Literature Study on Factors Influencing the Biochemical Analytes Stability in Blood, Serum and Plasma: Systematic Review

Abstract

Blood testing represents an essential phase in diagnosis and treatment. It is important to comprehend the biochemical analytes' stability. This research gathers information from different journals that have investigated the stability of biochemical analytes under different conditions. This research aims to collect and analyze data about conditions that promote stability, conditions that lead to instability, and how stability varies in different tubes. By combining the outcomes of these studies, this research aims to deliver a complete overview of the ability of biochemical analytes to remain unchangeable in various contexts. In this review study, we collected all articles studying pre-analytical stability. A PubMed and Web of Science search was performed with a time limit of 2005-2021 using the following keyword: "(Stability) and (biochemical laboratory tests)". 375 articles were obtained and we selected 20 articles according to the titles, abstracts, and indexation. In the 20 included references, 31 analytes were ranked according to the most frequently studied analytes: Creatinine, Alanine Aminotransferase (ALT), triglycerides, urea, cholesterol, Alkaline Phosphatase (ALP), lactate dehydrogenase, Aspartate Aminotransferase (AST), total bilirubin, gamma-glutamyltransferase, albumin, sodium, High-Density Lipoprotein (HDL), potassium, calcium, total protein, creatine kinase, uric acid, glucose, C-Protein Reactive (CRP), amylase, ferritine, magnesium, lipase, iron, chloride, direct bilirubin, Low-Density Lipoprotein (LDL), phosphate, transferrin, carbon dioxide (CO₂). Before centrifugation, creatinine, urea, Alkaline Phosphatase (ALP), total bilirubin, albumin, total protein, lipase, chloride, direct bilirubin, phosphate, and Carbon Dioxide (CO₂) were stable in whole blood at room temperature for up to 24 h. All the analytes in the plasma were stable except for potassium and AST. In serum, ALP, lipase, chloride, direct bilirubin, total bilirubin, LDL, Carbon Dioxide (CO₂), triglyceride, cholesterol, total protein, creatinine kinase, C-Reactive Protein (CRP), and transferrin were stable at room temperature, refrigerated temperature, and freezing temperature. Aspartate Aminotransferase (AST), Gamma-Glutamyl Transferase (GGT), Lactate Dehydrogenase (LDH), creatinine, glucose, and urea were unstable after cycles of freezing and thawing at -196°C. These analytes show important stability after cycles of freezing and thawing at -20°C, except for Lactate Dehydrogenase (LDH). We noticed after the comparison of the two collection tubes, the Plasma Separation Tube (PST II)" and the Serum Separation Tube "SST (SST II)", the instability of total protein, ferritine, phosphate, aspartate Aminotransferase (AST), total and direct bilirubin and calcium. This study summarizes the outcomes of 20 stability studies to generate maximum stability information.