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Licensed Unlicensed Requires Authentication Published by De Gruyter April 26, 2022

Impact of ultra-low temperature long-term storage on the preanalytical variability of twenty-one common biochemical analytes

  • Estibaliz Alegre , Nerea Varo , Pilar Fernández-Calle , Sofía Calleja and Álvaro González EMAIL logo



Retrospective studies frequently assume analytes long-term stability at ultra-low temperatures. However, these storage conditions, common among biobanks and research, may increase the preanalytical variability, adding a potential uncertainty to the measurements. This study is aimed to evaluate long-term storage stability of different analytes at <−70 °C and to assess its impact on the reference change value formula.


Twenty-one analytes commonly measured in clinical laboratories were quantified in 60 serum samples. Samples were immediately aliquoted and frozen at <−70 °C, and reanalyzed after 11 ± 3.9 years of storage. A change in concentration after storage was considered relevant if the percent deviation from the baseline measurement was significant and higher than the analytical performance specifications.


Preanalytical variability (CVP) due to storage, determined by the percentage deviation, showed a noticeable dispersion. Changes were relevant for alanine aminotransferase, creatinine, glucose, magnesium, potassium, sodium, total bilirubin and urate. No significant differences were found in aspartate aminotransferase, calcium, carcinoembryonic antigen, cholesterol, C-reactive protein, direct bilirubin, free thryroxine, gamma-glutamyltransferase, lactate dehydrogenase, prostate-specific antigen, triglycerides, thyrotropin, and urea. As nonnegligible, CVP must remain included in reference change value formula, which was modified to consider whether one or two samples were frozen.


After long-term storage at ultra-low temperatures, there was a significant variation in some analytes that should be considered. We propose that reference change value formula should include the CVP when analyzing samples stored in these conditions.

Corresponding author: Álvaro González, PhD, Service of Biochemistry, Clínica Universidad de Navarra, Avenida Pío XII 36, 31008 Pamplona, Spain, Phone: +34 948 255400, Fax: +34 948 296 500, E-mail:
Estibaliz Alegre and Nerea Varo contributed equally to this work.

Funding source: Roche Diagnostics


We thank Sonia Irisarri, Ruben del Campo, and Dra. María Romero for their technical assistance.

  1. Research funding: This study was partially supported by Roche Diagnostics, Barcelona, Spain.

  2. Author contribution: All authors have accepted responsibility for the entire content of this manuscript and approved its submission.

  3. Competing interests: Authors state no conflict of interest.

  4. Informed consent: Not applicable.

  5. Ethical approval: Sample collection and storage was approved by the local Ethics Committee (project 14/2004 and 111/2010 and collection ISCIII C.0003132).


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Supplementary Material

The online version of this article offers supplementary material (

Received: 2022-01-22
Accepted: 2022-04-11
Published Online: 2022-04-26
Published in Print: 2022-06-27

© 2022 Walter de Gruyter GmbH, Berlin/Boston

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