Clinical biochemistry最新文献

Secretoneurin is not associated with cardiovascular events or mortality in patients treated with hemodialysis: A prospective multicenter cohort study

IF 2.5 3区医学 Q2 MEDICAL LABORATORY TECHNOLOGY

Clinical biochemistry

Pub Date : 2025-02-21 DOI: 10.1016/j.clinbiochem.2025.110899

Caroline Liboriussen , Louis Nygaard , Magnus Nakrem Lyngbakken , Sara Marie Engelsvold Bakkan , Jens Dam Jensen , Rie Io Glerup , Torbjørn Omland , Helge Røsjø , My Hanna Sofia Svensson

Introduction

Secretoneurin (SN) is a novel cardiac biomarker with an upper reference limit of ∼60 pmol/L in healthy individuals. High SN concentrations have been associated with an increased risk of mortality in various cardiac diseases. We investigated the association between SN and the risk of cardiovascular (CV) events and all-cause mortality in patients treated with maintenance hemodialysis (HD).

Materials and Methods

Prospective multicenter cohort study with five years of follow-up. Serum SN (pmol/L) was measured at baseline. Outcomes were CV events (composite outcome) and all-cause mortality. The population was divided into tertiles according to SN concentrations: tertile 1 < 110.7 pmol/L, tertile 2 110.7–143 pmol/L, and tertile 3 > 143 pmol/L. The association between SN tertiles and outcomes was examined using Cox regression analysis.

Results

The study included 336 patients treated with HD. Median SN concentration was 126 (100–153) pmol/L. During a median follow-up of 5.05 (5.02–5.07) years, 42 % had a CV event and 60 % died. Despite overall high SN concentrations, neither SN tertile 2 nor SN tertile 3 was associated with the risk of CV events (HR_tertile2 1.27 (95 % CI 0.84–1.93) and HR_tertile3 1.20 (95 % CI 0.76–1.90)) or all-cause mortality (HR_tertile2 0.84 (95 % CI 0.60–1.18) and HR_tertile3 0.90 (95 % CI 0.62–1.31)), when compared to tertile 1.

Conclusions

Patients treated with HD have high SN concentrations; however, SN was not associated with CV events or all-cause mortality after five years of follow-up. High concentrations of SN, possibly explained by both impaired renal clearance and a high prevalence of cardiomyopathy, may limit its prognostic relevance in patients treated with maintenance HD.

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引用次数: 0

Diagnostic accuracy of breath tests based on volatile organic compounds for cancer: A systematic review and meta-analysis

IF 2.5 3区医学 Q2 MEDICAL LABORATORY TECHNOLOGY

Clinical biochemistry

Pub Date : 2025-02-18 DOI: 10.1016/j.clinbiochem.2025.110898

Ming-Jun Jin , En-Min Li , Li-Yan Xu

Exhaled volatile organic compounds (VOCs) are being extensively studied for the purposes of noninvasive cancer diagnoses. This systematic review and meta-analysis aims to evaluate the diagnostic accuracy of breath tests based on VOCs for cancer detection, and to propose potential cancer biomarkers. This study was conducted in accordance with the Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA) guidelines. Relevant studies up to February 2024 were retrieved from public databases, including PubMed, EMBASE, and Web of Science. A total of 114 articles were included, covering 125 non-duplicate studies involving 8768 cancer patients. Meta-analysis showed that the VOC breath test demonstrated a sensitivity of 87% and a specificity of 81% in cancer diagnosis, with an area under the receiver operating characteristic curve (AUC) of 0.93. Subgroup analyses based on cancer types and breath detection techniques also showed high sensitivity and specificity in diagnosing cancer patients. These suggest that breath analysis for VOCs has excellent diagnostic accuracy for cancer. The breath test based on VOCs, as a non-invasive detection method, shows great potential for cancer diagnosis.

目前正在对呼出的挥发性有机化合物（VOCs）进行广泛研究，以用于非侵入性癌症诊断。本系统综述和荟萃分析旨在评估基于挥发性有机化合物的呼气测试对癌症检测的诊断准确性，并提出潜在的癌症生物标志物。本研究根据《系统综述和荟萃分析首选报告项目》（Preferred Reporting Items for Systematic Review and Meta-Analyses，PRISMA）指南进行。从公共数据库（包括 PubMed、EMBASE 和 Web of Science）中检索了截至 2024 年 2 月的相关研究。共纳入 114 篇文章，涵盖 125 项非重复研究，涉及 8768 名癌症患者。元分析表明，VOC 呼气试验在癌症诊断中的灵敏度为 87%，特异度为 81%，接收者操作特征曲线下面积 (AUC) 为 0.93。根据癌症类型和呼气检测技术进行的分组分析也显示，该方法在诊断癌症患者方面具有很高的灵敏度和特异性。这表明，挥发性有机化合物呼气分析对癌症的诊断准确性极高。基于挥发性有机化合物的呼气检测作为一种无创检测方法，在癌症诊断方面显示出巨大的潜力。

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引用次数: 0

Cardiac troponin I is associated with ICU admission in pediatric patients with RSV.

IF 2.5 3区医学 Q2 MEDICAL LABORATORY TECHNOLOGY

Clinical biochemistry

Pub Date : 2025-02-16 DOI: 10.1016/j.clinbiochem.2025.110896

Meghan Brown, Sydney Lawless, Brittany Roemmich, Stephen M Roper, Christopher W Farnsworth

Background: Respiratory syncytial virus (RSV) is associated with morbidity and mortality in pediatric patients, but limited tools exist for prognostication of outcomes that may facilitate more rapid treatment. We assessed the utility of cardiac troponin I (cTnI) to prognosticate intensive care unit (ICU) length of stay (LOS) and bronchiolitis in pediatric patients.

Methods: Remnant EDTA plasma from 114 patients 6 months-18 years positive for RSV were enrolled. Forty-five patients with other respiratory infections were included as controls. The electronic medical record was assessed for demographic information. High sensitivity cTnI was assessed on an Abbott ARCHITECT i2000 within 24 h of collection. Proportions were compared using Fisher's exact test and multivariable logistic regression performed.

Results: Of patients admitted to ICU with RSV, 56.9 % had cTnI ≥ the limit of detection (LOD) compared to 27.0 % of patients not admitted to the ICU. Receiver operator characteristic analysis revealed an area of 0.62 (0.53-0.72) for predicting ICU admission. At the limit of quantitation, cTnI had a sensitivity of 25.8 %, a specificity of 88.9 %, and a positive likelihood ratio of 2.32 for ICU admission. Multivariable logistic regression revealed that log2 increases in cTnI (doubling) was associated with an odds ratio (OR) of 1.34 (95 % CI: 1.03-1.78) for ICU admission. cTnI > the LOD was associated with an OR of 2.37 (1.03-5.57) for ICU admission and bronchiolitis (2.78, 1.09-7.83).

Conclusions: Elevated cTnI above the LOD was associated with ICU admission and bronchiolitis in pediatric patients presenting with RSV. Further studies are needed to verify this finding.

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引用次数: 0

Accelerated diagnostic pathways for myocardial infarction using a Siemens High-Sensitivity cardiac troponin I assay

IF 2.5 3区医学 Q2 MEDICAL LABORATORY TECHNOLOGY

Clinical biochemistry

Pub Date : 2025-02-14 DOI: 10.1016/j.clinbiochem.2025.110897

Hiroyuki Azuma , Masafumi Tada , Hideyuki Matano , Naoki Yamada , Hiroyasu Uzui , Koji Maeno , Yoshimitsu Shimada , Hiroyuki Yoshida , Hajime Murahashi , Masaki Ando , Kenta Hachiya , Shun Tanaka , Tomonori Hattori , Akira Kuriyama , Takeshi Fujisawa , Andrew R. Chapman , Nicholas L. Mills , Hiroyuki Hayashi , Norio Watanabe , Toshi A Furukawa

Background

Few studies have comprehensively examined high-sensitivity cardiac troponin I (hs-cTnI) based diagnostic pathways for myocardial infarction (MI) in early presenters using a Siemens ADVIA Centaur hs-cTnI assay.

Methods

We conducted a prospective multicenter cohort study in Emergency Departments involving 414 patients suspected of MI within 6 h of symptom onset. We evaluated three hs-cTnI-based pathways (High-STEACS, ESC 0/1-h, 0/2-h); and four pathways incorporating medical history and physical findings (ADAPT, EDACS, HEART, GRACE). We evaluated negative predictive value (NPV) and sensitivity as safety measures, and percentage ruled out as an efficiency measure for a primary outcome of type 1 myocardial infarction or cardiac death within 30 days.