Test Catalog

Test ID: F2ISO    
F2-Isoprostanes, Random, Urine

Useful For Suggests clinical disorders or settings where the test may be helpful

Assessment of in vivo lipid peroxidation


Considered to be an index of systemic oxidative stress over time

Testing Algorithm Delineates situations when tests are added to the initial order. This includes reflex and additional tests.

When F2-Isoprostanes testing is performed, urine creatinine will always be performed at no additional charge.

Clinical Information Discusses physiology, pathophysiology, and general clinical aspects, as they relate to a laboratory test

Oxidative stress results from an imbalance of reactive oxygen species resulting in peroxidation of biomolecules. 15-F2t-isoprostane (F2ISO, also referred to as 8-iso-PGF2alpha or 8-isoprostane) is an F2-isoprostane and its measurement is considered the "gold standard: test for quantifying lipid peroxidation in vivo. F2ISO is a potent vasoconstrictor, induces vascular smooth muscle cell proliferation, and increased aspirin resistance to platelet aggregation. Elevated urinary F2ISO concentrations are associated with the presence and extent of coronary artery stenosis, peripheral artery disease, and increased risk of post-operative atrial fibrillation.


Urinary F2ISO concentrations are lowered by aerobic exercise training, smoking cessation, and fenofibrate therapy.

Reference Values Describes reference intervals and additional information for interpretation of test results. May include intervals based on age and sex when appropriate. Intervals are Mayo-derived, unless otherwise designated. If an interpretive report is provided, the reference value field will state this.

> or =18 years: < or =1.0 ng/mg creatinine

Reference values have not been established for patients who are <18 years of age

Interpretation Provides information to assist in interpretation of the test results

Elevated urinary F2-isoprostanes reflect widespread oxidative stress and systemic burden of lipid peroxidation end products. Quantitation of F2-isoprostanes in urine is highly dependent upon the methodology utilized; however, mass spectrometry methods (gas chromatography-mass spectrometry or liquid chromatography-tandem mass spectrometry) assays yield superior sensitivity and analytical specificity compared with immunoassays.


F2-isoprostanes demonstrate superior clinical sensitivity compared to other oxidative stress biomarkers but lack clinical specificity for any particular disease. Pharmacological treatment with antioxidant supplementation, hypoglycemic agents in diabetes, smoking cessation, and weight reduction have all been shown to decrease production of F2-isoprostanes.

Cautions Discusses conditions that may cause diagnostic confusion, including improper specimen collection and handling, inappropriate test selection, and interfering substances

For the most accurate assessment of lipid oxidation status, individuals should not be on aspirin or other nonsteroidal anti-inflammatory drugs, have smoked, or have had acute changes in statin mono- or combination therapies.


Patients should not take nonsteroidal antiinflammatory drugs (NSAIDs) within 72 hours or aspirin within 2 weeks prior to providing a urine specimen for analysis.

Clinical Reference Recommendations for in-depth reading of a clinical nature

1. Strobel NA, Fassett RG, Marsh SA, Coombes JS: Oxidative stress biomarkers as predictors of cardiovascular disease. Int J Cardiol. 2011;147:191-201

2. Davies SS, Roberts, LJ: F2-isoprostanes as an indicator and risk factor for coronary heart disease. Free Radic Biol Med. 2011 Mar 1;50(5):559-566

3. Kontush A, de Faria EC, Chantepie S, Chapman MJ: A normotriglyceridemic, low HDL-cholesterol phenotype is characterized by an elevated oxidative stress and HDL particles with attenuated antioxidative activity. Atherosclerosis. 2005;182:277-285

4. Vassale C, Botto N, Andreassi MG, et al: Evidence for enhanced 8-isoprostane plasma levels, as an index of oxidative stress in vivo, for patients with coronary artery disease. Coron Artery Dis. 2003 May;14(3):213-218

5. Milne GL, Sanchez SC, Musiek, ES, Morrow JD: Quantification of F2-isoprostanes as a biomarker of oxidative stress. Nature Prot. 2007;2:221-226

6. Zhang, Zhi-Jian: Systematic review on the association between F2-isoprostanes and cardiovascular disease. Ann Clin Biochem. 2013;50(Pt 2):108-114

7. Wu J, Marchioli R, Silletta MG, et al: Oxidative stress biomarkers and the incidence of postoperative atrial fibrillation in the Omega-3 Fatty Acids for Prevention of Postoperative Atrial Fibrillation (OPERA) Trial. J Am Heart Assoc. 2015 May;4(5):e001886

8. Vazzana N, Ganci A, Cefalu AB, et al. Enhanced lipid peroxidation and platelet activation as potential contributors to increased cardiovascular risk in the low-HDL phenotype. J Am Heart Assoc. 2013;2(2):e000063