Clinical biochemistry最新文献_第7页

Impact of blood volume, air exposure duration, transport duration, and testing delay on plasma total carbon dioxide in simulated open collections using microtainers 使用微容器进行模拟开放式采集时，血容量、空气暴露持续时间、运输持续时间和测试延迟对血浆总二氧化碳的影响。

IF 2.5 3区医学 Q2 MEDICAL LABORATORY TECHNOLOGY

Clinical biochemistry

Pub Date : 2024-09-30 DOI: 10.1016/j.clinbiochem.2024.110831

Michael S. Reid , Isolde Seiden Long , Lawrence de Koning

Background

Exposing blood specimens to air reduces plasma total carbon dioxide (TCO₂). We evaluated the degree of TCO₂ reduction attributed to open collection of neonatal blood in BD microtainers® (microtainers), microtainer transport duration and delayed testing of open plasma aliquots.

Methods

Venous blood was aliquoted into open microtainers in a 3x4 factorial design to simulate combined effects of blood volume (0.2–0.6 mL) and air exposure duration (0–5 min), with blood drawn in vacutainers as a control. Separate effects of in-hospital transport duration (0–120 min; whole blood), off-site transport duration (0–24 h; centrifuged whole blood), and the duration plasma aliquots remained open (0–120 min) were evaluated by repeated testing. Findings were analyzed using repeated-measures ANOVA and Student’s T-tests.

Results

In the factorial experiment, mean plasma TCO₂ in microtainers was on average 3.5 mmol/L lower than in vacutainers. Smaller blood volume but not greater air exposure duration significantly (p < 0.05) reduced TCO₂. Mean TCO₂ in filled (0.6 mL; 1–5 min air exposure) microtainers was on average 2.9 mmol/L lower than in vacutainers. Simulated off-site transport of microtainers containing centrifuged whole blood significantly reduced TCO₂ (4 h; mean change = -1.5 mmol/L), as did delayed testing of aliquoted plasma (15 min; mean change = -1.3 mmol/L).

Conclusions

Plasma TCO₂ decreased with reduced microtainer blood volume, extended off-site transport duration of centrifuged whole blood and testing delay of aliquoted plasma. To minimize TCO₂ reduction, microtainers should be fully filled and tested rapidly. Laboratories should also consider whether an interpretive comment, correction factor or separate reference intervals are appropriate for these tests.

背景：将血液标本暴露在空气中会降低血浆总二氧化碳（TCO2）。我们评估了在 BD 微容器®（微容器）中模拟开放式采集新生儿血液的 TCO2 降低程度、微容器运输持续时间以及开放式血浆等分的延迟测试：采用 3x4 因子设计将静脉血等分到开放式微容器中，以模拟血容量（0.2-0.6 毫升）和空气暴露持续时间（0-5 分钟）的综合影响，并以空泡采血器抽取的血液作为对照。通过重复试验分别评估了院内运送时间（0-120 分钟；全血）、院外运送时间（0-24 小时；离心全血）和血浆等分开放时间（0-120 分钟）的影响。结果采用重复测量方差分析和学生 T 检验进行分析：结果：在因子实验中，所有微量容器中的平均血浆 TCO2 平均比真空容器中低 3.5 mmol/L。较小的血容量与较长的空气暴露时间相比有显著差异（p 2.0）。灌装（0.6 毫升；1-5 分钟空气暴露）微量容器中的平均 TCO2 平均比真空容器中低 2.9 毫摩尔/升。对装有离心全血的微量容器进行模拟异地运输可显著降低 TCO2（4 小时；平均-1.5 毫摩尔/升），对等分血浆进行延迟测试也是如此（15 分钟；平均-1.3 毫摩尔/升）：结论：血浆 TCO2 会随着微容器血容量的减少、离心血液运输时间的延长和等分血浆检测的延迟而降低。为尽量减少 TCO2 的降低，微量容器应完全灌满并快速检测。实验室还应考虑这些检测是否适合使用解释性注释、校正因子或单独的参考区间。

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引用次数: 0

Minimal mathematical model for glycation of albumin 白蛋白糖化的最小数学模型

IF 2.5 3区医学 Q2 MEDICAL LABORATORY TECHNOLOGY

Clinical biochemistry

Pub Date : 2024-09-29 DOI: 10.1016/j.clinbiochem.2024.110830

Douglas F. Stickle , Gabriel J. DiNatale , Ross Molinaro

Background

Glycated albumin (GA) is often described as a reflection of glucose exposure over the past 2–4 weeks. We examined the scale of the operative interval for changes in %GA from the perspective of a theoretical model for GA formation, by simulating the time course of changes in %GA after changes in glucose.

Methods

Probability of survival of albumin (A) was according to first-order elimination based on t_1/2 of 17 days. Probability of formation of GA from A per unit time was proportional to glucose (G) and a glycation rate constant, k, deduced from reference values for %GA vs. G. We then simulated the kinetics of changes in %GA for conditions in which a prior steady-state (constant G) was followed by a step change in G.

Results

The glycation rate constant k was 9.79e-4/d/(mmol/L). We simulated changes in %GA for two scenarios involving step changes in G at time = 0: A. from 10 mmol/L to 15 mmol/L (%GA ultimately moves from 19.3% to 26.4%); B. from 15 mmol/L to 10 mmol/L (%GA ultimately moves from 26.4% to 19.3%). For both scenarios, the fractional transition of %GA between respective starting points and ultimate endpoints was after 30 days approximately 80% of the ultimate full transition.

Conclusions

Model-based calculations support the description of %GA as a reflection of G over the past 4–6 weeks, longer than the period of 2–4 weeks that is commonly cited.

背景：糖化白蛋白（GA糖化白蛋白（GA）通常被描述为过去 2-4 周内葡萄糖暴露的反映。我们从 GA 形成的理论模型的角度，通过模拟葡萄糖变化后 %GA 变化的时间过程，研究了 %GA 变化的操作时间间隔的规模：白蛋白（A）的存活概率根据一阶消除法计算，t1/2 为 17 天。单位时间内 A 形成 GA 的概率与葡萄糖（G）和糖化率常数 k 成正比，糖化率常数 k 是根据%GA 对 G 的参考值推导出来的。然后，我们模拟了在先稳态（恒定 G）后 G 发生阶跃变化的条件下%GA 的变化动力学：糖化速率常数 k 为 9.79e-4/d/(mmol/L)。我们模拟了两种情况下 G 在时间 = 0 时的阶跃变化：A. 从 10 mmol/L 到 15 mmol/L（%GA 最终从 19.3% 变为 26.4%）；B. 从 15 mmol/L 到 10 mmol/L（%GA 最终从 26.4% 变为 19.3%）。在这两种情况下，30 天后，%GA 在各自起点和最终终点之间的部分转变约为最终完全转变的 80%：基于模型的计算支持将 GA%描述为过去 4-6 周内 G 的反映，比通常所说的 2-4 周更长。

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引用次数: 0

Analytical evaluation of a direct ion-selective-based analyser: Still gaps to close 基于离子选择的直接分析仪的分析评估：仍有差距有待弥补。

IF 2.5 3区医学 Q2 MEDICAL LABORATORY TECHNOLOGY

Clinical biochemistry

Pub Date : 2024-09-28 DOI: 10.1016/j.clinbiochem.2024.110829

Matthijs Oyaert , Nick Verougstraete , Brecht Vandekerckhove , Bruno Lapauw , Eric Hoste , Veronique Stove

Introduction

Discrepancies between electrolyte concentrations determined by blood gas analysers (BGA) and core-lab chemistry analysers may create confusion in clinical practice. This problem is rooted in the different ion-selective electrode (ISE) methodologies that are used. Whilst most available chemistry analysers use indirect ISE, we evaluated the analytical performance of the new automated chemistry analyser Biossays™ E6 (Snibe), equipped with direct ISE, for the determination of sodium (Na⁺), potassium (K⁺), chloride (Cl⁻), ionized calcium (iCa²⁺) and pH.

Materials and methods

Total precision, estimated deviation and total error were evaluated for all analytes on the E6 analyser. Several patient cohorts were used to perform method comparisons between the E6 and the direct (RP500e BGA) and indirect (Architect c16000 analyser) ISE methods routinely used in the lab. Obtained data were compared against pre-set quality specifications and used for adjustment of the 2 direct ISE methods. For Na⁺ and iCa²⁺, agreement with the routinely used protein-corrected Na⁺ and total calcium (TCa²⁺) concentrations were assessed respectively.

Results

The analytical performance for the 4 tested electrolytes (Na⁺, K⁺, Cl⁻, iCa²⁺) and pH were acceptable and within the specified performance specifications. After adjustment of both direct methods, method comparison on an independent patient cohort showed good agreement. For Na⁺ and iCa²⁺, a good correlation with the protein corrected Na⁺ and TCa²⁺ results was observed.

Conclusion

The acceptable analytical performance and ease-of-use of the E6 direct ion selective instrument is making it feasible to optimize electrolyte determinations to direct methodology.

导言：血气分析仪（BGA）和核心实验室化学分析仪测定的电解质浓度之间的差异可能会在临床实践中造成混乱。这一问题的根源在于所使用的离子选择电极 (ISE) 方法不同。虽然大多数现有的化学分析仪都使用间接离子选择电极，但我们评估了配备直接离子选择电极的新型自动化学分析仪 Biossays™ E6（Snibe）在测定钠（Na+）、钾（K+）、氯化物（Cl-）、离子化钙（iCa2+）和 pH 值时的分析性能：对 E6 分析仪上所有分析物的总精密度、估计偏差和总误差进行了评估。使用几个病人组群对 E6 和实验室常规使用的直接（RP500e BGA）和间接（Architect c16000 分析仪）ISE 方法进行比较。获得的数据与预先设定的质量规格进行比较，并用于调整两种直接 ISE 方法。对于 Na+ 和 iCa2+，分别评估了与常规使用的蛋白质校正 Na+ 和总钙（TCa2+）浓度的一致性：结果：4 种测试电解质（Na+、K+、Cl-、iCa2+）和 pH 值的分析性能均可接受，符合规定的性能指标。对两种直接方法进行调整后，在一个独立的患者群体中进行方法比较，结果显示两者的一致性很好。就 Na+ 和 iCa2+ 而言，与蛋白质校正的 Na+ 和 TCa2+ 结果有很好的相关性：结论：E6 直接离子选择仪的分析性能和易用性使优化电解质测定的直接方法变得可行。

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引用次数: 0

Clinical, biochemical, molecular characteristics and clinical outcome of hyperhomocysteinemia in Malaysian children 马来西亚儿童高同型半胱氨酸血症的临床、生化、分子特征和临床结果

IF 2.5 3区医学 Q2 MEDICAL LABORATORY TECHNOLOGY

Clinical biochemistry

Pub Date : 2024-09-23 DOI: 10.1016/j.clinbiochem.2024.110828

Anasufiza Habib , Hamizah Idrus , Nur Aisyah Abdul Malik , Ainna Mohd Nor , Sofwatul Muktaroh Nasohah , Lip Hen Moey , Lua Seok Hian , Ngu Lock Hock , Nor Azimah Abdul Azize

Background

Hyperhomocysteinemia can be due to various abnormalities of the complex interaction of methionine, folate and vitamin B12. It has been known to be a cardiovascular risk factor. This study aims to review the clinical presentation, underlying causes and clinical outcome in paediatric patients diagnosed with significant hyperhomocysteinemia in Malaysia.

Design and methods

Data were obtained from the medical records and the laboratory information system. Paediatric patients with significant hyperhomocysteinemia were identified from a selective high-risk screening of 96,721 patients, performed between 2010 and 2022. Inclusion criteria for the study were paediatric patients with significant hyperhomocysteinemia (>40 µmol/L).

Results

Sixteen patients were identified. The average total homocysteine (tHcy) and methionine were 269 µmol/L and 499 µmol/L in cystathionine β-synthase deficiency (CBS), 127 µmol/L and 29 µmol/L in patients with remethylation defects and 390 µmol/L and 4 µmol/L in congenital B12 deficiency. We found c.609G>A as the most prevalent mutation in MMACHC gene and possible novel mutations for CBS (c.402del, c.1333C>T and c.1031T>G) and MTHFR genes (c.266T>A and c.1249del). Further subclassification revealed CBS was 5/16 patients (31 %), remethylation defects was 9/16 (56 %) and congenital B12 deficiency was 2/16 (13 %). All patients received standard treatment and regular monitoring of the main biomarkers. The average age at the time of diagnosis were 9.2 years (CBS) and 1.2 years (remethylation defects). Congenital B12 deficiency had slight delay in milestones, remethylation defects had mild to moderate learning disabilities, CBS had variable degree of intellectual disability, delayed milestones, ophthalmological abnormalities, and thrombosis at an early adolescent/adulthood.

Conclusions

The majority of significant hyperhomocysteinemia in Malaysian children was due to remethylation defects. Screening for hyperhomocysteinemia in Malaysian children is recommended for earlier treatment and improved clinical outcome.

背景高同型半胱氨酸血症可由蛋氨酸、叶酸和维生素 B12 的复杂相互作用的各种异常引起。众所周知，高同型半胱氨酸血症是心血管风险因素之一。本研究旨在回顾马来西亚被诊断为严重高同型半胱氨酸血症的儿科患者的临床表现、潜在原因和临床结果。2010年至2022年期间，对96721名患者进行了选择性高风险筛查，从中确定了患有严重高同型半胱氨酸血症的儿科患者。研究的纳入标准是患有严重高同型半胱氨酸血症（40 µmol/L）的儿科患者。胱硫醚β-合成酶缺乏症（CBS）患者的平均同型半胱氨酸总量（tHcy）和蛋氨酸含量分别为 269 µmol/L 和 499 µmol/L，再甲基化缺陷患者的平均同型半胱氨酸总量（tHcy）和蛋氨酸含量分别为 127 µmol/L 和 29 µmol/L，先天性 B12 缺乏症患者的平均同型半胱氨酸总量（tHcy）和蛋氨酸含量分别为 390 µmol/L 和 4 µmol/L。我们发现，c.609G>A 是 MMACHC 基因最常见的突变，而 CBS（c.402del、c.1333C>T 和 c.1031T>G）和 MTHFR 基因（c.266T>A 和 c.1249del）可能存在新的突变。进一步的亚分类显示，5/16 的患者患有 CBS（31%），9/16 的患者患有再甲基化缺陷（56%），2/16 的患者患有先天性 B12 缺乏症（13%）。所有患者都接受了标准治疗和主要生物标志物的定期监测。确诊时的平均年龄为 9.2 岁（CBS）和 1.2 岁（再甲基化缺陷）。先天性 B12 缺乏症患者有轻微的发育迟缓，再甲基化缺陷患者有轻度至中度的学习障碍，CBS 患者有不同程度的智力障碍、发育迟缓、眼科异常，并在青春期/成年早期出现血栓。建议对马来西亚儿童进行高同型半胱氨酸血症筛查，以便尽早治疗并改善临床结果。

{"title":"Clinical, biochemical, molecular characteristics and clinical outcome of hyperhomocysteinemia in Malaysian children","authors":"Anasufiza Habib , Hamizah Idrus , Nur Aisyah Abdul Malik , Ainna Mohd Nor , Sofwatul Muktaroh Nasohah , Lip Hen Moey , Lua Seok Hian , Ngu Lock Hock , Nor Azimah Abdul Azize","doi":"10.1016/j.clinbiochem.2024.110828","DOIUrl":"10.1016/j.clinbiochem.2024.110828","url":null,"abstract":"<div><h3>Background</h3><div>Hyperhomocysteinemia can be due to various abnormalities of the complex interaction of methionine, folate and vitamin B12. It has been known to be a cardiovascular risk factor. This study aims to review the clinical presentation, underlying causes and clinical outcome in paediatric patients diagnosed with significant hyperhomocysteinemia in Malaysia.</div></div><div><h3>Design and methods</h3><div>Data were obtained from the medical records and the laboratory information system. Paediatric patients with significant hyperhomocysteinemia were identified from a selective high-risk screening of 96,721 patients, performed between 2010 and 2022. Inclusion criteria for the study were paediatric patients with significant hyperhomocysteinemia (>40 µmol/L).</div></div><div><h3>Results</h3><div>Sixteen patients were identified. The average total homocysteine (tHcy) and methionine were 269 µmol/L and 499 µmol/L in cystathionine β-synthase deficiency (CBS), 127 µmol/L and 29 µmol/L in patients with remethylation defects and 390 µmol/L and 4 µmol/L in congenital B12 deficiency. We found c.609G>A as the most prevalent mutation in <em>MMACHC</em> gene and possible novel mutations for <em>CBS</em> (c.402del, c.1333C>T and c.1031T>G) and <em>MTHFR</em> genes (c.266T>A and c.1249del). Further subclassification revealed CBS was 5/16 patients (31 %), remethylation defects was 9/16 (56 %) and congenital B12 deficiency was 2/16 (13 %). All patients received standard treatment and regular monitoring of the main biomarkers. The average age at the time of diagnosis were 9.2 years (CBS) and 1.2 years (remethylation defects). Congenital B12 deficiency had slight delay in milestones, remethylation defects had mild to moderate learning disabilities, CBS had variable degree of intellectual disability, delayed milestones, ophthalmological abnormalities, and thrombosis at an early adolescent/adulthood.</div></div><div><h3>Conclusions</h3><div>The majority of significant hyperhomocysteinemia in Malaysian children was due to remethylation defects. Screening for hyperhomocysteinemia in Malaysian children is recommended for earlier treatment and improved clinical outcome.</div></div>","PeriodicalId":10172,"journal":{"name":"Clinical biochemistry","volume":"133 ","pages":"Article 110828"},"PeriodicalIF":2.5,"publicationDate":"2024-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142328069","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

Diagnostic value of serum GDF-15 in patients with pseudomyxoma peritonei 假性腹膜肌瘤患者血清 GDF-15 的诊断价值

IF 2.5 3区医学 Q2 MEDICAL LABORATORY TECHNOLOGY

Clinical biochemistry

Pub Date : 2024-09-18 DOI: 10.1016/j.clinbiochem.2024.110827

Bing Wang , Jie Zhang , Ruiqing Ma , Mingjian Bai , Yan Song , Guowei Liang

Background and aims

Pseudomyxoma peritonei (PMP) is a rare malignancy that lacks a highly sensitive and specific biomarker for its diagnosis. Identifying reliable serum markers is crucial for improving the diagnostic accuracy and management of PMP. This study aims to explore the diagnostic value of serum growth differentiation factor 15 (GDF-15) in patients with PMP.

Material and methods

We carried on a 1:1 matched case-control study. 44 patients with PMP hospitalized in Aerospace Center Hospital were recruited as cases, and 44 sex- and age-matched apparently healthy participants were selected as controls. The serum GDF-15 concentrations were tested using an ELISA method. The diagnostic value of GDF-15 in PMP patients was assessed by receiver operating characteristic (ROC) curve analysis.

Results

The median serum GDF-15 level in PMP patients was 1192.77 (843.03–1879.06) pg/mL, notably higher than that in healthy controls [533.27 (410.46–641.47) pg/mL] (P<0.001). The area under the curve (AUC) of serum GDF-15 for PMP diagnosis was 0.907, the optimal diagnostic threshold value was 644.58 pg/mL, the sensitivity was 93.18 %, and the specificity was 77.27 %. The AUC of GDF-15 combined with carbohydrate antigen 125 (CA125) was larger than that of GDF-15 alone (P=0.027), and the sensitivity and specificity achieved 86.36 % and 95.45 %. GDF-15 levels showed a significant correlation with age (P=0.042), with younger PMP patients exhibiting notably lower concentrations of GDF-15 compared to older patients.

Conclusion

Serum GDF-15 could become a new marker for the PMP diagnosis. The combination of GDF-15 and CA125 demonstrated superior diagnostic performance for PMP compared to GDF-15 alone, achieving a sensitivity of 86.36% and a specificity of 95.45%.

背景和目的腹膜假性肌瘤（PMP）是一种罕见的恶性肿瘤，缺乏高灵敏度和特异性的生物标志物用于诊断。确定可靠的血清标志物对于提高 PMP 的诊断准确性和管理至关重要。本研究旨在探讨血清生长分化因子 15（GDF-15）在 PMP 患者中的诊断价值。我们招募了 44 名在航天中心医院住院治疗的 PMP 患者作为病例，并选择了 44 名性别和年龄相匹配的表面健康者作为对照。采用 ELISA 方法检测血清中 GDF-15 的浓度。结果 PMP 患者血清 GDF-15 的中位水平为 1192.77 (843.03-1879.06) pg/mL，明显高于健康对照组 [533.27 (410.46-641.47) pg/mL]（P<0.001）。血清 GDF-15 诊断 PMP 的曲线下面积（AUC）为 0.907，最佳诊断阈值为 644.58 pg/mL，灵敏度为 93.18 %，特异度为 77.27 %。GDF-15与碳水化合物抗原125（CA125）联合检测的AUC大于GDF-15单独检测的AUC（P=0.027），灵敏度和特异度分别为86.36%和95.45%。GDF-15水平与年龄有明显相关性（P=0.042），年轻的PMP患者的GDF-15浓度明显低于年龄较大的患者。与单独检测 GDF-15 相比，GDF-15 和 CA125 联合检测对 PMP 的诊断效果更佳，灵敏度达 86.36%，特异度达 95.45%。

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引用次数: 0

Inter-laboratory variation for urine albumin among laboratories in a Swedish external quality assessment scheme 2005–2023 2005-2023 年瑞典外部质量评估计划中实验室间尿白蛋白的差异

IF 2.5 3区医学 Q2 MEDICAL LABORATORY TECHNOLOGY

Clinical biochemistry

Pub Date : 2024-09-18 DOI: 10.1016/j.clinbiochem.2024.110825

Morgan Lundgren , Peter Ridefelt , Carolina Kristoffersson , Ingegerd Samuelsson , Anders Larsson

Introduction

Increased albuminuria is associated with elevated mortality. Urine albumin (U-ALB) above 20 mg/L or albumin-to-creatinine ratio (U-ACR) of 3 g/mol are indicative of moderately increased albuminuria. Due to limited standardization among U-ALB methods, diagnosis of increased albuminuria might prove difficult.

Materials and methods

Data from Equalis’s external quality assessment scheme for low U-ALB levels during 2005–2023 were categorized according to manufacturer and divided into central laboratory (CLAB) and point-of-care testing (POCT) methods. Manufacturer median values were compared to total group mean consensus values and manufacturer CV% was compared at different U-ALB levels.

Results

CLAB was generally closer to consensus values and had lower CV% than POCT at U-ALB levels around 20 mg/L. For CLAB, Roche methods were approximately equal to consensus U-ALB, Abbott 4 % above, and Siemens 5 % below. For POCT, HemoCue was 1 % below, Siemens 7 % above, and Abbott 8 % below. For U-Creatinine, all manufacturers generally had a good agreement differing on average by 1–4 % from consensus.

Conclusions

Although U-ALB methods generally meet The National Kidney Disease Education Program (NKDEP) recommendations of method bias less than 13 % and imprecision less than 30 %, differences among manufacturers have increased over the last years, with 2023 showing the largest differences between methods. This highlights the need for guidelines for albuminuria and ACR to take method differences into consideration, but also for implementation of suitable urine reference materials.

导言白蛋白尿增加与死亡率升高有关。尿白蛋白（U-ALB）超过 20 毫克/升或白蛋白与肌酐比值（U-ACR）达到 3 克/摩尔表明白蛋白尿中度增加。由于 U-ALB 方法的标准化程度有限，白蛋白尿增加的诊断可能会很困难。材料和方法 2005-2023 年期间 Equalis 外部质量评估计划中的低 U-ALB 水平数据根据制造商进行了分类，并分为中心实验室 (CLAB) 和护理点检测 (POCT) 方法。结果在 U-ALB 水平为 20 mg/L 左右时，CLAB 一般比 POCT 更接近共识值，CV% 也更低。就 CLAB 而言，罗氏方法与共识 U-ALB 大致相当，雅培高出 4%，西门子低 5%。对于 POCT，HemoCue 低 1%，西门子高 7%，雅培低 8%。结论虽然 U-ALB 方法总体上符合美国国家肾脏病教育计划（NKDEP）的建议，即方法偏差小于 13%，不精确度小于 30%，但制造商之间的差异在过去几年中有所增加，2023 年的方法差异最大。这凸显了白蛋白尿和 ACR 指南需要考虑方法差异，同时也需要采用合适的尿液参考材料。

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引用次数: 0

Deteriorated thiol-disulphide and oxidized-reduced glutathione status in blood in Alzheimer’s disease 阿尔茨海默氏症患者血液中的硫醇-二硫化物和氧化还原型谷胱甘肽状况恶化

IF 2.5 3区医学 Q2 MEDICAL LABORATORY TECHNOLOGY

Clinical biochemistry

Pub Date : 2024-09-11 DOI: 10.1016/j.clinbiochem.2024.110817

Canan Akunal , Murat Alisik

Background

Alzheimer’s disease (AD) is a steadily advancing neurodegenerative condition, the occurrence and prevalence of which are on the rise in various populations. Suspected factors contributing to its development encompass the buildup of amyloid β (Aβ) plaques, the formation of neurofibrillary tangles induced by tau proteins, and heightened oxidative stress. In this study, we aimed to evaluate intra-cellular glutathione status and extracellular thiol-disulphide status in patients with AD.

Methods

Adult patients (>60 years old) diagnosed with AD based on DSM-IV diagnostic criteria were included in the study. Patients were divided into 3 groups as mild, moderate and severe according to Mini Mental Status Examination (MMSE) and clinical findings. Extracellular thiol-disulfide and intracellular oxidized-reduced glutathione status parameters for patient and control groups were analyzed before and after reduction procedures by using reaction of thiol groups with DTNB.

Results

The reduced forms of both balances (native thiol (NT) and reduced glutathione (GSH)) were significantly lower in the patient group than the control group (p = 0.031 and <0.001, respectively), while oxidized forms (disulphide (SS) and oxidized glutathione (GSSG)) and SS/NT and GSSG/GSH percent ratios were significantly higher (p < 0.05 for all). The disease duration and oxidative stress were significantly higher in the severe group of AD. There was a shift in intracellular and extracellular thiol balances towards the oxidized side, along with correlations between MMSE and these balances (rho = −0.412 for SS/NT and rho = −0.488 for GSSG/GSH), with GSSG/GSH identified as a significant predictive factor (odds ratio (95 % confidence interval): 1.352 (1.136–1.610) for the moderate group and 1.829 (1.451–2.305) for the severe group.

Conclusions

These findings suggest that blood redox balance is disrupted in AD.

背景阿尔茨海默病（AD）是一种持续发展的神经退行性疾病，其发生率和患病率在不同人群中呈上升趋势。淀粉样β（Aβ）斑块的堆积、由tau蛋白诱导的神经纤维缠结的形成以及氧化应激的加剧都是导致其发病的可疑因素。本研究旨在评估 AD 患者的细胞内谷胱甘肽状态和细胞外硫醇-二硫化物状态。方法纳入根据 DSM-IV 诊断标准确诊为 AD 的成年患者（60 岁）。根据迷你精神状态检查（MMSE）和临床表现将患者分为轻度、中度和重度三组。利用硫醇基团与 DTNB 的反应，分析患者组和对照组在还原程序前后的细胞外硫醇-二硫化物和细胞内氧化-还原谷胱甘肽状态参数。结果患者组中两种平衡的还原型（本硫醇（NT）和还原型谷胱甘肽（GSH））明显低于对照组（p = 0.031 和 <0.001），而氧化型（二硫化物（SS）和氧化型谷胱甘肽（GSSG））以及 SS/NT 和 GSSG/GSH 百分比则明显高于对照组（均为 p <0.05）。重度AD组的病程和氧化应激明显更长。细胞内和细胞外的硫醇平衡向氧化一侧偏移，MMSE 与这些平衡之间存在相关性（SS/NT 的 rho = -0.412，GSSG/GSH 的 rho = -0.488），GSSG/GSH 被认为是一个重要的预测因素（几率比（95 % 置信区间）：1.352（1.13% 置信区间））：结论这些研究结果表明，AD 患者的血液氧化还原平衡受到破坏。

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引用次数: 0

In vivo and in vitro relationship between ionized magnesium and ionized calcium 离子镁和离子钙在体内和体外的关系。

IF 2.5 3区医学 Q2 MEDICAL LABORATORY TECHNOLOGY

Clinical biochemistry

Pub Date : 2024-09-04 DOI: 10.1016/j.clinbiochem.2024.110815

Wouter M. Tiel Groenestege , Ron H. Stokwielder , Leosa R. Soels , Maaike A. Sikma , Tim J.A. Hutten

Objectives

The objective of this study was to determine the in vivo correlation of ionized magnesium (iMg) with ionized calcium (iCa), total calcium, albumin and pH. In addition, the analytical interference of iCa on iMg measurement on the Stat Profile Prime Plus (Nova Biomedical) and vice versa was defined.

Methods

In vivo correlation of iCa, iMg and pH was studied in 238 paired blood gas samples of 109 different patients admitted to the intensive care unit. Albumin and total magnesium (tMg) were measured in heparinized plasma samples. Measurement of iMg was performed with the ion selective magnesium electrode (ISE) of the Stat Profile Prime Plus (Nova Biomedical) and iCa and pH were measured with a Rapid Point 500 blood gas analyzer (Siemens). Albumin, total calcium and total magnesium were analyzed with a Siemens Atellica CH. Analytical interference of iCa with iMg and vice versa was investigated using unbuffered saline solutions.

Results

In the studied patient population, no significant correlations were observed between iMg and iCa, albumin, and pH. An inverse relationship was observed between iCa and Mg-ISE. For every 0.1 mmol/L change in iCa concentration, the iMg concentration deviated by 0.01 mmol/L at an iMg concentration of 0.5 mmol/L and by 0.013 mmol/L at an iMg concentration of 1.0 mmol/L. The measurement of iCa was not affected by iMg.

Conclusions

In vivo, no correlation was observed between iMg with iCa, albumin and pH. Interference of iCa on iMg measurement was noted, with a maximum deviation of ±0.02 mmol/L iMg across the reference range of iCa (1.15–1.32 mmol/L). Additionally, the iCa measurement was not affected by the iMg concentration.

研究目的本研究旨在确定体内离子化镁（iMg）与离子化钙（iCa）、总钙、白蛋白和 pH 值的相关性。此外，还确定了 iCa 对 Stat Profile Prime Plus（Nova Biomedical）上 iMg 测量的分析干扰，反之亦然：方法：研究了重症监护室 109 名不同患者的 238 份配对血气样本中 iCa、iMg 和 pH 的体内相关性。在肝素化血浆样本中测量了白蛋白和总镁（tMg）。iMg 用 Stat Profile Prime Plus（Nova Biomedical）的离子选择性镁电极（ISE）测量，iCa 和 pH 用 Rapid Point 500 血气分析仪（西门子）测量。使用西门子 Atellica CH 分析白蛋白、总钙和总镁。使用无缓冲生理盐水溶液研究了 iCa 对 iMg 的分析干扰，以及 iMg 对 iCa 的分析干扰：结果：在所研究的患者群体中，未观察到 iMg 与 iCa、白蛋白和 pH 值之间存在明显的相关性。iCa 和 Mg-ISE 之间呈反比关系。iCa 浓度每变化 0.1 毫摩尔/升，iMg 浓度就会偏离 0.01 毫摩尔/升（iMg 浓度为 0.5 毫摩尔/升）；iMg 浓度为 1.0 毫摩尔/升，iMg 浓度就会偏离 0.013 毫摩尔/升。iCa 的测量不受 iMg 的影响：在体内，iMg 与 iCa、白蛋白和 pH 之间没有相关性。注意到 iCa 对 iMg 测量的干扰，在 iCa 的参考范围（1.15-1.32 mmol/L）内，iMg 的最大偏差为 ±0.02 mmol/L。此外，iCa 测量不受 iMg 浓度的影响。

{"title":"In vivo and in vitro relationship between ionized magnesium and ionized calcium","authors":"Wouter M. Tiel Groenestege , Ron H. Stokwielder , Leosa R. Soels , Maaike A. Sikma , Tim J.A. Hutten","doi":"10.1016/j.clinbiochem.2024.110815","DOIUrl":"10.1016/j.clinbiochem.2024.110815","url":null,"abstract":"<div><h3>Objectives</h3><p>The objective of this study was to determine the in vivo correlation of ionized magnesium (iMg) with ionized calcium (iCa), total calcium, albumin and pH. In addition, the analytical interference of iCa on iMg measurement on the Stat Profile Prime Plus (Nova Biomedical) and vice versa was defined.</p></div><div><h3>Methods</h3><p>In vivo correlation of iCa, iMg and pH was studied in 238 paired blood gas samples of 109 different patients admitted to the intensive care unit. Albumin and total magnesium (tMg) were measured in heparinized plasma samples. Measurement of iMg was performed with the ion selective magnesium electrode (ISE) of the Stat Profile Prime Plus (Nova Biomedical) and iCa and pH were measured with a Rapid Point 500 blood gas analyzer (Siemens). Albumin, total calcium and total magnesium were analyzed with a Siemens Atellica CH. Analytical interference of iCa with iMg and vice versa was investigated using unbuffered saline solutions.</p></div><div><h3>Results</h3><p>In the studied patient population, no significant correlations were observed between iMg and iCa, albumin, and pH. An inverse relationship was observed between iCa and Mg-ISE. For every 0.1 mmol/L change in iCa concentration, the iMg concentration deviated by 0.01 mmol/L at an iMg concentration of 0.5 mmol/L and by 0.013 mmol/L at an iMg concentration of 1.0 mmol/L. The measurement of iCa was not affected by iMg.</p></div><div><h3>Conclusions</h3><p>In vivo, no correlation was observed between iMg with iCa, albumin and pH. Interference of iCa on iMg measurement was noted, with a maximum deviation of ±0.02 mmol/L iMg across the reference range of iCa (1.15–1.32 mmol/L). Additionally, the iCa measurement was not affected by the iMg concentration.</p></div>","PeriodicalId":10172,"journal":{"name":"Clinical biochemistry","volume":"133 ","pages":"Article 110815"},"PeriodicalIF":2.5,"publicationDate":"2024-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0009912024001097/pdfft?md5=cfeee0d962ed4277d52c9c1c630cb302&pid=1-s2.0-S0009912024001097-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142145246","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

Heart failure biomarkers and prediction of early left ventricle remodeling after acute coronary syndromes 心力衰竭生物标志物和急性冠状动脉综合征后左心室早期重塑的预测。

IF 2.5 3区医学 Q2 MEDICAL LABORATORY TECHNOLOGY

Clinical biochemistry

Pub Date : 2024-08-31 DOI: 10.1016/j.clinbiochem.2024.110814

Alberto Cordero , Irene Velasco , Emilio Flores , José Mª López-Ayala , Sonia Sánchez-Munuera , Mª Pilar Muñoz-Villalba , Alejandro Selva-Mora , Francisco Galán-Giménez , Rafael de la Espriella , Julio Nuñez

Introduction

Several biomarkers are characteristically elevated in patients with acute heart failure (AHF). Our hypothesis was they could predict early changes in left ventricular (LV) characteristics in acute coronary syndrome (ACS) patients. The objective of this study was two-fold: a) compare circulating concentrations of NT-pro BNP, CA-125, ST2, galectin-3 and pro-adrenomedullin among 4 groups of individuals (healthy controls; patients with ACS without AHF; patients with ACS and AHF and patients admitted for AHF); and b) evaluate whether these biomarkers predict adverse LV remodeling and ejection fraction changes in ACS.

Methods

6 biomarkers (NT-pro BNP, CA-125, ST2, galectin-3, pro-adrenomedullin and C-reactive) were measured within the first 48 h of admission. Echocardiograms were performed during admission and at 3 months. Variables associated with LV end-diastolic volume (EDV) and ejection fraction (LVEF) change were assessed by multivariate linear regression.

Results

We analyzed 51 patients with ACS, 16 with AHF and, 20 healthy controls. NT-pro BNP and ST2 concentrations were elevated at similar values in patients admitted for AHF and ACS complicated with HF but CA-125 concentrations were higher in AHF patients. NT-pro BNP concentrations were positively correlated with CA-125 (rho = 0.58; p < 0.001), ST2 (rho = 0.58; p < 0.001) and galectin-3 (rho = 0.37; p < 0.001)

Median change (median days was 83 days after) in EDV and LVEF was 5 %. CA-125 concentrations were positively associated to LV EDV change (β-coefficient 1.56) and negatively with LVEF trend (β-coefficient = −0.86). No other biomarker predicted changes in EDV or LVEF.

Conclusions

CA-125 correlates with early LV remodeling and LVEF deterioration in ACS patients.

简介急性心力衰竭（AHF）患者体内有几种生物标志物明显升高。我们的假设是，它们可以预测急性冠状动脉综合征（ACS）患者左心室特征的早期变化。本研究的目的有两个：a）比较四组人群（健康对照组、无急性心力衰竭的急性冠状动脉综合征患者、急性心力衰竭的急性冠状动脉综合征患者和因急性心力衰竭入院的患者）中 NT-pro BNP CA-125、ST2、galectin-3 和 pro-adrenomedullin 的循环浓度；b）评估这些生物标志物是否能预测急性冠状动脉综合征患者左心室的不良重构和射血分数的变化。方法：在入院后 48 小时内测量 6 种生物标志物（NT-pro BNP、CA-125、ST2、galectin-3、pro-肾上腺髓质素和 C-反应）。在入院期间和 3 个月时进行超声心动图检查。通过多变量线性回归评估了与左心室舒张末期容积（EDV）和射血分数（LVEF）变化相关的变量：我们分析了 51 名 ACS 患者、16 名 AHF 患者和 20 名健康对照者。AHF患者和ACS并发HF患者的NT-pro BNP和ST2浓度升高值相似，但AHF患者的CA-125浓度更高。NT-pro BNP 浓度与 CA-125 呈正相关（rho = 0.58；p 结论：NT-pro BNP 浓度与 CA-125 呈正相关：CA-125与ACS患者早期左心室重构和LVEF恶化相关。

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引用次数: 0

Serum glucose mediated association of serum lactate with acute kidney injury among AIS patients 血清葡萄糖介导的血清乳酸与 AIS 患者急性肾损伤的关系。

IF 2.5 3区医学 Q2 MEDICAL LABORATORY TECHNOLOGY

Clinical biochemistry

Pub Date : 2024-08-31 DOI: 10.1016/j.clinbiochem.2024.110816

Chunli Yu , Weiguo Yao , Kun Liu , Dingzhong Tang

Background

The serum lactate level has been confirmed to be an independent risk factor for the occurrence of acute kidney injury (AKI) in many diseases. However, the correlation between serum lactate level and AKI in critical patients with acute ischemic stroke (AIS) has not been clear. Moreover, limited studies have examined the mediating effect of serum glucose on the association between serum lactate and AKI.

Methods

We identified 1,435 AIS patients from the Medical Information Mart for Intensive Care (MIMIC-III) database and divided them into AKI or No-AKI groups. We used a propensity score matching method to reduce confounding factors. Linear regression, logistic regression, and restricted cubic splines (RCS) plots were used to evaluate relationships between serum lactate levels and AKI. Finally, the mediating role of serum glucose on the relationship between serum lactate and AKI was investigated utilizing the mediation analysis.

Results

In the present study, a total of 634 critical patients aged ≥ 18 years with AIS were included after propensity score matching (1:1). We used RCS plotting to reveal a linear association between serum lactate levels and AKI (P for nonlinearity < 0.001). After full adjustment for potential confounders (Model 3), high lactate levels increased the risk of AKI (odds ratio, 2.216; 95 % confidence interval, 1.559–3.271; P-value < 0.001). Serum glucose explained 14.9 % of the association between serum lactate and AKI among critical patients with AIS (P-value < 0.001), 16.4 % among patients with AIS and diabetes mellitus (DM) (P-value = 0.24), and 19.5 % among patients with AIS and without DM (P-value < 0.001).

Conclusion

Serum lactate was independently associated with increased risk-adjusted AKI in critical patients with AIS. The increase in serum glucose may have mediated this effect, especially in patients without DM.

背景：血清乳酸水平已被证实是许多疾病发生急性肾损伤（AKI）的独立危险因素。然而，急性缺血性卒中（AIS）危重患者血清乳酸水平与 AKI 之间的相关性尚未明确。此外，关于血清葡萄糖对血清乳酸与 AKI 之间关联的中介作用的研究也很有限：我们从重症监护医学信息市场（MIMIC-III）数据库中确定了 1,435 名 AIS 患者，并将其分为 AKI 组和无 AKI 组。我们采用倾向得分匹配法来减少混杂因素。我们使用线性回归、逻辑回归和限制性立方样条（RCS）图来评估血清乳酸水平与 AKI 之间的关系。最后，利用中介分析研究了血清葡萄糖对血清乳酸与 AKI 之间关系的中介作用：本研究共纳入了 634 名年龄≥ 18 岁的 AIS 危重患者，并进行了倾向评分匹配（1:1）。我们使用 RCS 图显示了血清乳酸水平与 AKI 之间的线性关系（P 为非线性结论）：在 AIS 危重患者中，血清乳酸与风险调整后的 AKI 增加有独立关联。血清葡萄糖的升高可能是这一效应的介导因素，尤其是在非糖尿病患者中。

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引用次数: 0