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Quantification of key folate forms in serum using stable-isotope dilution ultra performance liquid chromatography–tandem mass spectrometry
Authors:Susanne H Kirsch  Jean-Pierre KnappWolfgang Herrmann  Rima Obeid
Institution:Saarland University Hospital, Department of Clinical Chemistry and Laboratory Medicine, Building 57, 66421 Homburg/Saar, Germany
Abstract:Folates act as essential coenzymes in many biological pathways. Alteration in folate form distribution might have biological significance, especially in relation to certain genetic polymorphisms. We developed a stable-isotope dilution ultra performance liquid chromatography–mass spectrometry (UPLC–MS/MS) method for quantification of the folate forms 5-methyltetrahydrofolate (5-methylTHF), 5-formylTHF, 5,10-methenylTHF, THF, and folic acid in serum. After extraction using an ion exchange and mixed mode solid-phase, samples were separated and detected using an UPLC–MS/MS system. The quantification limits were between 0.17 nmol/L (5-formylTHF) and 1.79 nmol/L (THF), and the assay was linear up to 100 nmol/L (5-methylTHF) and 10 nmol/L (5-formylTHF, 5,10-methenylTHF, THF, and folic acid). The intraassay CVs for 5-methylTHF and 5-formylTHF were 2.0% and 7.2%, respectively. Mean recoveries were between 82.3% for THF and 110.8% for 5,10-methenylTHF. Concentrations of total folate measured by the new method showed a strong correlation with those measured by an immunologic assay (r = 0.939; p < 0.001). The mean total folate from 32 apparently healthy subjects was 18.09 nmol/L, of which 87.23% was 5-methylTHF. Concentrations of homocysteine showed a better correlation to the total folate measured by the new method compared to that obtained by an immunologic assay. We also confirmed that MTHFR polymorphism has a significant effect on folate distribution in this small population of non-supplemented subjects.
Keywords:DHF  dihydrofolate  GC/MS  gas chromatography&ndash  mass spectrometry  HPLC  high-performance liquid chromatography  LC&ndash  MS/MS  liquid chromatography with tandem mass spectrometry  LOD  limit of detection  LOQ  limit of quantification  MRM  multiple reaction monitoring  MS/MS  tandem mass spectrometry  MTHFR  5  10-methylenetetrahydrofolate reductase  pABA  p-aminobenzoic acid  PCR  polymerase chain reaction  SPE  solid-phase extraction  TFOL  total folate  THF  tetrahydrofolate  tHcy  total homocysteine  TIC  total ion chromatogram  UPLC  ultra performance liquid chromatography
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