to
assess the technique as a simple, rapid, and inexpensive method for
determination of total body water, no attempt was made to
thermoregulate the sample.
In conclusion, this report describes an improved infrared analytical method for measuring D2O enrichment in physiological fluids. It is simple, precise, rapid, and of potential value to the clinician who monitors and adjusts fluid therapy on a daily basis.
| References |
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