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Abstract
A marked decrease in analytical and post‐analytical variability has been achieved in clinical laboratories by the use of automated analytical systems. Current studies are now focused on the origin of pre‐analytical variability, such as that due to intra‐individual differences and biological rhythms. The objective of this work was to evaluate the occurrence of biological rhythms in several biochemical serum parameters in a Brazilian population. A retrospective study (1996 to 1998) was carried out to collect the test results within the reference intervals of adults, from 21 to 50 yr of age (average age of 36 yr) attending the outpatient clinics of the Teaching Hospital at the University of Campinas, São Paulo, Brazil. The reference sample was 52.9% male and 47.1% female and encompassed 15,036 calcium, 7,478 phosphorus, 53,641 urea, 58,315 creatinine and 6,433 uric acid determinations (140,903 in total). Significant annual rhythms were detected in serum calcium (p≤0.001), with maximum and minimum values in fall and spring, and in serum creatinine (p≤0.002), with maximum and minimum values in summer and winter. The other parameters did not present significant annual rhythmicity. The seasonal rhythms present in the serum concentrations of calcium and creatinine observed in this large population study, although of small amplitude, should be considered a component of the pre‐analytical variation of these clinical laboratory tests.