The potential for isotope dilution-LC-MS/MS to improve laboratory measurement of C-peptide: Reasons and critical determinants

• Main Authors: Deng, Y. (Author), Liu, Q. (Author), Zhang, C. (Author), Zhao, H. (Author), Zhou, W. (Author)
• Format: Article
• Language: English
• Published: Elsevier B.V. 2021
• Subjects: acromegaly; amino acid sequence; antibody affinity; Article; blood glucose monitoring; body mass; C peptide; cost effectiveness analysis; C-peptide; drug blood level; electrochemical analysis; erythrocyte deformability; health care personnel; hemoglobin A1c; high performance liquid chromatography; human; insulin antibody; ion exchange chromatography; isotope; Isotope dilution liquid chromatography-tandem mass spectrometry (ID-LC-MS/MS); limit of detection; liquid chromatography; liquid chromatography-mass spectrometry; mass spectrometry; mathematical phenomena; measurement accuracy; multiple reaction monitoring; point of care testing; polyacrylamide gel electrophoresis; protein synthesis; quality control; Sample preparation; sensitivity and specificity; signal noise ratio; size exclusion chromatography; standardization; Standardization; ultra performance liquid chromatography
• Online Access: View Fulltext in Publisher

 Human C-peptide is secreted in equimolar amounts with insulin by pancreatic beta-cells. Measurement of C-peptide plays an important role in the diagnosis and treatment of diabetes where it is used to evaluate the function of islet cells. However, C-peptide measurement results across different laboratories vary considerably and there is an urgent need to improve comparability between laboratories. As it is sensitive and specific, isotope dilution-liquid chromatography-tandem mass spectrometry (ID-LC-MS/MS) has made a major contribution and will continue to play a significant role in the standardization of C-peptide measurement. Here, we reviewed the application of ID-LC-MS/MS in C-peptide measurement by discussing the biochemical properties of C-peptide, common sample preparation procedures, and the sensitivity problems often encountered with ID-LC-MS/MS C-peptide measurement. Collectively, these factors are crucial for the development of ID-LC-MS/MS methods for C-peptide measurement. We also discussed the advantages, disadvantages, and progress of implementing ID-LC-MS/MS as a routine measurement tool for C-peptide in clinical laboratories. Finally, we summarized the existing reference system and the status of C-peptide measurement in clinical laboratories to convey the necessity of improving the comparability of C-peptide measurement in clinical laboratories using ID-LC-MS/MS. © 2021