1. Blood samples Kari Kuulasmaa Luxembourg 9-11 April 2008

2. Uses of blood samples Lipid measurements Total cholesterol HDL-cholesterol Glucose Fatty acids and lipoproteins Biomarkers E.g. Refl. nutrition (vitamins, flavonoids..) Antibodies Markers of infection and inflammation DNA

3. Blood collection Fasting Not required for cholesterols 8 h (overnight) for glucose By certified phlebotomist Subject in sitting position Minimal use of tourniquet

4. Cholesterol Serum preferred Clotting in room temperature for 30- 60 min Centrifuging within an hour Analysis preferably on the day of collection or on refrigerated samples within 3 days or frozen samples (max 6 months at - 20, longer at -70)

5. Glucose Tubes with citrate and fluoride Centrifuge within an hour Analysis preferably on the day of collection or on refrigerated samples within 3 days or frozen samples (max 6 months at - 20, longer at -70)

6. Change (%) of glucose concentration in whole blood samples Uchida et al. Clinica Chimica Acta 1988;172:101-108

7. Change (%) of glucose concentration in whole blood samples Citrate-fluoride mix NaF/K-oxsalate NaF/EDTA Li-hep Time (h) Väisänen et al. Kliin Lab 2008; 3-4

8. Laboratory procedures Use accredited laboratory Good direct enzymatic methods are available CDC has a certification program for clinical diagnostic products for cholesterols External quality control needs to be set up