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Test Code F2ISO F2-Isoprostanes, Urine

Reporting Name

F2-Isoprostanes, U

Useful For

The assessment of in vivo lipid peroxidation and considered to be an index of systemic oxidative stress over time 

Additional Tests

Test ID Reporting Name Available Separately Always Performed
AACT Creatinine, U No Yes

Testing Algorithm

When F2-Isoprostanes testing is performed, urine creatinine will always be performed at no additional charge.

Performing Laboratory

Mayo Medical Laboratories in Rochester

Specimen Type

Urine


Specimen Required


Patient Preparation: Patient should not have taken nonsteroidal anti-inflammatory drugs within 72 hours or aspirin within 2 weeks prior to collection of a specimen.

Container/Tube: Plastic, 5-mL urine tube (T465)

Specimen Volume: 5 mL

Collection Instructions:

1. Collect a random urine specimen.

2. No preservative.


Specimen Minimum Volume

1 mL

Specimen Stability Information

Specimen Type Temperature Time
Urine Refrigerated (preferred) 7 days
  Frozen  90 days
  Ambient  7 days

Reference Values

≥18 years: ≤1.0 ng/mg creatinine

<18 years: not established

Day(s) and Time(s) Performed

Wednesday; 11 a.m.

Test Classification

This test was developed and its performance characteristics determined by Mayo Clinic in a manner consistent with CLIA requirements. This test has not been cleared or approved by the U.S. Food and Drug Administration.

CPT Code Information

82542

LOINC Code Information

Test ID Test Order Name Order LOINC Value
F2ISO F2-Isoprostanes, U In Process

 

Result ID Test Result Name Result LOINC Value
88677 15-F2t-Isoprostane, U In Process

Clinical Information

Oxidative stress results from the generation and overaccumulation of reactive oxygen and nitrogen species and has been shown to damage lipoproteins, lipids, DNA, and proteins. Furthermore, oxidative stress may modulate modifications to these lipoproteins and DNA such that endothelial function and inflammatory processes are altered, ultimately resulting in the initiation and progression of atherosclerosis and cardiovascular disease (CVD). Isoprostanes are a series of prostaglandin-like compounds produced via the free-radical catalyzed peroxidation of arachidonic acid, independent of the cyclooxygenase-derived prostaglandins. F2-isoprostanes are considered the "gold standard" test for quantifying lipid peroxidation/oxidative stress in vivo. 15-F2t-isoprostane (15-F2t-IsoP), also referred to as 8-iso-PGF2 alpha or 8-isoprostane F2 alpha, is 1 of the F2-isoprostanes produced in abundance in vivo and has demonstrated potency as a vasoconstrictor within the vasculature of the heart, brain, lung, and kidneys. Generation of 15-F2t-IsoP induces downstream effects including proliferation of vascular smooth muscle cells and release of endothelin. Additional evidence suggests that F2-isoprostanes may increase aspirin resistance to platelet aggregation within platelets and whole blood.

 

F2-isoprostanes are advantageous over other markers of lipid peroxidation due to their in vivo and in vitro stability and are detectable in a variety of human tissues and biological fluids including plasma, urine, lavage fluid, RBCs, and cerebrospinal fluid. Quantitation of F2-isoprostanes in a random urine specimen is considered to be the most accurate and robust measurement of circulating isoprostanes and is a noninvasive method of assessment.

Interpretation

Elevated urinary F2-isoprostanes reflect widespread oxidative stress and systemic burden of lipid peroxidation end products. Quantitation of F2-isoprostanes in urine is highly dependent upon the methodology utilized; however, mass spectrometry methods (gas chromatography-mass spectrometry or liquid chromatography-tandem mass spectrometry) assays yield superior sensitivity and analytical specificity compared with immunoassays.

 

F2-isoprostanes demonstrate superior clinical sensitivity compared to other oxidative stress biomarkers but lack clinical specificity for any particular disease. Pharmacological treatment with antioxidant supplementation, hypoglycemic agents in diabetes, smoking cessation, and weight reduction have all been shown to decrease production of F2-isoprostanes.

Clinical Reference

1. Strobel NA, Fassett RG, Marsh SA, Coombes JS: Oxidative stress biomarkers as predictors of cardiovascular disease. Int J Cardiol 2011;147:191-201

2. Davies SS, Roberts, LJ: F2-isoprostanes as an indicator and risk factor for coronary heart disease. Free Radic Biol Med 2011 Mar 1;50(5):559-566

3. Kontush A, de Faria EC, Chantepie S, Chapman MJ: A normotriglyceridemic, low HDL-cholesterol phenotype is characterized by an elevated oxidative stress and HDL particles with attenuated antioxidative activity. Atherosclerosis 2005;182:277-285

4. Vassale C, Botto N, Andreassi MG, et al: Evidence for enhanced 8-isoprostane plasma levels, as an index of oxidative stress in vivo, for patients with coronary artery disease. Coron Artery Dis 2003 May;14(3):213-218

Analytic Time

2 days

Reject Due To

Hemolysis

NA

Lipemia

NA

Icterus

NA

Other

NA

Method Name

F2ISO: Liquid Chromatography-Tandem Mass Spectrometry (LC-MS/MS)

AACT: Enzymatic Colorimetric Assay

Forms

If not ordering electronically, complete, print, and send a Cardiovascular Test Request Form (T724) with the specimen (http://www.mayomedicallaboratories.com/it-mmfiles/cardiovascular-request-form.pdf).