Assessment of the stability of exogenous gamma hydroxybutyric acid (GHB) in stored blood and urine specimens

Eur Rev Med Pharmacol Sci. 2015 Nov;19(21):4187-94.

Abstract

Objective: The aim of this work is to test the stability of exogenous GHB in whole blood and urine samples collected from living and deceased GHB free-users, spiked with known concentrations of GHB and stored at different temperatures (-20°C, 4°C and 20°C) up to 4 weeks.

Materials and methods: GHB was added to GHB-free ante-mortem blood and urine samples at the concentration of 5 and 10 mg/L, respectively whereas in post-mortem blood and urine specimens at 50 and 10 mg/L respectively. All samples were stored at three different temperatures: -20°C, 4°C and 20°C and extracted and analyzed at three days, 1 week, 2 weeks, 3 and 4 weeks in duplicate. No preservatives were added. GHB was quantified by GC-MS after LLE according to a previously published method.

Results: Post-mortem blood specimens showed a reduction of GHB levels higher than 10% only after a period of 4 weeks of storage for samples kept at +4°C and +20°C, whereas samples stored at -20°C showed a mean reduction of 8.7%. In post-mortem urine samples, there was a mean reduction of GHB levels higher than 20% at all storage temperatures, after 4 weeks of storage. Ante-mortem blood samples showed a reduction of GHB levels lower than 10% only after 3 days of storage at -20°C and at +4°C (samples stored at +20°C showed a mean reduction of 10.4%). After 4 weeks of storage, there was a mean reduction of GHB concentrations higher than 20% at all storage temperatures. Ante-mortem urine samples showed a reduction of GHB levels higher than 10% after just 3 days of storage for samples kept at all tested temperatures. After 4 weeks of storage, there was a mean reduction of GHB concentrations higher than 25% at all storage temperatures.

Conclusions: According to our findings, it would be useful to perform GHB analysis both in blood and urine specimens within 3 days of sampling and the specimens should be stored at -20°C or 4°C in order to avoid instability issues.

MeSH terms

  • Adult
  • Autopsy
  • Female
  • Gas Chromatography-Mass Spectrometry
  • Humans
  • Hydroxybutyrates / blood*
  • Hydroxybutyrates / urine*
  • Male
  • Middle Aged
  • Specimen Handling / standards*
  • Substance Abuse Detection / methods
  • Substance Abuse Detection / standards*
  • Substance-Related Disorders / blood
  • Substance-Related Disorders / diagnosis
  • Substance-Related Disorders / urine
  • Temperature
  • Time Factors

Substances

  • Hydroxybutyrates
  • 4-hydroxybutyric acid