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Epidemiology:
doi: 10.1097/EDE.0b013e318187865e
Methods: Original Article

Intraindividual Variability in Serum Micronutrients: Effects on Reliability of Estimated Parameters

Shvetsov, Yurii B.; Hernandez, Brenda Y.; Wong, Sze H.; Wilkens, Lynne R.; Franke, Adrian A.; Goodman, Marc T.

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Abstract

Background: Although serum measures of micronutrients are more specific than questionnaires in quantifying nutritional status, the reliability of serum measures depends on between- and within-person variability of circulating micronutrient levels. The extent to which multiple samples per person might improve reliability is useful information for planning studies and interpreting results.

Methods: We analyzed levels of 25 micronutrients in serum samples taken from 381 Hawaii women at 4-month intervals. For all subjects and for subjects at the low and high end of the micronutrient distributions, we calculated inter- and intraindividual variability, reliability coefficients, and the number of measurements required to limit attenuation in estimated parameters (ie, to keep estimates close to their true values).

Results: For 18 of the 25 micronutrients, a single measurement provided an estimate within 20% of the true value. For regression coefficients, 2 measurements were needed to limit attenuation to no more than 20% for nearly half of the micronutrients. To achieve no more than 10% attenuation, the number of measurements required ranged from 2 to 10 for correlation and from 3 to 20 for regression coefficients. To achieve no more than 5% attenuation, the corresponding ranges were 3 to 21 for correlation and 6 to 42 regression coefficients. In general, more measurements were required for adequate characterization of subjects with relatively high levels of micronutrients than for subjects with lower levels.

Conclusions: Our analysis suggests that 2 or 3 blood measurements are enough to limit attenuation of regression coefficients within 20% of the true value for most carotenoids and tocopherols. For 10% attenuation or less, 4 or more micronutrient measurements may be needed.

© 2009 Lippincott Williams & Wilkins, Inc.

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