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Characterizing the SARS-CoV-2 antibody response and associations with patient factors: Serological profiling of participants enrolled in the GENCOV study 表征SARS-CoV-2抗体反应及其与患者因素的关联:GENCOV研究参与者的血清学分析
IF 2.5 3区 医学 Q2 MEDICAL LABORATORY TECHNOLOGY Pub Date : 2025-01-01 DOI: 10.1016/j.clinbiochem.2024.110859
Gregory Morgan , Chun Yiu Jordan Fung , Anne-Claude Gingras , Karen Colwill , Laurent Briollais , Erika Frangione , Dawit Wolday , Freda Qi , Adrian Pasculescu , Melanie Delgado-Brand , Genevieve Mailhot , Tulunay Tursun , Saranya Arnoldo , Erin Bearss , Alexandra Binnie , Bjug Borgundvaag , Selina Casalino , Sunakshi Chowdhary , Marc Dagher , Luke Devine , Jennifer Taher

Introduction

The GENCOV study sought to evaluate serological differences between individuals with differing COVID-19 severity and outcomes. We assessed the SARS-CoV-2 antibody response of GENCOV participants cross-sectionally 1-, 6-, and 12-months following COVID-19 diagnosis to identify patient factors associated with more robust and durable humoral immune responses.

Materials and Methods

COVID-19 patients and a control cohort of vaccinated infection-naïve participants were recruited at hospital sites across the Greater Toronto Area in Ontario, Canada. Commercially available and laboratory-developed serological assays were used to characterize features of participants’ antibody responses, including both binding and neutralizing antibodies. Regression analyses were performed to identify associations between participant characteristics and features of the SARS-CoV-2 antibody response.

Results

Samples were obtained from participants 1- (n = 938), 6- (n = 842), and 12-months (n = 662) post-infection or vaccination. At all time points, vaccinees, and to a greater extent those who were both infected and vaccinated, had significantly elevated anti-spike antibody levels compared to unvaccinated participants. Increasing age and/or illness severity were associated with significantly higher antibody levels among unvaccinated participants. Among vaccines, those who were vaccinated after infection (i.e., hybrid immunity) had consistently higher antibody levels compared to participants who were infection-naïve or vaccinated before their infection (i.e., breakthrough infections). Additionally, receiving more vaccine doses and having a more recent vaccination were strongly associated with higher antibody levels across all time points.

Conclusions

Our findings highlight various patient factors, including vaccination, which contribute to robust, durable SARS-CoV-2 antibody responses. Overall, the findings presented here may inform future vaccine development and rollout plans.
GENCOV研究旨在评估不同COVID-19严重程度和结局的个体之间的血清学差异。我们评估了GENCOV参与者在COVID-19诊断后1、6和12个月的SARS-CoV-2抗体反应,以确定与更强大和持久的体液免疫反应相关的患者因素。材料和方法:在加拿大安大略省大多伦多地区的医院招募了COVID-19患者和接种疫苗infection-naïve的对照队列参与者。市售和实验室开发的血清学分析用于表征参与者抗体反应的特征,包括结合抗体和中和抗体。进行回归分析以确定参与者特征与SARS-CoV-2抗体反应特征之间的关联。结果:从感染或接种疫苗后1- (n = 938)、6- (n = 842)和12个月(n = 662)的参与者中获得样本。在所有时间点,与未接种疫苗的参与者相比,接种疫苗者,以及在更大程度上既感染又接种疫苗的人,抗刺突抗体水平显著升高。在未接种疫苗的参与者中,年龄和/或疾病严重程度的增加与抗体水平的显著升高相关。在疫苗接种中,感染后接种疫苗的人(即混合免疫)的抗体水平始终高于感染前接种infection-naïve或接种疫苗的参与者(即突破性感染)。此外,在所有时间点上,接受更多的疫苗剂量和最近的疫苗接种与更高的抗体水平密切相关。结论:我们的研究结果强调了包括疫苗接种在内的各种患者因素,这些因素有助于产生稳健、持久的SARS-CoV-2抗体反应。总的来说,这里提出的研究结果可能为未来的疫苗开发和推广计划提供信息。
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引用次数: 0
Serological proteomic profiling uncovered CDK5RAP2 as a novel marker in benign prostatic hyperplasia 血清学蛋白质组学分析发现CDK5RAP2是良性前列腺增生的新标志物。
IF 2.5 3区 医学 Q2 MEDICAL LABORATORY TECHNOLOGY Pub Date : 2025-01-01 DOI: 10.1016/j.clinbiochem.2024.110867
Huan Xie , Junli Fan , Jiajun Wang , Tao Liu , Lili Chen , Yunbao Pan , Yirong Li , Xinran Li

Background

Benign prostatic hyperplasia (BPH) affects approximately half of men over the age of 50. Early detection and timely treatment facilitate disease intervention and achieve a better clinical outcome. However, current clinical methods, such as prostate specific antigen (PSA), lack the sensitivity to accurately distinguish between BPH and prostate cancer (PCa). Thus, optimal serum markers are warranted to complement existing diagnostic tests.

Methods

In this study, we recruited 1987 BPH patients and characterized their clinical features. To explore BPH proteomic alterations, a data independent acquisition-based mass spectrometry proteomics approach was adopted for 66 serum samples from healthy males (n = 22), patients with BPH (n = 22) and prostate cancer (n = 22). Bioinformatic evaluations were performed for proteomic profiling and candidate selection. In addition, a promising candidate was further validated with ELISA assay.

Results

Our findings revealed that the level of free PSA correlated with prostate volume. 7.95 % of BPH patients had a PSA value greater than 10 ng/mL, with elevated free PSA, prostate volume, PSA density, and decreased free to total PSA ratio. Mass spectrometry-based serum profiling demonstrated distinct differences between BPH and PCa. CDK5RAP2 was weighted most important in BPH patients’ serum and achieved an area under the receiver operating characteristic curve of 0.900 in distinguishing BPH and PCa, which was further validated by publicly-available mRNA microarray analysis and cellular phenotype evaluation.

Conclusion

Our comprehensive analysis systematically explored BPH serum characteristics, proteomic profiles, and identified novel serum markers that may contribute to the understanding of BPH and facilitate early diagnosis and intervention.
背景:50岁以上的男性中约有一半患有良性前列腺增生(BPH)。早期发现和及时治疗有利于疾病干预,达到较好的临床效果。然而,目前的临床方法,如前列腺特异性抗原(PSA),缺乏准确区分BPH和前列腺癌(PCa)的敏感性。因此,最佳的血清标记物是必要的,以补充现有的诊断测试。方法:在本研究中,我们招募了1987例BPH患者,并对其临床特征进行了分析。为了探讨前列腺增生蛋白组学的改变,采用数据独立获取的质谱蛋白质组学方法,对健康男性(n = 22)、前列腺增生患者(n = 22)和前列腺癌患者(n = 22)的66份血清样本进行了研究。进行生物信息学评估以进行蛋白质组学分析和候选物选择。另外,利用ELISA进一步验证了一种有希望的候选药物。结果:游离PSA水平与前列腺体积相关。7.95 % BPH患者PSA值大于10 ng/mL,游离PSA、前列腺体积、PSA密度升高,游离PSA与总PSA之比降低。基于质谱的血清谱分析显示BPH和PCa之间存在明显差异。CDK5RAP2在BPH患者血清中权重最大,在区分BPH和PCa时,其受体算子曲线下面积为0.900,通过mRNA微阵列分析和细胞表型评价进一步验证了这一点。结论:我们的综合分析系统地探讨了BPH的血清特征、蛋白质组学特征,并发现了新的血清标记物,这些标记物可能有助于了解BPH并促进早期诊断和干预。
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引用次数: 0
Evaluation of Siemens Atellica AMH assay and comparison with Roche, Beckman and Ansh Labs 评估西门子 Atellica AMH 检测法,并与罗氏、贝克曼和安氏实验室进行比较。
IF 2.5 3区 医学 Q2 MEDICAL LABORATORY TECHNOLOGY Pub Date : 2025-01-01 DOI: 10.1016/j.clinbiochem.2024.110863
Emily Shang , Hilario Agustin , Jason K.Y. Lee , Matt Scheidegger , JoAnna Jones , Charbel Abou-Diwan , Joe M. El-Khoury , Jieli Li

Background

Anti-Müllerian hormone (AMH) is an important marker for ovarian reserve and response to fertility treatments. However, interassay variability exists due to the lack of a standardized method. This study evaluates the performance of the new Siemens Healthineers Atellica IM AMH assay against established assays (Beckman DxI 600 Access, Roche cobas Elecsys® e801, and Ansh Labs AMH ELISA).

Methods

We measured AMH concentrations in 120 residual serum samples from patients presenting for routine AMH testing using all four assays. Passing-Bablok regression and Bland-Altman method were used for data analysis.

Results

The Siemens Healthineers Atellica IM assay demonstrated strong correlation with Beckman DxI (slope: 1.07, R2: 0.9881) but showed a minimal positive bias. Conversely, the Roche cobas Elecsys® e801 assay exhibited a negative bias compared to Beckman DxI (slope: 0.74, R2: 0.9696), while the Ansh Labs assay demonstrated a significant positive bias with increasing variability at higher AMH concentrations.

Conclusion

Overall, the Siemens Healthineers Atellica IM assay shows promise as an alternative method for AMH measurement, demonstrating good correlation with established assays. However, differences were observed between all assays, highlighting the importance of assay-specific interpretation for accurate clinical assessment.
背景:抗缪勒氏管激素(AMH)是卵巢储备和对生育治疗反应的重要标志物。然而,由于缺乏标准化方法,测定间存在差异。本研究评估了新型西门子Healthineers Atellica IM AMH测定与现有测定(Beckman DxI 600 Access、Roche cobas Elecsys® e801和Ansh Labs AMH ELISA)的性能:我们使用所有四种检测方法测量了120份残留血清样本中的AMH浓度,这些样本来自接受常规AMH检测的患者。采用Passing-Bablok回归法和Bland-Altman法进行数据分析:结果:西门子Healthineers Atellica IM测定与贝克曼DxI(斜率:1.07,R2:0.9881)有很强的相关性,但正偏倚很小。相反,与贝克曼 DxI 相比,罗氏 cobas Elecsys® e801 检测试剂盒显示出负偏倚(斜率:0.74,R2:0.9696),而 Ansh Labs 检测试剂盒则显示出显著的正偏倚,在 AMH 浓度较高时变异性增加:总的来说,西门子医疗Atellica IM测定法有望成为AMH测定的替代方法,与现有测定法具有良好的相关性。然而,所有检测方法之间都存在差异,这凸显了特定检测方法的解释对于准确临床评估的重要性。
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引用次数: 0
Immune complexome analysis reveals an autoimmune signature predictive of COVID-19 severity 免疫复合物分析揭示了可预测COVID-19严重程度的自身免疫特征。
IF 2.5 3区 医学 Q2 MEDICAL LABORATORY TECHNOLOGY Pub Date : 2025-01-01 DOI: 10.1016/j.clinbiochem.2024.110865
Marino Moriishi , Takahiro Takazono , Junya Hashizume , Nozomi Aibara , Yuki Jimbayashi Kutsuna , Masaki Okamoto , Toyomitsu Sawai , Teppei Hoshino , Yusuke Mori , Yuichi Fukuda , Yukikazu Awaya , Hirotomo Yamanashi , Yuichiro Furusato , Toyoshi Yanagihara , Hirotaka Miyamoto , Kayoko Sato , Yukinobu Kodama , Shusaku Mizukami , Noriho Sakamoto , Kazuko Yamamoto , Kaname Ohyama

Background

The factors contributing to the development of severe coronavirus disease 2019 (COVID-19) following infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) remain unclear. Although the presence of immune complexes (ICs), formed between antibodies and their antigens, has been linked to COVID-19 severity, their role requires further investigation, and the antigens within these ICs are yet to be characterized.

Method

Here, a C1q enzyme-liked immunosorbent assay and immune complexome analysis were used to determine IC concentrations and characterize IC antigens, respectively, in the sera of 64 unvaccinated COVID-19 patients with PCR-confirmed SARS-CoV-2 infection, enrolled at seven participating centers in 2020. For the analysis, the patients were split into the severe (n = 35) and non-severe (n = 28) groups on the basis of their COVID-19 symptoms.

Results

We found that neither serum IC concentration nor IC antigen number was associated with COVID-19 severity. However, we identified six IC antigens, which were significantly enriched in the severe versus non-severe group. These IC antigens were all derived from human proteins, namely haptoglobin, the serum amyloid A-2 protein, the serum amyloid A-1 protein, clusterin, and lipopolysaccharide-binding protein, and complement-factor-H-related protein 3. Meanwhile, we found no association between COVID-19 severity and IC antigens derived from SARS-CoV-2 proteins. Collectively, the six IC antigens predicted COVID-19 severity with a moderate degree of accuracy (area under the receiver operating characteristic curve = 0.90, sensitivity = 94 %, specificity = 79 %).

Conclusions

The IC antigen signature identified in this study may have important implications for the diagnosis and treatment of severe COVID-19.
背景:严重急性呼吸综合征冠状病毒2型(SARS-CoV-2)感染后发生严重冠状病毒病2019 (COVID-19)的因素尚不清楚。虽然在抗体和抗原之间形成的免疫复合物(ic)的存在与COVID-19的严重程度有关,但它们的作用需要进一步研究,而且这些ic内的抗原尚未被表征。方法:本研究采用C1q酶样免疫吸附试验和免疫络合体分析分别测定了64例未接种疫苗的SARS-CoV-2感染患者血清中的IC浓度和IC抗原特征,这些患者于2020年在7个参与中心登记。为了进行分析,根据患者的COVID-19症状将患者分为重症组(n = 35)和非重症组(n = 28)。结果:我们发现血清IC浓度和IC抗原数量与COVID-19严重程度无关。然而,我们发现了6种IC抗原,在严重组和非严重组中显著富集。这些IC抗原均来源于人蛋白,即:触珠蛋白、血清淀粉样蛋白A-2、血清淀粉样蛋白A-1、聚簇蛋白和脂多糖结合蛋白、补体因子- h相关蛋白3。同时,我们发现COVID-19严重程度与SARS-CoV-2蛋白衍生的IC抗原之间没有关联。总的来说,6种IC抗原预测COVID-19严重程度的准确度中等(受试者工作特征曲线下面积 = 0.90,灵敏度 = 94 %,特异性 = 79 %)。结论:本研究确定的IC抗原特征可能对重症COVID-19的诊断和治疗具有重要意义。
{"title":"Immune complexome analysis reveals an autoimmune signature predictive of COVID-19 severity","authors":"Marino Moriishi ,&nbsp;Takahiro Takazono ,&nbsp;Junya Hashizume ,&nbsp;Nozomi Aibara ,&nbsp;Yuki Jimbayashi Kutsuna ,&nbsp;Masaki Okamoto ,&nbsp;Toyomitsu Sawai ,&nbsp;Teppei Hoshino ,&nbsp;Yusuke Mori ,&nbsp;Yuichi Fukuda ,&nbsp;Yukikazu Awaya ,&nbsp;Hirotomo Yamanashi ,&nbsp;Yuichiro Furusato ,&nbsp;Toyoshi Yanagihara ,&nbsp;Hirotaka Miyamoto ,&nbsp;Kayoko Sato ,&nbsp;Yukinobu Kodama ,&nbsp;Shusaku Mizukami ,&nbsp;Noriho Sakamoto ,&nbsp;Kazuko Yamamoto ,&nbsp;Kaname Ohyama","doi":"10.1016/j.clinbiochem.2024.110865","DOIUrl":"10.1016/j.clinbiochem.2024.110865","url":null,"abstract":"<div><h3>Background</h3><div>The factors contributing to the development of severe coronavirus disease 2019 (COVID-19) following infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) remain unclear. Although the presence of immune complexes (ICs), formed between antibodies and their antigens, has been linked to COVID-19 severity, their role requires further investigation, and the antigens within these ICs are yet to be characterized.</div></div><div><h3>Method</h3><div>Here, a C1q enzyme-liked immunosorbent assay and immune complexome analysis were used to determine IC concentrations and characterize IC antigens, respectively, in the sera of 64 unvaccinated COVID-19 patients with PCR-confirmed SARS-CoV-2 infection, enrolled at seven participating centers in 2020. For the analysis, the patients were split into the severe (n = 35) and non-severe (n = 28) groups on the basis of their COVID-19 symptoms.</div></div><div><h3>Results</h3><div>We found that neither serum IC concentration nor IC antigen number was associated with COVID-19 severity. However, we identified six IC antigens, which were significantly enriched in the severe versus non-severe group. These IC antigens were all derived from human proteins, namely haptoglobin, the serum amyloid A-2 protein, the serum amyloid A-1 protein, clusterin, and lipopolysaccharide-binding protein, and complement-factor-H-related protein 3. Meanwhile, we found no association between COVID-19 severity and IC antigens derived from SARS-CoV-2 proteins. Collectively, the six IC antigens predicted COVID-19 severity with a moderate degree of accuracy (area under the receiver operating characteristic curve = 0.90, sensitivity = 94 %, specificity = 79 %).</div></div><div><h3>Conclusions</h3><div>The IC antigen signature identified in this study may have important implications for the diagnosis and treatment of severe COVID-19.</div></div>","PeriodicalId":10172,"journal":{"name":"Clinical biochemistry","volume":"135 ","pages":"Article 110865"},"PeriodicalIF":2.5,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142845817","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Evaluation of a new soluble transferrin receptor assay and comparison to three measurement procedures 一种新的可溶性转铁蛋白受体测定方法的评价和三种测量方法的比较。
IF 2.5 3区 医学 Q2 MEDICAL LABORATORY TECHNOLOGY Pub Date : 2025-01-01 DOI: 10.1016/j.clinbiochem.2024.110862
Mary Kathryn Bohn , Marvin Berman , Salman Ali , Pow Lee Cheng , Xiao Yan Wang , Randal J. Schneider , Vathany Kulasingam

Background

Soluble transferrin receptor (sTfR) is a useful marker in the differentiation of anemia. Clinical utility is limited by lack of standardization between measurement procedures and interpretative recommendations. Our objective was to evaluate the analytical performance of a research sTfR immunoturbidimetric assay (Alinity c, Abbott Diagnostics) and compare it to three established measurement procedures.

Methods

Assay imprecision was assessed with 7 panels across the analytical measuring interval. 159 patient samples were measured across four instrument systems (Alinity c [Abbott Diagnostics], Tina-quant c502 [Roche Diagnostics], Quantex Biokit [Werfen], and ACCESS [Beckman Coulter]). Ferritin was also measured to calculate an sTfR/Log Ferritin ratio. Sera from 100 reference individuals were assayed for sTfR and ferritin (Alinity) for reference interval (RI) verification (sTfR) or establishment (sTfR index).

Results

Assay imprecision met defined goals. Method comparison between Alinity c and ACCESS sTfR assays showed good agreement (slope: 1.06, intercept: −0.12, r: 0.989). Comparisons across other assays demonstrated significant proportional bias with slopes ranging from 0.44 (Tina-quant c502, mean bias: −2.52 mg/L) to 1.24 (Quantex Biokit, mean bias: 0.60 mg/L). A proportional bias was observed between other instruments. While the sTfR RI was verified on the Alinity assay, agreement in interpretation (within vs outside RI) between Alinity and other platforms ranged from 74.2 to 80.5 %.

Conclusion

We report the first characterization of the performance of a research sTfR immunoturbidimetric assay (Alinity c, Abbott Diagnostics). Our findings emphasize the lack of harmonization between measurement procedures and result interpretation for sTfR and sTfR index, necessitating standardization efforts and clinical studies.
背景:可溶性转铁蛋白受体(sTfR)是鉴别贫血的有用标志物。临床应用受到测量程序和解释性建议之间缺乏标准化的限制。我们的目的是评估研究sTfR免疫比浊法(Alinity c, Abbott Diagnostics)的分析性能,并将其与三种已建立的测量程序进行比较。方法:在整个分析测量区间内用7个面板评估分析不精密度。159例患者样本通过四种仪器系统(Alinity c [Abbott Diagnostics]、Tina-quant c502 [Roche Diagnostics]、Quantex Biokit [Werfen]和ACCESS [Beckman Coulter])进行测量。测定铁蛋白以计算sTfR/Log铁蛋白比率。测定100例参考个体血清的sTfR和铁蛋白(aliniity),用于验证参考区间(RI) (sTfR)或建立参考区间(sTfR指数)。结果:测定不精密度达到规定目标。Alinity c和ACCESS sTfR检测结果一致(斜率:1.06,截距:-0.12,r: 0.989)。其他试验的比较显示出显著的比例偏差,斜率范围从0.44 (Tina-quant c502,平均偏差:-2.52 mg/L)到1.24 (Quantex Biokit,平均偏差:0.60 mg/L)。在其他仪器之间观察到比例偏差。虽然在Alinity检测中验证了sTfR RI,但Alinity与其他平台之间的解释一致性(在RI内与外部)范围为74.2-80.5 %。结论:我们报告了研究sTfR免疫比浊测定性能的第一个特征(Alinity c, Abbott Diagnostics)。我们的研究结果强调了sTfR和sTfR指数的测量程序和结果解释之间缺乏一致性,需要标准化工作和临床研究。
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引用次数: 0
DNA methylation levels may contribute to severe hypertriglyceridemia in multifactorial chylomicronemia syndrome DNA甲基化水平可能导致多因子乳糜微粒血症综合征中的严重高甘油三酯血症。
IF 2.5 3区 医学 Q2 MEDICAL LABORATORY TECHNOLOGY Pub Date : 2025-01-01 DOI: 10.1016/j.clinbiochem.2025.110873
Simon-Pierre Guay , Martine Paquette , Amélie Taschereau , Véronique Desgagné , Luigi Bouchard , Sophie Bernard , Alexis Baass

Background and aims

Familial chylomicronemia syndrome (FCS) and multifactorial chylomicronemia syndrome (MCS) are the two main causes of severe hypertriglyceridemia (sHTG). FCS is a rare autosomal recessive form of sHTG, whereas MCS is mainly polygenic in nature with both common and rare variants accumulating and leading to sHTG. However, 30 to 50% of MCS patients have no identified genetic cause of sHTG. DNA methylation (DNAm) is a non-traditional heritable factor known to be associated with triglyceride (TG) levels. The aim of this study is to determine if DNAm level at three candidate genes for hypertriglyceridemia (ABCG1, CPT1A and SREBF1) could contribute to sHTG in MCS patients.

Methods

A total of 114 MCS and 20 FCS patients were included in this retrospective study. DNAm levels were measured at ABCG1 (cg06500161), CPT1A (cg00574958), and SREBF1 (cg11024682) gene loci using pyrosequencing of bisulfite-treated DNA.

Results

DNAm levels at ABCG1, CPT1A and SREBF1 were significantly associated with TG levels or minimal TG levels in MCS patients. Prevalence of patients with at least 2 loci with DNAm levels into the top tertile of DNAm associated with hypertriglyceridemia was significantly higher in MCS patients with genetically undefined sHTG compared to MCS patients with polygenic sHTG and FCS patients (57 % vs. 24 % vs. 0 %, respectively; p < 0.0001).

Conclusion

This study suggests for the first time that DNAm could contribute to sHTG in MCS patients. It suggests that further studies of epivariations may contribute to better understand the clinical heterogeneity seen in MCS patients.
背景和目的:家族性乳糜微粒血症综合征(FCS)和多因素乳糜微粒血症综合征(MCS)是导致严重高甘油三酯血症(sHTG)的两个主要原因。FCS 是一种罕见的常染色体隐性高甘油三酯血症(sHTG),而 MCS 主要是多基因遗传,常见变异和罕见变异都会累积并导致高甘油三酯血症(sHTG)。然而,30%至 50%的 MCS 患者并没有发现导致 sHTG 的遗传原因。DNA甲基化(DNAm)是一种非传统遗传因素,已知与甘油三酯(TG)水平有关。本研究旨在确定高甘油三酯血症的三个候选基因(ABCG1、CPT1A 和 SREBF1)的 DNAm 水平是否会导致 MCS 患者的高甘油三酯血症:这项回顾性研究共纳入了 114 名 MCS 和 20 名 FCS 患者。结果:ABCG1、CPT1A和SREBF1基因位点的DNAm水平可能是导致MCS患者SHTG的原因之一:ABCG1、CPT1A和SREBF1基因位点的DNAm水平与MCS患者的TG水平或最低TG水平显著相关。与多基因 sHTG 的 MCS 患者和 FCS 患者相比(分别为 57% vs. 24% vs. 0%;P 结论:该研究首次表明,在 MCS 患者中,DNAm 水平与高甘油三酯血症相关的至少 2 个位点达到最高三分位点的患者比例明显较高:本研究首次表明,DNAm 可能是导致 MCS 患者 sHTG 的原因之一。这表明,进一步研究外显子可能有助于更好地理解 MCS 患者的临床异质性。
{"title":"DNA methylation levels may contribute to severe hypertriglyceridemia in multifactorial chylomicronemia syndrome","authors":"Simon-Pierre Guay ,&nbsp;Martine Paquette ,&nbsp;Amélie Taschereau ,&nbsp;Véronique Desgagné ,&nbsp;Luigi Bouchard ,&nbsp;Sophie Bernard ,&nbsp;Alexis Baass","doi":"10.1016/j.clinbiochem.2025.110873","DOIUrl":"10.1016/j.clinbiochem.2025.110873","url":null,"abstract":"<div><h3>Background and aims</h3><div>Familial chylomicronemia syndrome (FCS) and multifactorial chylomicronemia syndrome (MCS) are the two main causes of severe hypertriglyceridemia (sHTG). FCS is a rare autosomal recessive form of sHTG, whereas MCS is mainly polygenic in nature with both common and rare variants accumulating and leading to sHTG. However, 30 to 50% of MCS patients have no identified genetic cause of sHTG. DNA methylation (DNAm) is a non-traditional heritable factor known to be associated with triglyceride (TG) levels. The aim of this study is to determine if DNAm level at three candidate genes for hypertriglyceridemia (<em>ABCG1</em>, <em>CPT1A</em> and <em>SREBF1</em>) could contribute to sHTG in MCS patients.</div></div><div><h3>Methods</h3><div>A total of 114 MCS and 20 FCS patients were included in this retrospective study. DNAm levels were measured at <em>ABCG1</em> (cg06500161), <em>CPT1A</em> (cg00574958), and <em>SREBF1</em> (cg11024682) gene loci using pyrosequencing of bisulfite-treated DNA.</div></div><div><h3>Results</h3><div>DNAm levels at <em>ABCG1</em>, <em>CPT1A</em> and <em>SREBF1</em> were significantly associated with TG levels or minimal TG levels in MCS patients. Prevalence of patients with at least 2 loci with DNAm levels into the top tertile of DNAm associated with hypertriglyceridemia was significantly higher in MCS patients with genetically undefined sHTG compared to MCS patients with polygenic sHTG and FCS patients (57 % vs. 24 % vs. 0 %, respectively; <em>p</em> &lt; 0.0001).</div></div><div><h3>Conclusion</h3><div>This study suggests for the first time that DNAm could contribute to sHTG in MCS patients. It suggests that further studies of epivariations may contribute to better understand the clinical heterogeneity seen in MCS patients.</div></div>","PeriodicalId":10172,"journal":{"name":"Clinical biochemistry","volume":"135 ","pages":"Article 110873"},"PeriodicalIF":2.5,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142930660","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Constructing a predictive model for high intraoperative excessive bleeding in patients undergoing posterior lumbar decompression and fusion internal fixation surgery during outpatient visits 建立腰椎后路减压融合内固定手术患者门诊时术中大量大出血的预测模型。
IF 2.5 3区 医学 Q2 MEDICAL LABORATORY TECHNOLOGY Pub Date : 2025-01-01 DOI: 10.1016/j.clinbiochem.2024.110856
Zhenmin Sun , Nan Yang , Lei Wang , Jiansuo Zhou , Hua Zhang , Jun Wang

Objective

1. Construct a risk prediction model to predict the factors of high intraoperative bleeding in patients undergoing posterior lumbar decompression and fusion internal fixation surgery during outpatient visits. 2. Implement pre-hospital blood management for surgery patients, to improve clinical outcomes.

Design & Methods

We collected patients who underwent two-segment and three-segment posterior lumbar decompression and fusion internal fixation surgery in our hospital from 2016 to 2021. A total of 24 preoperative indicators were analyzed, covering medical history, demographic characteristics, segment, operator and laboratory test results. We used a logistic regression model to optimize the model’s feature selection. The predictive model was constructed using the multivariable logistic regression method with all included methods, and a nomogram was created to display the model. Activated partial thromboplastin time, surgeon volume, American Society of Anesthesiologists classification, body mass index, and the number of fusion and fixation lumbar segments were used to construct the predictive model. The predictive model’s discrimination, calibration, clinical applicability, and rationality were evaluated.

Results

The predictive model’s area under the receiver operating characteristic curve is 0.723, with a 95% confidence interval of (0.685–0.760). The training set’s decision curve analysis demonstrates that applying this diagnostic curve will increase the net benefit when the threshold probability is between 5% and 40%.

Conclusion

This study developed a novel nomogram with relatively good accuracy to assist clinical doctors in assessing the high intraoperative bleeding risk in patients undergoing posterior lumbar decompression and fusion internal fixation surgery during outpatient visits. By evaluating individual risk, surgeons can develop an individualized treatment plan to reduce the risk of intraoperative bleeding for each patient.
目的:1。建立风险预测模型,预测门诊腰椎后路减压融合内固定手术患者术中高出血因素。2. 对手术患者实施院前血液管理,提高临床疗效。设计与方法:我们收集2016年至2021年在我院行二节段和三节段后路腰椎减压融合内固定手术的患者。共分析24项术前指标,包括病史、人口统计学特征、手术部位、手术操作者和实验室检查结果。我们使用逻辑回归模型来优化模型的特征选择。采用多变量logistic回归方法建立了预测模型,并建立了模型的模态图。激活部分凝血活素时间、外科医生体积、美国麻醉医师学会分类、体重指数、融合固定腰椎节段数量被用于构建预测模型。对预测模型的鉴别、校正、临床适用性和合理性进行评价。结果:预测模型的受试者工作特征曲线下面积为0.723,95%置信区间为(0.685 ~ 0.760)。训练集的决策曲线分析表明,当阈值概率在5% ~ 40%之间时,应用该诊断曲线可以提高净效益。结论:本研究开发了一种准确度相对较高的新型nomogram方法,可帮助临床医生在门诊期间评估后路腰椎减压融合内固定手术患者的高术中出血风险。通过评估个体风险,外科医生可以制定个性化的治疗计划,以减少每个患者术中出血的风险。
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引用次数: 0
Serial secretoneurin measurement and risk of ventricular arrhythmias and death in patients with left ventricular systolic dysfunction 左心室收缩功能不全患者的连续分泌神经素测定与室性心律失常和死亡的风险。
IF 2.5 3区 医学 Q2 MEDICAL LABORATORY TECHNOLOGY Pub Date : 2025-01-01 DOI: 10.1016/j.clinbiochem.2024.110868
Torbjørn Omland , Helge Røsjø , Torbjørn Wisløff , Michael L. Bernard , A.Elise Hiltbold , Sammy Khatib , Glenn M. Polin , Paul A. Rogers , Daniel P. Morin

Background

Secretoneurin, a member of the granin protein family, is associated with the risk of mortality in patients with acute and chronic heart failure. Secretoneurin may play an important role in cardiomyocyte calcium handling, suggesting that it may influence cardiac arrhythmia risk. We hypothesized that baseline and serial measurements of circulating secretoneurin are associated with the risk of incident ventricular tachyarrhythmias (VA) and death, and that serial measurement would provide prognostic information beyond baseline values.

Methods

We measured circulating secretoneurin concentrations in blood samples obtained at 3-month intervals for one year in a prospectively enrolled cohort of ambulatory patients with left ventricular ejection fraction (LVEF) ≤ 35 % and a primary-prevention implanted cardioverter defibrillator (ICD). Associations between secretoneurin modeled as a time-dependent variable and the incidences of VA and death were assessed.

Results

154 patients (66 ± 14 years, LVEF 23 ± 8 %) were included in the analysis. During one-year follow-up, 26 (17 %) patients experienced VA, and 16 (10 %) died. Adjusting for age, sex, eGFR, and LVEF, baseline secretoneurin concentration was associated with the risk of death (hazard ratio (HR) per 10 pmol/L increase: 1.14 (95 % CI: 1.02–1.27), p = 0.020) but not VA (HR: 0.98 (0.81–1.19), p = 0.856). Using serial measurements at 3-month intervals, time-varying secretoneurin was associated with a similarly higher risk of death (HR: 1.14 (1.02–1.27), p = 0.017) but not of VA (HR: 0.97 (0.81–1.17), p = 0.776).

Conclusion

In stable ambulatory patients with reduced LV systolic function and a primary prevention indication for ICD, secretoneurin concentration was associated with the risk of death but not ventricular tachyarrhythmia.
背景:分泌神经蛋白是颗粒蛋白家族的一员,与急性和慢性心力衰竭患者的死亡风险相关。分泌神经素可能在心肌细胞钙处理中起重要作用,提示它可能影响心律失常的风险。我们假设循环分泌神经素的基线和连续测量与室性心动过速(VA)和死亡的风险相关,并且连续测量将提供超出基线值的预后信息。方法:我们对一组左室射血分数(LVEF) ≤ 35 %并使用一级预防植入式心律转复除颤器(ICD)的非住院患者进行前瞻性研究,每隔3个月采集血液样本,测量血液中循环分泌神经蛋白的浓度。作为时间相关变量的分泌神经素模型与VA和死亡发生率之间的关系进行了评估。结果:154例患者(66 ± 14 岁,LVEF 23 ± 8 %)纳入分析。在一年的随访中,26例(17 %)患者发生了VA, 16例(10 %)死亡。调整年龄、性别、eGFR和LVEF后,基线分泌神经素浓度与死亡风险相关(每增加10 pmol/L风险比(HR): 1.14(95 % CI: 1.02-1.27), p = 0.020),但与VA无关(HR: 0.98 (0.81-1.19), p = 0.856)。通过间隔3个月的连续测量,时间变化的分泌神经素与同样较高的死亡风险相关(HR: 1.14 (1.02-1.27), p = 0.017),但与VA无关(HR: 0.97 (0.81-1.17), p = 0.776)。结论:在稳定的左室收缩功能降低且有ICD一级预防指征的门诊患者中,分泌神经蛋白浓度与死亡风险相关,但与室性心动过速无关。
{"title":"Serial secretoneurin measurement and risk of ventricular arrhythmias and death in patients with left ventricular systolic dysfunction","authors":"Torbjørn Omland ,&nbsp;Helge Røsjø ,&nbsp;Torbjørn Wisløff ,&nbsp;Michael L. Bernard ,&nbsp;A.Elise Hiltbold ,&nbsp;Sammy Khatib ,&nbsp;Glenn M. Polin ,&nbsp;Paul A. Rogers ,&nbsp;Daniel P. Morin","doi":"10.1016/j.clinbiochem.2024.110868","DOIUrl":"10.1016/j.clinbiochem.2024.110868","url":null,"abstract":"<div><h3>Background</h3><div>Secretoneurin, a member of the granin protein family, is associated with the risk of mortality in patients with acute and chronic heart failure. Secretoneurin may play an important role in cardiomyocyte calcium handling, suggesting that it may influence cardiac arrhythmia risk. We hypothesized that baseline and serial measurements of circulating secretoneurin are associated with the risk of incident ventricular tachyarrhythmias (VA) and death, and that serial measurement would provide prognostic information beyond baseline values.</div></div><div><h3>Methods</h3><div>We measured circulating secretoneurin concentrations in blood samples obtained at 3-month intervals for one year in a prospectively enrolled cohort of ambulatory patients with left ventricular ejection fraction (LVEF) ≤ 35 % and a primary-prevention implanted cardioverter defibrillator (ICD). Associations between secretoneurin modeled as a time-dependent variable and the incidences of VA and death were assessed.</div></div><div><h3>Results</h3><div>154 patients (66 ± 14 years, LVEF 23 ± 8 %) were included in the analysis. During one-year follow-up, 26 (17 %) patients experienced VA, and 16 (10 %) died. Adjusting for age, sex, eGFR, and LVEF, baseline secretoneurin concentration was associated with the risk of death (hazard ratio (HR) per 10 pmol/L increase: 1.14 (95 % CI: 1.02–1.27), p = 0.020) but not VA (HR: 0.98 (0.81–1.19), p = 0.856). Using serial measurements at 3-month intervals, time-varying secretoneurin was associated with a similarly higher risk of death (HR: 1.14 (1.02–1.27), p = 0.017) but not of VA (HR: 0.97 (0.81–1.17), p = 0.776).</div></div><div><h3>Conclusion</h3><div>In stable ambulatory patients with reduced LV systolic function and a primary prevention indication for ICD, secretoneurin concentration was associated with the risk of death but not ventricular tachyarrhythmia.</div></div>","PeriodicalId":10172,"journal":{"name":"Clinical biochemistry","volume":"135 ","pages":"Article 110868"},"PeriodicalIF":2.5,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142871632","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Comparison of three different cystatin C measurement procedures in a pediatric chronic kidney disease cohort: Calibration for longitudinal measurements and implications for clinical estimation of GFR 儿童慢性肾病队列中三种不同胱抑素C测量方法的比较:纵向测量的校准及其对GFR临床估计的影响
IF 2.5 3区 医学 Q2 MEDICAL LABORATORY TECHNOLOGY Pub Date : 2024-12-24 DOI: 10.1016/j.clinbiochem.2024.110869
Derek K. Ng , George J. Schwartz , Bradley A. Warady , Susan L. Furth , Jesse C. Seegmiller , for the CKiD Study Investigators

Introduction

Serum cystatin C (CysC) is used to estimate glomerular filtration rate (eGFR), including in the Chronic Kidney Disease in Children (CKiD) Under 25 years (U25eGFR) equations. Several CysC measurement procedures available from diagnostic vendors include reference material for calibration, but the extent of heterogeneity across manufacturers is unclear. Since heterogeneity may have clinical and research implications for eGFR, we evaluated three CysC procedures in samples from the CKiD study representing a wide spectrum of kidney function.

Materials and Methods

The three CysC measurement procedures evaluated were: Siemens BN II N Latex CystatinC Assay; Gentian CystatinC Immunoassay; and Roche Tina-quant CystatinC Gen.2. Bland-Altman quantified agreement with Siemens as reference because that method was used for longitudinal CKiD samples from 2003 to 2023. We present derivation of the interquartile range (IQR) of U25eGFR as a measure of precision and describe differences outside this range.

Results

From 53 samples from 44 participants, Gentian measurements were 7 % higher than Siemens (95 %CI: +5.6 %,+8.5 %), while Roche measurements were 4.8 % lower on average (95 %CI: −6.2 %,-3.3 %). Both had very high correlation: 0.9926 and 0.9906, respectively. There was strong agreement across procedures, but a simple correction factor of 7 % reduction applied to Gentian yielded unbiased estimates (+0.03 %, 95 %CI: −1.3 %,+1.4 %) and strong performance in Deming regression. For precision, 98 % of U25eGFR values based on Gentian and Roche CysC were each within the IQR of the Siemens-based estimates.

Conclusions

Despite reference material calibration, heterogeneity across CysC measurement procedures was observed. Procedure variability was within the limits of U25eGFR estimates indicating that practically, all procedures are appropriate for clinical use. Clinicians may consider calculating IQR of U25eGFR estimates for pediatric chronic kidney disease management.
血清胱抑素C (CysC)用于估计肾小球滤过率(eGFR),包括在25岁以下儿童慢性肾病(CKiD) 年(U25eGFR)方程中。诊断供应商提供的几种CysC测量程序包括用于校准的参考材料,但各制造商之间的异质性程度尚不清楚。由于异质性可能对eGFR具有临床和研究意义,我们评估了CKiD研究样本中的三种CysC程序,代表了广泛的肾功能。材料和方法:评估的三种CysC测量方法为:Siemens BN II N Latex CystatinC Assay;龙胆CystatinC免疫测定;和罗氏Tina-quant CystatinC Gen.2。Bland-Altman量化了Siemens的一致性作为参考,因为该方法用于2003年至2023年的纵向CKiD样本。我们提出了U25eGFR的四分位数范围(IQR)的推导,作为精度的度量,并描述了该范围之外的差异。结果:在44名参与者的53份样本中,龙胆草的测量值比西门子高7 %(95 %CI: +5.6 %,+8.5 %),而罗氏的测量值平均低4.8 %(95 %CI: -6.2 %,-3.3 %)。两者的相关性都非常高,分别为0.9926和0.9906。在整个过程中有很强的一致性,但对龙胆草进行简单的校正因子7 %的减少产生了无偏估计(+0.03 %,95 %CI: -1.3 %,+1.4 %),并且在Deming回归中表现良好。为了精确起见,98 %基于龙胆草和罗氏CysC的U25eGFR值都在基于西门子的估计的IQR内。结论:尽管进行了标准物质校准,但在CysC测量过程中观察到异质性。手术的可变性在U25eGFR估计的范围内,这表明实际上,所有手术都适合临床使用。临床医生可以考虑计算IQR的U25eGFR估计儿童慢性肾脏疾病的管理。
{"title":"Comparison of three different cystatin C measurement procedures in a pediatric chronic kidney disease cohort: Calibration for longitudinal measurements and implications for clinical estimation of GFR","authors":"Derek K. Ng ,&nbsp;George J. Schwartz ,&nbsp;Bradley A. Warady ,&nbsp;Susan L. Furth ,&nbsp;Jesse C. Seegmiller ,&nbsp;for the CKiD Study Investigators","doi":"10.1016/j.clinbiochem.2024.110869","DOIUrl":"10.1016/j.clinbiochem.2024.110869","url":null,"abstract":"<div><h3>Introduction</h3><div>Serum cystatin C (CysC) is used to estimate glomerular filtration rate (eGFR), including in the Chronic Kidney Disease in Children (CKiD) Under 25 years (U25eGFR) equations. Several CysC measurement procedures available from diagnostic vendors include reference material for calibration, but the extent of heterogeneity across manufacturers is unclear. Since heterogeneity may have clinical and research implications for eGFR, we evaluated three CysC procedures in samples from the CKiD study representing a wide spectrum of kidney function.</div></div><div><h3>Materials and Methods</h3><div>The three CysC measurement procedures evaluated were: Siemens BN II N Latex CystatinC Assay; Gentian CystatinC Immunoassay; and Roche Tina-quant CystatinC Gen.2. Bland-Altman quantified agreement with Siemens as reference because that method was used for longitudinal CKiD samples from 2003 to 2023. We present derivation of the interquartile range (IQR) of U25eGFR as a measure of precision and describe differences outside this range.</div></div><div><h3>Results</h3><div>From 53 samples from 44 participants, Gentian measurements were 7 % higher than Siemens (95 %CI: +5.6 %,+8.5 %), while Roche measurements were 4.8 % lower on average (95 %CI: −6.2 %,-3.3 %). Both had very high correlation: 0.9926 and 0.9906, respectively. There was strong agreement across procedures, but a simple correction factor of 7 % reduction applied to Gentian yielded unbiased estimates (+0.03 %, 95 %CI: −1.3 %,+1.4 %) and strong performance in Deming regression. For precision, 98 % of U25eGFR values based on Gentian and Roche CysC were each within the IQR of the Siemens-based estimates.</div></div><div><h3>Conclusions</h3><div>Despite reference material calibration, heterogeneity across CysC measurement procedures was observed. Procedure variability was within the limits of U25eGFR estimates indicating that practically, all procedures are appropriate for clinical use. Clinicians may consider calculating IQR of U25eGFR estimates for pediatric chronic kidney disease management.</div></div>","PeriodicalId":10172,"journal":{"name":"Clinical biochemistry","volume":"136 ","pages":"Article 110869"},"PeriodicalIF":2.5,"publicationDate":"2024-12-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142892091","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Re-evaluating the utility of iron indices in hereditary hemochromatosis genotyping: A retrospective study 重新评价铁指标在遗传性血色素沉着病基因分型中的应用:一项回顾性研究
IF 2.5 3区 医学 Q2 MEDICAL LABORATORY TECHNOLOGY Pub Date : 2024-11-29 DOI: 10.1016/j.clinbiochem.2024.110860
Amy Lou , Manal O. Elnenaei , Julie Zhu , Kevork Peltekian , Eric Liu , Jennifer A. Jamieson , Hammam Said , Bassam A. Nassar

Introduction

Hereditary hemochromatosis (HH), associated with C282Y or H63D mutations in the HFE gene, is the commonest genetic disorder in Canada. The majority of HH cases are attributable to C282Y homozygosity which can precipitate iron overload and organ damage, but with low penetrance. Elevated transferrin saturation (TSat) and ferritin levels are key biochemical indicators of iron overload in C282Y homozygotes. This retrospective study examined TSat and ferritin levels as predictors of C282Y homozygosity in genotyped patients.

Methods

This study included 23,432 individuals from Maritime provinces who underwent HFE genotyping from 2009 to 2022. Those with available biomarkers (TSat, ferritin, ALT) were included in the study sample. C282Y and H63D variants were identified based on HFE genotying. Median values for each biomarker were compared across genotypes and their diagnostic performance in predicting C282Y homozygosity evaluated using ROC analysis.

Results

1241 individuals (5.3 %) showed C282Y homozygosity, marking the largest North American study cohort. C282Y homozygotes showed significantly higher median TSat and ferritin levels than wildtypes. TSat showed the best diagnostic performance in detecting C282Y homozygosity (AUC = 0.82, 95 % CI: 0.78–0.85), outperforming ferritin (AUC = 0.54, 95 % CI: 0.50–0.58) and ALT (AUC = 0.59, 95 % CI: 0.56–0.63). TSat thresholds of 32 % (females) and 35 % (males) had a 90 % sensitivity for C282Y homozygosity. Using thresholds of TSat ≤46 % and ferritin ≤370 µg/L (females), and TSat ≤49 % and ferritin ≤703 µg/L (males) reduced the need for genotyping by up to 50 % without missing significant biochemical iron overload cases. Implementing this strategy across 23,432 tests could save $1,701,163 and potentially reduce unnecessary downstream management.

Conclusion

Our study suggests significant efficiency savings by implementing an algorithm to reduce unnecessary HFE genotyping and alleviate unwarranted genetic testing anxiety.
遗传性血色素沉着症(HH)与HFE基因的C282Y或H63D突变相关,是加拿大最常见的遗传性疾病。大多数HH病例可归因于C282Y纯合性,可导致铁超载和器官损伤,但外显率低。转铁蛋白饱和度(TSat)和铁蛋白水平升高是C282Y纯合子铁超载的关键生化指标。本回顾性研究检验了TSat和铁蛋白水平作为基因型患者C282Y纯合性的预测因子。方法本研究纳入2009 - 2022年来自沿海省份的23,432例HFE基因分型患者。具有可用生物标志物(TSat、铁蛋白、ALT)者纳入研究样本。通过HFE基因测序鉴定C282Y和H63D变异。比较各基因型生物标志物的中位数,并使用ROC分析评估其预测C282Y纯合性的诊断性能。结果1241例(5.3%)个体显示C282Y纯合性,是北美最大的研究队列。C282Y纯合子的TSat和铁蛋白水平中位数明显高于野生型。TSat对C282Y纯合性的诊断效果最好(AUC = 0.82, 95% CI: 0.78 ~ 0.85),优于铁蛋白(AUC = 0.54, 95% CI: 0.50 ~ 0.58)和ALT (AUC = 0.59, 95% CI: 0.56 ~ 0.63)。TSat阈值为32%(女性)和35%(男性),对C282Y纯合性的敏感性为90%。使用TSat≤46%和铁蛋白≤370µg/L(女性)以及TSat≤49%和铁蛋白≤703µg/L(男性)的阈值,在不遗漏显著生化铁超载病例的情况下,减少了高达50%的基因分型需求。在23,432个测试中实施该策略可以节省1,701,163美元,并可能减少不必要的下游管理。结论本研究表明,通过实施一种算法来减少不必要的HFE基因分型和减轻不必要的基因检测焦虑,可以显著节省效率。
{"title":"Re-evaluating the utility of iron indices in hereditary hemochromatosis genotyping: A retrospective study","authors":"Amy Lou ,&nbsp;Manal O. Elnenaei ,&nbsp;Julie Zhu ,&nbsp;Kevork Peltekian ,&nbsp;Eric Liu ,&nbsp;Jennifer A. Jamieson ,&nbsp;Hammam Said ,&nbsp;Bassam A. Nassar","doi":"10.1016/j.clinbiochem.2024.110860","DOIUrl":"10.1016/j.clinbiochem.2024.110860","url":null,"abstract":"<div><h3>Introduction</h3><div>Hereditary hemochromatosis (HH), associated with C282Y or H63D mutations in the HFE gene, is the commonest genetic disorder in Canada. The majority of HH cases are attributable to C282Y homozygosity which can precipitate iron overload and organ damage, but with low penetrance. Elevated transferrin saturation (TSat) and ferritin levels are key biochemical indicators of iron overload in C282Y homozygotes. This retrospective study examined TSat and ferritin levels as predictors of C282Y homozygosity in genotyped patients.</div></div><div><h3>Methods</h3><div>This study included 23,432 individuals from Maritime provinces who underwent HFE genotyping from 2009 to 2022. Those with available biomarkers (TSat, ferritin, ALT) were included in the study sample. C282Y and H63D variants were identified based on HFE genotying. Median values for each biomarker were compared across genotypes and their diagnostic performance in predicting C282Y homozygosity evaluated using ROC analysis.</div></div><div><h3>Results</h3><div>1241 individuals (5.3 %) showed C282Y homozygosity, marking the largest North American study cohort. C282Y homozygotes showed significantly higher median TSat and ferritin levels than wildtypes. TSat showed the best diagnostic performance in detecting C282Y homozygosity (AUC = 0.82, 95 % CI: 0.78–0.85), outperforming ferritin (AUC = 0.54, 95 % CI: 0.50–0.58) and ALT (AUC = 0.59, 95 % CI: 0.56–0.63). TSat thresholds of 32 % (females) and 35 % (males) had a 90 % sensitivity for C282Y homozygosity. Using thresholds of TSat ≤46 % and ferritin ≤370 µg/L (females), and TSat ≤49 % and ferritin ≤703 µg/L (males) reduced the need for genotyping by up to 50 % without missing significant biochemical iron overload cases. Implementing this strategy across 23,432 tests could save $1,701,163 and potentially reduce unnecessary downstream management.</div></div><div><h3>Conclusion</h3><div>Our study suggests significant efficiency savings by implementing an algorithm to reduce unnecessary HFE genotyping and alleviate unwarranted genetic testing anxiety.</div></div>","PeriodicalId":10172,"journal":{"name":"Clinical biochemistry","volume":"135 ","pages":"Article 110860"},"PeriodicalIF":2.5,"publicationDate":"2024-11-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142757008","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
期刊
Clinical biochemistry
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