Annals of Clinical Biochemistry > Volume 45, Number 6 > Pp. 575-584

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Simultaneous determination of guanidinoacetate, creatine and creatinine in urine and plasma by un-derivatized liquid chromatography-tandem mass spectrometry

R S Carling¹, S L Hogg¹, T C Wood² and J Calvin¹

¹ Biochemical Genetics Unit, Box 247, Addenbrookes Hospital, Hills Road, Cambridge CB2 0QQ, UK; ² Biochemical Genetics Laboratory, Greenwood Genetic Center, 125 Gregor Mendel Circle, Greenwood SC 29646, USA

View larger version (14K): [in this window] [in a new window]   Figure 1 Creatine biosynthetic pathway. CRTR, creatine transporter; SAH, S-adenosylhomocysteine; SAM, S-adenosylmethionine

 

View larger version (10K): [in this window] [in a new window]   Figure 2 Typical chromatogram of a urine sample (a) creatinine, (b) guanidinoacetate and (c) creatine

 

View larger version (28K): [in this window] [in a new window]   Figure 3 Ion suppression (a) represents the constant infusion of labelled guanidinoacetate, (b) represents the injection of an extracted plasma sample containing guanidinoacetate eluting away from the region of ion suppression, (c) represents the constant infusion of labelled creatine and (d) represents the injection of an extracted plasma sample containing creatine eluting away from the region of ion suppression

 

View larger version (24K): [in this window] [in a new window]   Figure 4 Increase in concentration of urinary creatine with time when stored at room temperature (n = 6). CN, creatine (µmol/L); CNN, creatinine (mmol/L)

 

View larger version (16K): [in this window] [in a new window]   Figure 5 Average standard deviation from the European Research Network Inherited Disorders of Metabolism all-laboratory trimmed mean for creatine and guanidinoacetate in plasma and urine

 

View larger version (16K): [in this window] [in a new window]   Figure 6 Bland–Altman plot for urinary creatine (a) represents the comparison with the gas chromatography-mass spectrometry method while (b) represents the comparison with the liquid chromatography-tandem mass spectrometry method

 

View larger version (16K): [in this window] [in a new window]   Figure 7 Bland–Altman plot for urinary guanidinoacetate (a) represents the comparison with the gas chromatography-mass spectrometry method while (b) represents the comparison with the liquid chromatography-tandem mass spectrometry method

 

View larger version (11K): [in this window] [in a new window]   Figure 8 Bland–Altman plot for the comparison of urinary creatinine with the liquid chromatography-tandem mass spectrometry method

 

View larger version (15K): [in this window] [in a new window]   Figure 9 Bland–Altman plot for the comparison of (a) plasma guanidinoacetate and (b) plasma creatine with the gas chromatography-mass spectrometry method

 

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