Intra-Individual Variation and Reliability of Biomarkers of the Antioxidant Defense System by Considering Dietary and Lifestyle Factors in Premenopausal Women

Epidemiological studies frequently rely on a single biomarker measurement to assess the relationship between antioxidant status and diseases. This bears an inherent risk for misclassification, if the respective biomarker has a high intra-individual variability. The present study investigates the intra-individual variation and reliability of enzymatic and non-enzymatic biomarkers of the antioxidant system in premenopausal women. Forty-four apparently healthy females provided three consecutive fasting blood samples in a four-week rhythm. Analyzed blood biomarkers included Trolox equivalent antioxidant capacity (TEAC), catalase, glutathione peroxidase, glutathione, vitamin C, bilirubin, uric acid, coenzyme Q10, tocopherols, carotenoids and retinol. Intra- and inter-individual variances for each biomarker were estimated before and after adjusting for relevant influencing factors, such as diet, lifestyle and use of contraceptives. Intraclass correlation coefficient (ICC), index of individuality, reference change value and number of measurements needed to confine attenuation in regression coefficients were calculated. Except for glutathione and TEAC, all biomarkers showed a crude ICC ≥ 0.50 and a high degree of individuality indicating that the reference change value is more appropriate than population-based reference values to scrutinize and classify intra-individual changes. Apart from glutathione and TEAC, between 1 and 9 measurements were necessary to reduce attenuation in regression coefficients to 10%. The results indicate that the majority of the assessed biomarkers have a fair to very good reliability in healthy premenopausal women, except for glutathione and TEAC. To assess the status of the antioxidant system, the use of multiple measurements and biomarkers is recommended.