Quantitative Analysis of Vit D Metabolites in Human Plasma using Exactive System

Similar documents
MS/MS as an LC Detector for the Screening of Drugs and Their Metabolites in Race Horse Urine

LC-MS/MS Method for the Determination of Tenofovir from Plasma

Robust extraction, separation, and quantitation of structural isomer steroids from human plasma by SPE-UHPLC-MS/MS

Quantitative Analysis of THC and Main Metabolites in Whole Blood Using Tandem Mass Spectrometry and Automated Online Sample Preparation

Bioanalytical Quantitation of Biotherapeutics Using Intact Protein vs. Proteolytic Peptides by LC-HR/AM on a Q Exactive MS

High-Throughput Quantitative LC-MS/MS Analysis of 6 Opiates and 14 Benzodiazepines in Urine

A Robustness Study for the Agilent 6470 LC-MS/MS Mass Spectrometer

Analysis of Limonin in Citrus Juice Using QuEChERS and LC-MS/MS

Screening and quantitation of drugs in oral fluids using Q Exactive system

SPE-LC-MS/MS Method for the Determination of Nicotine, Cotinine, and Trans-3-hydroxycotinine in Urine

Increased Identification Coverage and Throughput for Complex Lipidomes

High-Throughput, Cost-Efficient LC-MS/MS Forensic Method for Measuring Buprenorphine and Norbuprenorphine in Urine

Testing robustness: Immunosuppressant drugs in blood with a TSQ Quantis MS for clinical research

LC-MS/MS Method for the Determination of 21 Opiates and Opiate Derivatives in Urine

UPLC-MS/MS Analysis of Azole Antifungals in Serum for Clinical Research

Analysis of anti-epileptic drugs in human serum using an Agilent Ultivo LC/TQ

All stocks and calibration levels were prepared in water: methanol (50:50) v/v to cover range of all steroid concentrations (refer Table 1).

Vitamin D Metabolite Analysis in Biological Samples Using Agilent Captiva EMR Lipid

Vitamin D3 and related compounds by ESI and APCI

A Novel Solution for Vitamin K₁ and K₂ Analysis in Human Plasma by LC-MS/MS

Sample Concentration and Analysis of Human Hormones in Drinking Water

High Resolution Accurate Mass Spectrometry in Clinical Toxicology. William Clarke, PhD, MBA, DABCC Johns Hopkins University School of Medicine

Dayana Argoti, Kerry Hassell, Sarah J. Fair, and Joseph Herman Thermo Fisher Scientific, Franklin, MA, USA

Determination of Chlorophenoxyacetic Acid and Other Acidic Herbicides Using a QuEChERS Sample Preparation Approach and LC-MS/MS Analysis

Comparison of Full Scan MS2 and MS3 Linear Ion Trap Approaches for Quantitation of Vitamin D

The Investigation of Factors Contributing to Immunosuppressant Drugs Response Variability in LC-MS/MS Analysis

Characterization of an Unknown Compound Using the LTQ Orbitrap

DETERMINATION OF CANNABINOIDS, THC AND THC-COOH, IN ORAL FLUID USING AN AGILENT 6490 TRIPLE QUADRUPOLE LC/MS

Fast and easy separation of 23 drugs of abuse. including high, stable resolution of isobaric opioids from human urine by UHPLC-MS/MS

Analysis of Choline and its Metabolites on the Finnigan LTQ

LCMS Vitamin D3 Method development

Analysis of Testosterone, Androstenedione, and Dehydroepiandrosterone Sulfate in Serum for Clinical Research

Quantitative Analysis of Underivatized Amino Acids in Plant Matrix by Hydrophilic Interaction Chromatography (HILIC) with LC/MS Detection

LC-MS/MS Method for the Determination of Raloxifene and its Glucuronide Metabolites from Human Plasma Using SPE Micro Elution

Evaluation of an LC-MS/MS Research Method for the Analysis of 33 Benzodiazepines and their Metabolites

New Solvent Grade Targeted for Trace Analysis by UHPLC-MS

LC-MS/MS quantitative analysis of Polyunsaturated Omega 3, 6,7 and 9 Fatty Acids in Serum for

Dienes Derivatization MaxSpec Kit

O O H. Robert S. Plumb and Paul D. Rainville Waters Corporation, Milford, MA, U.S. INTRODUCTION EXPERIMENTAL. LC /MS conditions

Efficient Quantitative Analysis of THC and Metabolites in Human Plasma Using Agilent Captiva EMR Lipid and LC-MS/MS

A FORENSIC TOXICOLOGY METHOD FOR THE DETERMINATION OF DESOMORPHINE, HEROIN, METHADONE, BUPRENORPHINE AND METABOLITES IN URINE USING LC/MS QQQ

Detection of Cotinine and 3- hydroxycotine in Smokers Urine

LCMS-8030 Application Report. Steroids: Testosterone, Progesterone, Estradiol, Ethinylestradiol

UPLC/MS Monitoring of Water-Soluble Vitamin Bs in Cell Culture Media in Minutes

Analyze Barbiturates in Urine with Agilent 6430 LC/MS/MS and Poroshell 120 EC-C18

Measuring Phytosterols in Health Supplements by LC/MS. Marcus Miller and William Schnute Thermo Fisher Scientific, San Jose, CA, USA

Rapid Analysis of Water-Soluble Vitamins in Infant Formula by Standard-Addition

Determination of 6-Chloropicolinic Acid (6-CPA) in Crops by Liquid Chromatography with Tandem Mass Spectrometry Detection. EPL-BAS Method No.

Monitoring of plasmatic concentrations of AEDs is important to improve patient s theraphy.

Edgar Naegele. Abstract

Robust and Fast Analysis of Tobacco-Specific Nitrosamines by LC-MS/MS

Detection of oxygenated polycyclic aromatic hydrocarbons (oxy-pahs) in APCI mode with a single quadrupole mass spectrometer

Supporting Information

Application of LC/Electrospray Ion Trap Mass Spectrometry for Identification and Quantification of Pesticides in Complex Matrices

Analysis of Acrylamide in French Fries using Agilent Bond Elut QuEChERS AOAC kit and LC/MS/MS

Extraction of Multiple Mycotoxins From Nuts Using ISOLUTE Myco prior to LC-MS/MS Analysis

Pesticide Residue Analysis in Whole Milk by QuEChERS and LC-MS/MS

Reduced Ion Suppression and Improved LC/MS Sensitivity with Agilent Bond Elut Plexa

Impurity Profiling of Carbamazepine by HPLC/UV

for the Identification of Phosphorylated Peptides


Fast quantitative Forensic Analysis of THC and its Metabolites in Biological Samples using Captiva EMR- Lipid and LC/MSMS

Extraction of Multiple Mycotoxins From Grain Using ISOLUTE Myco prior to LC-MS/MS Analysis

Determination of Amantadine Residues in Chicken by LCMS-8040

Quantification of lovastatin in human plasma by LC/ESI/MS/MS using the Agilent 6410 Triple Quadrupole LC/MS system

LC/MS/MS Separation of Cholesterol and Related Sterols in Plasma on an Agilent InfinityLab Poroshell 120 EC C18 Column

Measuring Lipid Composition LC-MS/MS

Analysis of Pesticides (II) Metribuzin & their metabolites in Rice Jun Yonekubo, Nihon Waters, JAPAN

Determination of Gamma-Hydroxy-Butyrate (GHB) in Biological Samples

Detection, Confirmation, and Quantification of Chloramphenicol in Honey, Shrimp and Chicken Using the Agilent 6410 LC/MS Triple Quadrupole

Ultra High Definition Optimizing all Analytical Dimensions

Sue D Antonio Application Chemist Cedar Creek, TX

New Mass Spectrometry Tools to Transform Metabolomics and Lipidomics

Lipidomic Analysis by UPLC-QTOF MS

Analysis of Vitamins Using an SFC/UHPLC Hybrid System with a Triple Quadrupole LC/MS for Quantification

Title: Pharmacokinetics of daikenchuto, a traditional Japanese medicine (Kampo) after. single oral administration to healthy Japanese volunteers

More structural information with MS n

Quantitation of Protein Phosphorylation Using Multiple Reaction Monitoring

Application Note. Agilent Application Solution Analysis of ascorbic acid, citric acid and benzoic acid in orange juice. Author. Abstract.

Single Quadrupole Compact Mass Spectrometer for Liquid Sample

[ APPLICATION NOTE ] UPLC-MS/MS Analysis of 45 Amino Acids Using the Kairos Amino Acid Kit for Biomedical Research INTRODUCTION APPLICATION BENEFITS

Determination of Bath Salts (Pyrovalerone Analogs) in Biological Samples

Quantitative Analysis of Amphetamine-Type Drugs by Extractive Benzoylation and LC/MS/MS. Application. Introduction. Authors. Abstract.

4.5 Minute Analysis of Benzodiazepines in Urine and Whole Blood Using LC/MS/MS and an Ultra Biphenyl Column

25-Hydroxyvitamin D2-D3 Serum LC-MS/MS APCI Analysis Kit User Manual

FOURIER TRANSFORM MASS SPECTROMETRY

LC-MS/MS for the quantification of Peptide biomarker and mixture of closely related Protein in formulation

The setup and validation of an LC-MS/MS assay of Androstenedione & Testosterone a labs experience

Integration of steroids analysis in serum using LC-MS/MS with full-automated sample preparation

Fast and simultaneous analysis of ethanol metabolites and barbiturates using the QTRAP 4500 LC-MS/MS system

Rapid, Simple Impurity Characterization with the Xevo TQ Mass Spectrometer

NON TARGETED SEARCHING FOR FOOD

High resolution mass spectrometry for bioanalysis at Janssen. Current experiences and future perspectives

Development and Validation of a Polysorbate 20 Assay in a Therapeutic Antibody Formulation by RP-HPLC and Charged Aerosol Detector (CAD)

Highly sensitive simultaneous quantitative analysis of estrone and equilin from plasma using LC/MS/MS

New Methodologies for POPs Analysis using Orbitrap GC-MS in Official Food Control

A Simple and Accurate Method for the Rapid Quantitation of Drugs of Abuse in Urine Using Liquid Chromatography

Dry eye disease commonly known as atopic keratoconjunctivitis is an autoimmune disease of

Abstract. Introduction

Transcription:

Quantitative Analysis of Vit D Metabolites in Human Plasma using Exactive System Marta Kozak Clinical Research Applications Group Thermo Fisher Scientific San Jose CA Clinical Research use only, Not for use in Diagnostics Procedure

Calibrators and Controls Six calibrators at 2, 5 1, 25, 5 andng/ml in BSA Three QCs at 5ng/mL, 4 ng/ml and 8 ng/ml in BSA Cals and QC s prepared by fortifying bovine serum albumin diluent with 2 ng/ml 25-hydryoxyvitamin D2 and D3 standard mix. Precipitating reagent was prepared by adding deuterated D6-25- hydroxyvitamin D3 to acetonitrile for a final concentration of 75ng/mL. Pooled donor serum samples were crashed 2 to 1 with Acetonitrile and spiked with analytes for a final concentration of 2 ng/ml for 25- hydroxyvitamin D2 2 Clinical Research use only, Not for use in Diagnostics Procedure

Presentation Overview Goals Introduction to Exactive Sample preparation and LC/MS method for 25 OH-Vit D Calibration curves, LOQ and results on QCs Blinded sample results comparison Appendix QQQ: Triple Quadrupole MS/MS system 3 Clinical Research use only, Not for use in Diagnostics Procedure

Goal Results comparison between Exactive and QQQ method for quantitation of 25-OH-Vit D2 and 25-OH-Vit D3 in human plasma Exactive@Thermo - Off line sample prep and 2 min gradient QQQ@Service lab - Protein precipitation followed by Turboflow and 6min gradient Evaluate Exactive system for analysis of 1, 25 di hydroxy Vit D3 4 Clinical Research use only, Not for use in Diagnostics Procedure

Exactive System Introduction 5 Clinical Research use only, Not for use in Diagnostics Procedure

Exactive Benchtop LC-MS Resolution, at 1 scan per second 1, at 1 scans per second Mass accuracy Sub ppm Dynamic range >1, within a spectrum Scan speed Up to 1 scans per second Mass range m/z 5-4 Polarity switching One positive and one negative scan < 1 second (25K Resolution) 6 Clinical Research use only, Not for use in Diagnostics Procedure

Orbitrap Principle of Operation r z φ Hyper-logarithmic potential distribution: ideal Kingdon trap k 2 2 2 U ( r, z) = { z r / 2 + Rm ln( r / R m )} 2 Characteristic frequencies: Frequency of rotation ω φ Frequency of radial oscillations ω r Frequency of axial oscillations ω z ω z = k m / q ω z R m 2 R m ω ϕ = 1 ω r = ω z 2 2 R R 2 Makarov A. Anal. Chem. 2, 72, 1156-1162. 7 Clinical Research use only, Not for use in Diagnostics Procedure

Ethinyl-Estradiol at Different Mass Resolutions Resolution: 1k, 3k, 5k, k Butyl-Phthalate, 279.1599 (ubiquitous background ion) 9 8 7 Relative Abundance 6 5 4 3 Ethinyl-Estradiol, 279.17434 2 1 279.12 279.14 279.16 279.18 279.2 m/z Note:Ethinyl Estradiol used just to demonstrate the power of resolution 8 Clinical Research use only, Not for use in Diagnostics Procedure

ppb Hormone Sample (5 pg on-column) ppb Hormone sample measured @ different resolution settings Ethinyl-Estradiol Phthalate Estradiol Phthalate Estradiol Relative Abundance Relative Abundance 5 5 5 5 18.3 19.32 17.22 18.17 16.4 18.76 17.73 RP =, 17 18 19 Time (min) 16.68 17.59 17.81 18.7 18.94 17 18 19 Time (min) 19.4 RP = 1, Note:Ethnyl Estradiol used just to demonstrate the power of resolution The isobaric phthalate background ion interferes with the Ethinyl-Estradiol ion. At resolution of 1, the steroid mass is off because the isobaric ions are not resolved. 9 Clinical Research use only, Not for use in Diagnostics Procedure

Exactive method Sample preparation Standards preparation µg/ml 25-OH-D3 and 25-OH-D2 mix in Ethanol Sample preparation µl plasma + 2 µl IS 5 ng/ml [2H6]-25OH-D3 Serial dilutions down to ng/ml 1 µl std + 99 ul of 5% Ethanol Calibration standards 1 to 2 ng/ml Vortex Centrifuge 1 min @ 132 RPM Supernatant 5 µl inject Note: Stock IS in ACN; Standards, QC and samples were processed using identical procedure 1 Clinical Research use only, Not for use in Diagnostics Procedure

Data acceptance criteria Current generally acceptable LC/MS precision Samples Cal Standard 1 Cal Standard 2 Cal Standard 3 Cal Standard 4 Cal Standard 5 Cal Standard 6 Cal Standard 7 QC 1* QC 2 QC 3 Concentration [ng/ml] 1 2 1 2 5 2 5 for Vit-D2 and 2 for Vit-D3* 5 2 Required Precision [%] 2 15 15 15 15 15 15 2 15 15 * QC1 spiked with 5 ng/ml of Vit-D3 and Vit-D2. Only total concentration was analyzed for QC1 sample. 11 Clinical Research use only, Not for use in Diagnostics Procedure

25OH-Vit D2 and D3 Exactive mass spectrum D2 - H2O D3 - H2O D3 (2 x H2O) D2 - (2 x H2O) D2 12 Clinical Research use only, Not for use in Diagnostics Procedure

Exactive 3 Selected M/Z Analyte Monitored m/z 25-OH-D 3 25-OH-D 2 41.3411 (M+H) 383.336 (M - H 2 O + H) 365.32 (M - 2 x H 2 O) + H) 413.3411 (M+H) 395.335 (M - H 2 O + H) 377.3199 (M - 2 x H 2 O) + H m/z with minimum interference [ 2 H 6 ] 25-OH-D 3 (Internal Standard) 47.3787 (M+H) 389.3679 (M - H 2 O + H) 371.3576 (M - 2 x H 2 O) + H 13 Clinical Research use only, Not for use in Diagnostics Procedure

Exactive LC/MS Method LC method Thermo Hypersil aqgold 5 x 2.1 mm, 5um (1, 25 Vit D3) Thermo Hypersil aqgold 5 x 2.1 mm, 5µm (25 OH Vit D) Mobile phase A: water containing.1% formic acid Mobile phase B: methanol containing.1% formic acid Column Temp: 5 Deg C Exactive MS method HESI source Full scan MS acquisition @ 5, Resolution External mass calibration Extract Ion Chromatogram for molecule of interest (m/z)@ better than 5ppm mass accuracy Confirm the identity using mass accuracy and RT Quantitate using peak area in the chromatogram Note: Details in appendix 14 Clinical Research use only, Not for use in Diagnostics Procedure

Linearity and Accuracy 25OH-Vit D3 Vit D3 - Validation1 Vit D3 - Validation 2.65 Y =.576964+.27313*X R^2 =.9918 W: 1/X^2.7 Y =.56991+.298291*X R^2 =.9954 W: 1/X^2.65.6.6.55.55.5.5.45.45.4.4 Area Ratio.35.3 Area Ratio.35.3.25.25.2.2.15.15.1.1.5.5. 2 4 6 8 12 14 16 18 2 22 ng/ml. 2 4 6 8 12 14 16 18 2 22 ng/ml.75.7 Vit D3 - Validation 3 Y =.571591+.317597*X R^2 =.9946 W: 1/X^2 % Difference.65 Standard Validation_1 Validation_2 Validation_3.6.55 1 ng/ml Precision just below set criteria.5.45 2 ng/ml 2.2 1.5.8 Area Ratio.4.35 1 ng/ml -1.5-9.6-6.5.3.25 2 ng/ml -.2 4.9 7.8.2.15 5 ng/ml -7.5-2.4-7.9.1.5 ng/ml 2.9-2.3-1.7. 2 4 6 8 12 14 16 18 2 22 2 ng/ml 13. 7.9 7.6 Note: Calibration curve using neat standards 15 Clinical Research use only, Not for use in Diagnostics Procedure

Linearity and Accuracy 25OH-Vit D2 Vit D2 Validation 1 Vit D2 Validation 2 2.8 Y =.43257+.119399*X R^2 =.9919 W: 1/X^2 2.8 Y =.89+.121633*X R^2 =.9943 W: 1/X^2 2.6 2.6 2.4 2.4 2.2 2.2 2. 2. 1.8 1.8 1.6 1.6 Area Ratio 1.4 1.2 Area Ratio 1.4 1.2 1. 1..8.8.6.6.4.4.2.2.. 2 4 6 8 12 14 16 18 2 22 2 4 6 8 12 14 16 18 2 22 ng/ml ng/ml Vit D2 Validation 3 2.6 Y = -.622327+.121577*X R^2 =.9996 W: 1/X^2 % Difference 2.4 2.2 Standard Validation_1 Validation_2 Validation_3 2. 1 ng/ml 5.4-4.4.6 1.8 1.6 2 ng/ml -1.6 9.7 -.7 Area Ratio 1.4 1.2 1 ng/ml -4.3-4.4-2.9 1. 2 ng/ml 7.5 2.1 2..8.6 5 ng/ml -8.6-5.9-1.4.4 ng/ml.8-5.3.3.2. 2 4 6 8 12 14 16 18 2 22 2 ng/ml 9.7 8.2 2.1 Note: Calibration curve using neat standards 16 Clinical Research use only, Not for use in Diagnostics Procedure

Lower points in calibration curve Good ppecificity 1ng_std - m/z= 365.32-365.32 SM: 5 RT:.75-1.5 NL: 4.36E4 F: {,} + p APCI Full ms [ 35.-42.] RT: 1.12 95 9 D3-1ng/mL 85 8 75 7 65 R e la tiv e In te n s ity 6 55 5 %RSD>2% 45 4 35 3 25 2 1.2 15 1.47 1.77.87.97 5.8.9 1. 1.1 1.2 1.3 1.4 Time (min) 2ng_std - m/z= 365.32-365.32 SM: 5 RT:.76-1.51 NL: 5.39E4 F: {,} + p APCI Full ms [ 35.-42.] R e la tiv e In te n s ity 95 9 85 8 75 7 65 6 55 5 45 4 35 3 25 2 15 1 5.78.83.88.96 RT: 1.13 LOQ D3-2ng/mL.8.9 1. 1.1 1.2 1.3 1.4 1.5 Time (min) 1.25 1.32 1.44 1ng_std - m/z= 365.32-365.32 SM: 5 RT:.76-1.51 NL: 1.49E5 F: {,} + p APCI Full ms [ 35.-42.] R e la tiv e In te n s ity 95 9 85 8 75 7 65 6 55 5 45 4 35 3 25 2 15 1 5 RT: 1.13 1.25 1.31 1.41.81.89.98 1.3 1.48.8.9 1. 1.1 1.2 1.3 1.4 1.5 Time (min) D3-1ng/mL 1ng_std - m/z= 395.33-395.33 SM: 5 RT:.79-1.54 NL: 7.47E4 F: {,} + p APCI Full ms [ 35.-42.] RT: 1.16 95 9 85 8 75 7 65 R e la tiv e In te n s ity 6 55 5 45 4 35 3 25 2 15 1 1.29 5 1..86.92.8.9 1. 1.1 1.2 1.3 1.4 1.5 Time (min) LOQ D2-1ng/mL 2ng_std - m/z= 395.33-395.33 SM: 5 RT:.78-1.53 NL: 1.37E5 F: {,} + p APCI Full ms [ 35.-42.] RT: 1.16 95 9 85 D2-2ng/mL 8 75 7 65 6 55 5 45 4 35 3 25 2 15 1 5 1.31 1.41 1.35.83.91.99 1.5.8.9 1. 1.1 1.2 1.3 1.4 1.5 Time (min) Note:Extracted Ion Chromatogram (XIC)@accuracy of 5 ppm R e la tiv e In te n s ity 1ng_std - m/z= 395.33-395.33 SM: 5 RT:.8-1.55 NL: 5.8E5 F: {,} + p APCI Full ms [ 35.-42.] RT: 1.17 95 D2-1ng/mL 9 85 8 75 7 65 6 55 5 45 R e la tiv e In te n s ity 4 35 3 25 2 15 1 5.86.99 1.37.8.9 1. 1.1 1.2 1.3 1.4 1.5 Time (min) 17 Clinical Research use only, Not for use in Diagnostics Procedure

QC Results - 25OH-Vit D3 inter and intra assay Excellent accuracy, precision and recovery QC1 (22 ng/ml) QC2 (5 ng/ml) QC3 (2 ng/ml) Replicate Val 1 Val 2 Val 3 Replicate Val 1 Val 2 Val 3 Replicate Val 1 Val 2 Val 3 1 19.6 21.5 2.3 1 47.4 5.2 48.2 1 29 215 24 2 21.3 19.9 2.1 2 53.1 49.7 54.9 2 215 224 29 3 19. 2.9 19.9 3 55.8 54.9 47.7 3 218 212 21 4 22.1 22.6 2.4 4 53.5 53.9 49.1 4 2 212 24 5 21.5 23.1 19.3 5 49.6 54.7 47.3 5 22 213 27 Mean 2.7 21.6 2. Mean 51.9 52.7 49.4 Mean 212 215 25 %RSD 6.5 5.8 2.2 %RSD 6.4 4.7 6.3 %RSD 3.8 2.3 1.5 %Rec ND ND ND %Rec 14 15 98.9 %Rsc 16 18 12 18 Clinical Research use only, Not for use in Diagnostics Procedure

QC Results - 25OH-Vit D2 inter and intra assay Excellent accuracy, precision and recovery QC1 (5 ng/ml) QC2 (5 ng/ml) QC3 (2 ng/ml) Replicate Val1 Val 2 Val 3 Replicate Val 1 Val 2 Val 3 Replicate Val 1 Val 2 Val 3 1 5. 4.4 4.3 1 47.3 45.6 49.7 1 189 197 23 2 4.8 4.1 4.7 2 51.1 48.5 48.1 2 191 29 29 3 4.2 5.1 3.9 3 47.3 48.9 51.6 3 191 186 184 4 5.3 4.8 4.4 4 54.2 45. 49.1 4 177 188 199 5 4.9 4.9 4.4 5 52.2 54. 48. 5 191 187 19 Mean 4.8 4.6 4.4 Mean 5.4 48.4 49.3 Mean 188 193 22 SD.37.4.28 %RSD 6. 7.3 3. %RSD 3.4 5. 8.9 %Rec 96.9 93. 87.4 %Rec 11 96.8 98.6 %Rec 93.9 96.7 11 19 Clinical Research use only, Not for use in Diagnostics Procedure

Blinded Sample Results Comparison 2 Clinical Research use only, Not for use in Diagnostics Procedure

Blinded sample - Results comparison Seven blinded samples from service lab analyzed Comparison with service labs 6 min TurboFlow TM QQQ method 5 replicate analysis on Exactive to asses precision 21 Clinical Research use only, Not for use in Diagnostics Procedure

Blinded samples Results summary Good agreement between Exactive and service lab QQQ results Vitamin D3 Vitamin D2 Sample # Exactive (ng/ml) Clinical Service lab Lab (ng/ml) % Diff Exactive (ng/ml) Clinical Service Lab lab (ng/ml) % Diff A 39.6 33.5-15.4 <1 <1.9 ND B 34. 34.8 2.3 <1 2.1 ND C 14.6 16.6 13.7 4.3 7.2 67.4 D 19.7 2.4 3.5 <1 <1.9 ND E 32.3 36.3-12.4 <1 2.3 ND F 25.5 25.8-1.2 <1 2. ND G 34.2 34..6 <1 2.4 ND Note: External service lab used Access QQQ 22 Clinical Research use only, Not for use in Diagnostics Procedure

Chromatograms - Blinded sample A Exactive 39.6 ng/ml Vitamin D 3 Access 33.5 ng/ml c:\xcalibur\...\rawfiles\sample_a5 7/13/29 4:47:5 PM c:\xcalibur\...\rawfiles\sample_a_3 7/14/29 3:31:6 PM RT:. - 2.2 SM: 5B R e l a t i v e A b u n d a n c e 5 5 5 5 5 RT:.9 AA: 1925 RT: 1.14 AA: 25893.21 RT:.37 AA: 21678.49.61.65.72.78.93 1.1 1.38 1.44 1.49 1.57 1.68 1.83 1.87 1.99 RT: 1.14 MA: 2488.8.14.23.36.5.64.72.9.93 1.5 1.3 1.35 1.45 1.54 1.72 1.78 1.91 RT: 1.15 MA: 2178738 1.33.3.14.22.35.41.45.58.63.69.82.89.94 1.37 1.48 1.59 1.67 1.75 1.79 1.95 RT: 1.15 MA: 225493.5.9.2.27.33.43.49.59.68.76.91 1.3 1.29 1.36 1.51 1.63 1.68 1.73 1.91 1.95 RT: 1.14 MA: 1964455.8.14.19.35.48.55.59.77.86.9 1.5 1.33 1.49 1.6 1.65 1.69 1.82 1.9..1.2.3.4.5.6.7.8.9 1. 1.1 1.2 1.3 1.4 1.5 1.6 1.7 1.8 1.9 2. Time (min) NL: 5.21E5 m/z= 365.3182-365.3218 F: FTMS {,} + p APCI Full ms [35.-42.] MS ICIS Sample_A1 NL: 4.45E5 m/z= 365.3182-365.3218 F: FTMS {,} + p APCI Full ms [35.-42.] MS sample_a2 NL: 4.57E5 m/z= 365.3182-365.3218 F: FTMS {,} + p APCI Full ms [35.-42.] MS sample_a3 NL: 4.72E5 m/z= 365.3182-365.3218 F: FTMS {,} + p APCI Full ms [35.-42.] MS sample_a4 NL: 4.33E5 m/z= 365.3182-365.3218 F: FTMS {,} + p APCI Full ms [35.-42.] MS sample_a5 RT:. - 2. SM: 5B R elative A bundance R elative A bundance R elative A bundance 8 6 4 2 8 6 4 2 8 6 4.9.24.47.54 RT:.84 MA: 176719.96 1.5.74 1.19 1.28 1.46 1.74.37 RT:.84 MA: 193612 1.67 1.86.75.97 1.7.11.17.26.38.54.63 1.13 1.18 1.45 1.64 1.75 1.8 1.93 RT:.84 MA: 844399 2.74.97 1.7 1.14 1.19.11.21.39.47.55 1.46 1.57 1.77 1.84 1.96..2.4.6.8 1. 1.2 1.4 1.6 1.8 2. Time (min) NL: 3.87E5 TIC F: + c APCI SRM ms2 383.28 [257.13-257.153, 365.75-365.125] MS Sample_A_1 NL: 3.7E5 TIC F: + c APCI SRM ms2 383.28 [257.13-257.153, 365.75-365.125] MS sample_a_2 NL: 2.84E5 TIC F: + c APCI SRM ms2 383.28 [257.13-257.153, 365.75-365.125] MS sample_a_3 Note: 5 injections on Exactive and 3 injections on Access 23 Clinical Research use only, Not for use in Diagnostics Procedure

Chromatograms - Blinded sample A Exactive <LOQ Vitamin D 2 Access <LOQ See appendix for other 6 samples c:\xcalibur\...\rawfiles\sample_a5 7/13/29 4:47:5 PM C:\Xcalibur\...\Rawfiles\Sample_A_1 7/14/29 3:25:28 PM RT:. - 2.2 SM: 5B R e l a t i v e A b u n d a n c e 5 5 5 5 5.3.15.23.34.67.12.26.33.43.56.68.9.9.87.8.28.32.49.55.64.71.76.13.19.3.43.49.59.75.13.18.24.28.52.59.71.74 1.19 1.15..1.2.3.4.5.6.7.8.9 1. 1.1 1.2 1.3 1.4 1.5 1.6 1.7 1.8 1.9 2. Time (min) 1.17.88.93 1.16.87 1.13 1.25 1.29 1.46 1.52 1.67 1.42 1.82 1.89 1.46 1.63 1.76 1.84 1.42 1.48 1.52 1.67 1.76 1.89 NL: 2.14E4 m/z= 395.3285-395.3325 1.98 F: FTMS {,} + p APCI Full ms [35.-42.] MS sample_a2 1.94 1.94 1.55 1.52 1.63 1.89 1.76 1.63 1.83 1.57 1.92 1.98 1.97 NL: 5.32E3 m/z= 395.3285-395.3325 F: FTMS {,} + p APCI Full ms [35.-42.] MS Sample_A1 NL: 3.29E4 m/z= 395.3285-395.3325 F: FTMS {,} + p APCI Full ms [35.-42.] MS sample_a3 NL: 3.53E4 m/z= 395.3285-395.3325 F: FTMS {,} + p APCI Full ms [35.-42.] MS sample_a4 NL: 1.74E4 m/z= 395.3285-395.3325 F: FTMS {,} + p APCI Full ms [35.-42.] MS sample_a5 RT:. - 2. SM: 5B R e l a ti v e A b u n d a n c e R e l a ti v e A b u n d a n c e R e l a ti v e A b u n d a n c e 8 6 4 2 8 6 4 2 8 6 4 2.79.84.95 1..3.25.3.46.62 1.24 1.45 1.62 1.67 1.84 1.94.76.81.85.94.7.15.26.42.56.66 1.25 1.46 1.59 1.66 1.89..2.4.6.8 1. 1.2 1.4 1.6 1.8 2. Time (min) 1.18 1.1 1.6 1.15.2.2.39.57 1.26 1.46 1.65 1.8 1.96.79 NL: 7.9E4 TIC F: + c APCI SRM ms2 395.29.84 [269.93-269.143, 377.175-377.225].93 MS sample_a_3 1.1 1.3 1.15 NL: 8.68E4 TIC F: + c APCI SRM ms2 395.29 [269.93-269.143, 377.175-377.225] MS Sample_A_1 NL: 8.68E4 TIC F: + c APCI SRM ms2 395.29 [269.93-269.143, 377.175-377.225] MS sample_a_2 Note: 5 injections on Exactive and 3 injections on Access 24 Clinical Research use only, Not for use in Diagnostics Procedure

Appendix 25 OH Vit D Analysis 25 Clinical Research use only, Not for use in Diagnostics Procedure

Reagents 25-OH-D 3 was purchased from Cerilliant, 25-OH-D 2 was purchased from Sigma. Both compounds were stored in -2 deg.c. [ 2 H 6 ]-25-OH-D 3 (Internal Standard) was purchased from Medical Isotopes and it was stored in -7 deg.c. 26 Clinical Research use only, Not for use in Diagnostics Procedure

Method validation Confirm method accuracy Total quantity in QC sample Endogenous quantity in minus blank plasma measured using IS alone = 25-OH-D3 = 16.5 ng/ml 25-OH-D2 =.8 ng/ml Actual spiked amount in QC sample Intra assay variability - 5 replicates of each QC sample Inter assay variability - 5 replicates of each QC sample in 3 different batches 27 Clinical Research use only, Not for use in Diagnostics Procedure

25-OH-Vit D - Ionization source parameters Exactive Mass Spectrometer Ionization APCI, positive, Ion Max source, Discharge current 5. Vaporizer temperature (deg C) 39 Sheath gas 15 Ion Sweep Gas Pressure:. Aux gas 5 Capillary temperature (deg C) 275 28 Clinical Research use only, Not for use in Diagnostics Procedure

25-OH-Vit D - Exactive Method Polarity: Positive Microscans: 1 Resolution: Ultra High ( ) Target: Balanced Max Inject time: 25 Scan range: 35-42 Divert valve: switch events 4 1-.95 min to waste.95-1.4 to detector 1.4-1.9 to waste 1.9-2. to detector 29 Clinical Research use only, Not for use in Diagnostics Procedure

25-OH-Vit D - LC method LC Conditions Surveyor autosampler and pump Mobile Phase A: water containing.1% formic acid B: methanol containing.1% formic acid Column 5 x 2.1 mm id packed with 3 µm, C18-aQ stationary phase Injection volume: 5 µl Flow rate: 7 µl/min Gradient Time (min) % A %B 2 8.1 2 8.2 5 95 1.4 5 95 1.5 2 8 2. 2 8 3 Clinical Research use only, Not for use in Diagnostics Procedure

25-OH-Vit D - Autosampler method 31 Clinical Research use only, Not for use in Diagnostics Procedure