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HelpTest Code F2ISO F2-Isoprostanes, Random, Urine
Reporting Name
F2-Isoprostanes, UUseful For
Assessment of in vivo lipid peroxidation
Considered to be an index of systemic oxidative stress over time
Additional Tests
| Test ID | Reporting Name | Available Separately | Always Performed |
|---|---|---|---|
| CRETR | Creatinine, Random, U | No | Yes |
Testing Algorithm
When F2-isoprostanes testing is performed, urine creatinine will always be performed at an additional charge.
Performing Laboratory
Mayo Clinic Laboratories in Rochester
Specimen Type
UrineSpecimen Required
Patient Preparation: Patient should not take nonsteroidal anti-inflammatory drugs within the 72 hours or aspirin within the 2 weeks prior to specimen collection.
Supplies: Sarstedt 5 mL Aliquot Tube (T914)
Container/Tube: Plastic urine tube
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 | Special Container |
|---|---|---|---|
| Urine | Refrigerated (preferred) | 7 days | |
| Frozen | 30 days | ||
| Ambient | 7 days |
Reference Values
≥18 years: ≤1.0 ng/mg creatinine
Reference values have not been established for patients who are younger than 18 years of age
Day(s) Performed
Tuesday
Test Classification
This test was developed and its performance characteristics determined by Mayo Clinic in a manner consistent with CLIA requirements. It has not been cleared or approved by the US Food and Drug Administration.CPT Code Information
82542
LOINC Code Information
| Test ID | Test Order Name | Order LOINC Value |
|---|---|---|
| F2ISO | F2-Isoprostanes, U | 90783-2 |
| Result ID | Test Result Name | Result LOINC Value |
|---|---|---|
| 88677 | 15-F2t-Isoprostane, U | 90783-2 |
Clinical Information
Oxidative stress results from an imbalance of reactive oxygen species resulting in peroxidation of biomolecules. 15-F2t-isoprostane (F2ISO, also referred to as 8-iso-PGF2alpha or 8-isoprostane) is an F2-isoprostane and its measurement is considered the "gold standard†test for quantifying lipid peroxidation in vivo. F2ISO is a potent vasoconstrictor, induces vascular smooth muscle cell proliferation, and increased aspirin resistance to platelet aggregation. Elevated urinary F2ISO concentrations are associated with the presence and extent of coronary artery stenosis, peripheral artery disease, and increased risk of post-operative atrial fibrillation.
Urinary F2ISO concentrations are lowered by aerobic exercise training, smoking cessation, and fenofibrate therapy.
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.
Cautions
Patients should not take nonsteroidal anti-inflammatory drugs within 72 hours or aspirin within 2 weeks prior to providing a urine specimen for analysis.
Clinical Reference
1. Strobel NA, Fassett RG, Marsh SA, Coombes JS. Oxidative stress biomarkers as predictors of cardiovascular disease. Int J Cardiol. 2011;147(2):191-201
2. Davies SS, Roberts, LJ. F2-isoprostanes as an indicator and risk factor for coronary heart disease. Free Radic Biol Med. 2011;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(2):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
5. Milne GL, Sanchez SC, Musiek, ES, Morrow JD. Quantification of F2-isoprostanes as a biomarker of oxidative stress. Nature Prot. 2007;2(1):221-226
6. Zhang Z. Systematic review on the association between F2-isoprostanes and cardiovascular disease. Ann Clin Biochem. 2013;50(Pt 2):108-114
7. Wu J, Marchioli R, Silletta MG, et al. Oxidative stress biomarkers and the incidence of postoperative atrial fibrillation in the Omega-3 Fatty Acids for Prevention of Postoperative Atrial Fibrillation (OPERA) Trial. J Am Heart Assoc. 2015;4(5):e001886
8. Vazzana N, Ganci A, Cefalu AB, et al. Enhanced lipid peroxidation and platelet activation as potential contributors to increased cardiovascular risk in the low-HDL phenotype. J Am Heart Assoc. 2013;2(2):e000063
Method Description
15-F2t-Isoprostane is separated and quantified in urine by liquid chromatography-tandem mass spectrometry (LC-MS/MS).(Unpublished Mayo method)
Report Available
2 to 9 daysSpecimen Retention Time
7 daysReject Due To
All specimens will be evaluated at Mayo Clinic Laboratories for test suitability.Method Name
F2ISO: Liquid Chromatography Tandem Mass Spectrometry (LC-MS/MS)
CRETR: Enzymatic Colorimetric Assay
Forms
If not ordering electronically, complete, print, and send a Cardiovascular Test Request Form (T724) with the specimen.