Chemical structures and descriptions

HK:XA ratio

HK-XA

What is HK:XA?

HK:XA is the ratio of HK divided by XA, which is a substrate:product pair of kynurenine aminotransferase (see also the description of HKr). In general, metabolite ratios cancel out the influence from potential confounders affecting the components (metabolites) in the nominator and denominator. This explains why the HK:XA is less affected by e.g. renal function and inflammation than e.g. HK alone (2). HK:XA is somewhat less sensitive and specific to PLP concentrations and more influenced by cellular immunity activation than the HKr index. HK:XA has properties that makes it a integrated index for intracellular vitamin B6 status and cellular immunity activation (3).
Method: LC-MS/MS 

Indication(s)

Assessment of vitamin B6 status.

Specimen, collection and processing

Patient/subject:
Matrix: EDTA plasma and serum.
Volume: Minimum volume is 60 µL, but 200 µL is optimal and allows reanalysis.
Preparation and stability: HK decreases while XA is stable during storage of serum/plasma samples. The blood sample must be centrifuged and the plasma/serum fraction put on ice, and frozen.

Transportation

Frozen, on dry ice. (for general instruction on transportation, click here.)

Reported values, interpretation

Reported values: 1.5-2.7.
Intraclass correlation coefficients (ICC): na.

Literature

1. Midttun, O., Hustad, S., and Ueland, P.M. (2009). Quantitative profiling of biomarkers related to B-vitamin status, tryptophan metabolism and inflammation in human plasma by liquid chromatography/tandem mass spectrometry. Rapid Commun Mass Sp 23, 1371-79.
2. Ueland, P.M., Ulvik, A., Rios-Avila, L., Midttun, Ø., and Gregory, J.F. (2015). Direct and Functional Biomarkers of Vitamin B6 Status. Annu Rev Nutr 35, 33-70.
3. Ulvik, A., Theofylaktopoulou, D., Midttun, O., Nygård, O., Eussen, S.J., and Ueland, P.M. (2013). Substrate product ratios of enzymes in the kynurenine pathway measured in plasma as indicators of functional vitamin B-6 status. Am J Clin Nutr 98, 934-940.

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Statistical power is the probability that a statistical test will correctly reject a false null hypothesis (H0​) when a specific alternative hypothesis (H1​) is true. H0​ is the null hypothesis, which states there is no effect or no difference. H1​ is the alternative hypothesis, which states there is a real effect or difference. Alpha (α) is the probability of a Type I error (a false positive), which is the risk of incorrectly rejecting the H0​ when it is actually true. You set this value before the experiment, commonly at 0.05. Beta (β) is the probability of a Type II error (a false negative), which is the risk of failing to reject the H0​ when it is actually false.

Power is calculated as 1−β. Increasing power means you are decreasing the probability of making a Type II error.

Several factors can be adjusted to increase the power of a statistical test:

  • Effect Size: This is the magnitude of the difference you are trying to detect. A larger effect size is easier to detect, thus increasing power. 

  • Sample Size: The number of observations in a study. A larger sample size provides more information about the population, reducing the margin of error and increasing the power to detect a true effect.

  • Variation: Refers to the spread or standard deviation of the data within the population. Less variation makes it easier to distinguish a real effect from random noise, thereby increasing power.

  • Alpha (): Increasing the alpha level (e.g., from 0.05 to 0.10) also increases power, but at the cost of a higher risk of a Type I error. This trade-off is often undesirable.

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