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Lipidomic profiling in patients with familial hypercholesterolemia: Abnormalities in glycerolipids and oxysterols 家族性高胆固醇血症患者的脂质体分析:甘油三酯和氧杂醇异常
IF 2.5 3区 医学 Q2 MEDICAL LABORATORY TECHNOLOGY Pub Date : 2024-08-27 DOI: 10.1016/j.clinbiochem.2024.110812
Shiva Ganjali , Vladimiro Cardenia , Ambra Bonciolini , Raul D. Santos , Khalid Al-Rasadi , Amirhossein Sahebkar

Objectives and aim

This study aimed to identify precise biomarkers and develop targeted therapeutic strategies for preventing premature atherosclerotic cardiovascular disease in patients with familial hypercholesterolemia (FH) by investigating the quantitative and qualitative abnormalities in the metabolic network of lipids in these patients using an advanced lipidomics platform.

Design & Methods

The study population comprised 18 homozygous (HoFH), 18 heterozygous (HeFH) FH patients, and 20 healthy controls. Cholesterol oxidation products (oxysterol, COPs) and main lipid classes were determined using gas chromatography–mass spectrometry. Results were expressed as percentages of total fat matter for lipid classes and percentages of total COPs for oxysterols. The principal component analysis (PCA) was also carried out, to highlight the correlation between studied parameters and groups investigated.

Results

Patients (both HoFH and HeFH) showed lower content of free fatty acids (FFAs) and greater values of triacylglycerols (TAGs) in comparison to controls. HoFH showed lower monoacylglycerols (P<0.01) and higher free cholesterol (FC) (P<0.05) when compared to HeFH and controls. The total content of COPs ranged from 1.96 to 4.25 mg/dL, from 2.27 to 4.05 mg/dL, and from 0.79 to 4.12 mg/dL in healthy controls, HoFH and HeFH groups, respectively, with no significant differences between patients and controls. In general, the 7α-hydroxycholesterol (7α-HC) was greater than other COPs. However, no significant differences were found between the three studied groups. Moreover, an opposite trend was observed between 7α-HC and 7-ketocholesterol (7-KC). Additionally, when PCA was carried out, the first two PCs explained 92.13 % of the total variance, of which the PC1 describes 53.94 % of variance mainly correlated to TAGs, diacylglycerols (DAGs), and 7-KC. On the other hand, the PC2 was correlated primarily for FFAs, FC and esterified sterols (E-STE).

Conclusions

In conclusion, abnormal levels of TAGs, DAGs and 7-KC were associated with HeFH while HoFH was associated with the abnormal amount of E-STE.

目的和目标本研究旨在利用先进的脂质组学平台研究家族性高胆固醇血症(FH)患者脂质代谢网络的定量和定性异常,从而确定精确的生物标志物,并制定有针对性的治疗策略,预防这些患者过早患上动脉粥样硬化性心血管疾病。采用气相色谱-质谱法测定胆固醇氧化产物(氧基甾醇,COPs)和主要脂质类别。脂质类别的结果以脂肪总量的百分比表示,氧化甾醇的结果以 COPs 总量的百分比表示。与对照组相比,患者(HoFH 和 HeFH)的游离脂肪酸 (FFA) 含量较低,三酰甘油 (TAG) 含量较高。与 HeFH 和对照组相比,HoFH 表现出较低的单酰甘油(P<0.01)和较高的游离胆固醇(FC)(P<0.05)。健康对照组、HoFH 组和 HeFH 组的 COP 总含量分别为 1.96 至 4.25 mg/dL、2.27 至 4.05 mg/dL 和 0.79 至 4.12 mg/dL,患者与对照组之间无显著差异。一般来说,7α-羟基胆固醇(7α-HC)高于其他 COPs。不过,三个研究组之间没有发现明显差异。此外,7α-HC 和 7-酮胆固醇(7-KC)之间也出现了相反的趋势。此外,在进行 PCA 分析时,前两个 PC 解释了总方差的 92.13%,其中 PC1 解释了 53.94%的方差,主要与 TAG、二酰甘油(DAG)和 7-KC 相关。结论总之,TAGs、DAGs 和 7-KC 水平异常与 HeFH 有关,而 HoFH 与 E-STE 的异常量有关。
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引用次数: 0
Low concentration of serum vitamin B12 may be a strong predictor of large-artery atherosclerosis stroke: A case-control study 血清维生素 B12 浓度低可能是预测大动脉粥样硬化性中风的一个重要因素:病例对照研究
IF 2.5 3区 医学 Q2 MEDICAL LABORATORY TECHNOLOGY Pub Date : 2024-08-26 DOI: 10.1016/j.clinbiochem.2024.110813
Xia Chen , Pingping Yu , Li Zhou , Yongjun Tan , Jiani Wang , Yilin Wang , Youlin Wu , Xiaosong Song , Qin Yang

Introduction

Identifying controllable risk factors for large-artery atherosclerosis (LAA) stroke is crucial due to its significant role as a leading cause of ischemic stroke. We aimed to validate the correlation of serum vitamin B12 with LAA stroke.

Methods

Inpatients with LAA stroke and healthy controls were retrospectively collected for a case-control study from January 2020 to May 2022. Serum vitamin B12 concentration and other blood indicators, demographic, lifestyle factors and comorbidities were investigated. Logistic regression analysis was used to identify the correlation of serum vitamin B12 concentrations with LAA stroke, meanwhile adjusted for confounding factors.

Results

Patients with LAA stroke had significantly lower serum vitamin B12 concentrations in comparison to those of controls. In the fully adjusted model, vitamin B12 (per 1 interquartile range increase, odds ratio [OR] = 0.84, 95 % confidence interval [CI]: 0.77–0.91), vitamin B12 < 200 pg/mL (OR=7.70, 95 %CI: 2.19–27.03) and vitamin B12 < 300 pg/mL (OR=4.19, 95 %CI: 1.82–9.66) were independently factors for LAA stroke. Furthermore, the optimal cut-off values for vitamin B12 to predict LAA stroke were 305.25 pg/mL (area under the curve [AUC] = 0.71) when unadjusted and 308.25 pg/mL when adjusted for age and sex (AUC=0.68). Lower vitamin B12 concentrations were significantly associated with male sex, smoking, older age, higher neutrophil count, higher creatinine, lower folate and higher total homocysteine.

Conclusion

Results indicate that low concentration of serum vitamin B12 may be a strong predictor for the risk of LAA stroke.

导言由于大动脉粥样硬化性脑卒中(LAA)是缺血性脑卒中的主要病因,因此确定其可控风险因素至关重要。我们的目的是验证血清维生素 B12 与 LAA 中风的相关性。研究调查了血清维生素 B12 浓度和其他血液指标、人口统计学因素、生活方式因素和合并症。结果与对照组相比,LAA脑卒中患者的血清维生素B12浓度明显较低。0.77-0.91)、维生素 B12 < 200 pg/mL(OR=7.70,95 %CI:2.19-27.03)和维生素 B12 < 300 pg/mL(OR=4.19,95 %CI:1.82-9.66)是导致 LAA 中风的独立因素。此外,预测 LAA 中风的维生素 B12 最佳临界值未经调整时为 305.25 pg/mL(曲线下面积 [AUC] = 0.71),根据年龄和性别调整后为 308.25 pg/mL(AUC=0.68)。维生素 B12 浓度较低与男性、吸烟、年龄较大、中性粒细胞计数较高、肌酐较高、叶酸较低和总同型半胱氨酸较高明显相关。
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引用次数: 0
New Psychoactive Substances: A Canadian perspective on emerging trends and challenges for the clinical laboratory 新型精神活性物质:从加拿大的角度看临床实验室面临的新趋势和新挑战。
IF 2.5 3区 医学 Q2 MEDICAL LABORATORY TECHNOLOGY Pub Date : 2024-08-23 DOI: 10.1016/j.clinbiochem.2024.110810
Jessica J. Miller , Mehrdad Yazdanpanah , David A. Colantonio , Daniel R. Beriault , Sarah R. Delaney
The production and use of New Psychoactive Substances (NPS) has skyrocketed over the last decade, causing major challenges for government authorities, public health agencies, and laboratories across the world. NPS are designed to mimic the psychoactive effects of unregulated or controlled drugs, while constantly being modified to evade drug control regulation. Hence, they are referred to as “legal highs”, as they are technically legal to sell, possess, and use. NPS can be classified by their pharmacological mechanism of action and include cannabimimetic, depressants, dissociatives, hallucinogens, opioids, and stimulants. There is significant structural diversity within each NPS class, leading to variable detection using traditional clinical laboratory testing and complicating the interpretation of results. In this article, we review each of the NPS classes and summarize their associated mechanism of action, common structures, and metabolic pathways, and provide examples of recent drugs and emerging threats with a focus on Canadian drug trends. We also explore the current analytical advantages and limitations commonly faced by the clinical laboratory and provide insight on how toxicosurveillance can improve detection of NPS in the ever-changing NPS landscape.
过去十年来,新型精神活性物质(NPS)的生产和使用激增,给世界各地的政府当局、公共卫生机构和实验室带来了重大挑战。新型精神活性物质旨在模仿未受管制或受管制药物的精神活性作用,同时不断改良以逃避药物管制条例。因此,它们被称为 "合法兴奋剂",因为从技术上讲,它们的销售、拥有和使用都是合法的。非兴奋剂可按其药理作用机制分类,包括大麻拟物、抑制剂、解离剂、致幻剂、类阿片和兴奋剂。每一类 NPS 在结构上都有很大的差异,导致传统临床实验室检测的结果各不相同,并使结果的解释变得复杂。在本文中,我们回顾了每一类 NPS,总结了它们的相关作用机制、常见结构和代谢途径,并以加拿大的毒品趋势为重点,举例说明了最近的毒品和新出现的威胁。我们还探讨了临床实验室目前普遍面临的分析优势和局限性,并就毒物监测如何在不断变化的 NPS 环境中改进 NPS 检测提供了见解。
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引用次数: 0
Preanalytical and analytical factors affecting elastase quantitation in stool 影响粪便中弹性蛋白酶定量的分析前和分析因素。
IF 2.5 3区 医学 Q2 MEDICAL LABORATORY TECHNOLOGY Pub Date : 2024-08-15 DOI: 10.1016/j.clinbiochem.2024.110811
Heather A. Nelson

Exocrine pancreatic insufficiency (EPI) is a condition caused by a deficiency of exocrine pancreatic enzymes, resulting in malabsorption of nutrients. Clinical manifestations of EPI may include steatorrhea, weight loss, diarrhea, and abdominal pain. Although direct testing is the most sensitive and specific for EPI, these tests are invasive, time consuming, expensive, and not well standardized. Fecal elastase (FE-1) has been shown to be an indirect marker of the exocrine secretory capacity of the pancreas and has become the most commonly employed indirect test for diagnosis of EPI. Measurement of fecal elastase consists of two main phases, a preanalytical phase and analytical phase. The preanalytical phase involves stool collection, storage and handling. The second phase is the analytical phase, which includes the actual assay processes and products used to produce a result. For FE-1 this includes sample extraction and measurement on an immunoassay. Each step in the process can influence the result and contribute to heterogeneity in FE-1 measurement, potentially impacting clinical diagnosis and management. Thus, this paper provides an overview of the preanalytical and analytical factors that can affect measurement and interpretation of FE-1 results.

胰腺外分泌功能不全(EPI)是一种因缺乏胰腺外分泌酶而导致营养吸收不良的疾病。EPI 的临床表现可能包括脂肪泻、体重减轻、腹泻和腹痛。虽然直接检测对 EPI 最为敏感和特异,但这些检测具有侵入性、耗时、昂贵且标准化程度不高。粪便弹性蛋白酶(FE-1)已被证明是胰腺外分泌能力的间接标志物,并已成为诊断 EPI 最常用的间接检测方法。粪便弹性蛋白酶的测定包括两个主要阶段,即分析前阶段和分析阶段。分析前阶段包括粪便收集、储存和处理。第二个阶段是分析阶段,包括实际检测过程和用于产生结果的产品。对于 FE-1 而言,这包括样本提取和免疫测定。流程中的每个步骤都会影响结果,并导致 FE-1 测量的不一致性,从而对临床诊断和管理产生潜在影响。因此,本文概述了可能影响 FE-1 测量和结果解读的分析前和分析因素。
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引用次数: 0
Is there any association between blood glycoalkaloid levels and anencephaly in human? 人类血液中的糖醛酸水平与无脑畸形之间是否存在关联?
IF 2.5 3区 医学 Q2 MEDICAL LABORATORY TECHNOLOGY Pub Date : 2024-08-03 DOI: 10.1016/j.clinbiochem.2024.110809
Emre Ekmekci , Alev Esercan , Orhan Yanar , Yasin Yakar , Eyup Yasar

Aim

In various experimental animal studies, it has been proven that solanine, a subtype of glycoalkaloids, is responsible for neural tube defects. However, there have not been any human studies yet in this area. Our aim is to investigate whether there are any connections between blood glycoalkaloid levels and anencephaly in humans.

Methods

Blood and amniotic fluid samples were taken from patients diagnosed with fetal anencephaly during pregnancy. The samples from patients with normal pregnancies were taken as well and was compared to the patients with fetal anencephaly during pregnancy. We searched the levels of three glycoalkaloids: solanine, chaconine and solamargine in the collected samples.

Results

Solanine, which is one of the glycoalkaloids, could not be detected in both serum and amniotic fluid in the anencephaly as well as the control groups. However, alpha-solamargine levels were observed to be significantly higher in the blood and amniotic fluid samples of the control group than in the study group (p = 0.04). Alpha-chaconine levels were also significantly higher in the control group (p < 0.001) as well.

Conclusion

Based on our tests, we can conclude that no connections were found between blood solanine levels and anencephaly during pregnancy. Alpha-chaconine and alpha-solamargine levels were observed to be higher in blood and amniotic fluid in pregnancies without anencephaly. The relationship between glycoalkaloids and congenital anomalies needs to be further investigated in tissues other than blood.

目的:在各种动物实验研究中,已证实茄碱(一种糖类生物碱)是导致神经管畸形的原因。然而,目前还没有这方面的人体研究。我们的目的是研究血液中的糖类生物碱水平与人类无脑畸形之间是否存在联系:方法:从妊娠期被诊断为胎儿无脑畸形的患者身上采集血液和羊水样本。我们还从正常妊娠患者身上采集了样本,并与妊娠期胎儿无脑畸形患者进行了比较。我们检测了采集样本中三种糖生物碱的含量:茄碱、查康碱和茄马碱:结果:在无脑畸形组和对照组的血清和羊水中均未检测到作为糖生物碱之一的茄碱。不过,在对照组的血液和羊水样本中,α-茄碱的水平明显高于研究组(p = 0.04)。对照组的α-可可碱水平也明显高于研究组(p 结论:研究组的α-可可碱水平明显高于对照组:根据测试结果,我们可以得出结论,血液中的茄碱水平与孕期无脑畸形之间没有关联。在没有无脑畸形的孕妇中,血液和羊水中的α-查可宁和α-索拉马宁水平较高。糖生物碱与先天性畸形之间的关系需要在血液以外的组织中进一步研究。
{"title":"Is there any association between blood glycoalkaloid levels and anencephaly in human?","authors":"Emre Ekmekci ,&nbsp;Alev Esercan ,&nbsp;Orhan Yanar ,&nbsp;Yasin Yakar ,&nbsp;Eyup Yasar","doi":"10.1016/j.clinbiochem.2024.110809","DOIUrl":"10.1016/j.clinbiochem.2024.110809","url":null,"abstract":"<div><h3>Aim</h3><p>In various experimental animal studies, it has been proven that solanine, a subtype of glycoalkaloids, is responsible for neural tube defects. However, there have not been any human studies yet in this area. Our aim is to investigate whether there are any connections between blood glycoalkaloid levels and anencephaly in humans.</p></div><div><h3>Methods</h3><p>Blood and amniotic fluid samples were taken from patients diagnosed with fetal anencephaly during pregnancy. The samples from patients with normal pregnancies were taken as well and was compared to the patients with fetal anencephaly during pregnancy. We searched the levels of three glycoalkaloids: solanine, chaconine and solamargine in the collected samples.</p></div><div><h3>Results</h3><p>Solanine, which is one of the glycoalkaloids, could not be detected in both serum and amniotic fluid in the anencephaly as well as the control groups. However, alpha-solamargine levels were observed to be significantly higher in the blood and amniotic fluid samples of the control group than in the study group (p = 0.04). Alpha-chaconine levels were also significantly higher in the control group (p &lt; 0.001) as well.</p></div><div><h3>Conclusion</h3><p>Based on our tests, we can conclude that no connections were found between blood solanine levels and anencephaly during pregnancy. Alpha-chaconine and alpha-solamargine levels were observed to be higher in blood and amniotic fluid in pregnancies without anencephaly. The relationship between glycoalkaloids and congenital anomalies needs to be further investigated in tissues other than blood.</p></div>","PeriodicalId":10172,"journal":{"name":"Clinical biochemistry","volume":"131 ","pages":"Article 110809"},"PeriodicalIF":2.5,"publicationDate":"2024-08-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0009912024001036/pdfft?md5=2eca97020e2cd39e9ef4e0d92a73e9d8&pid=1-s2.0-S0009912024001036-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141892996","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
A new assay falsely increases lactate dehydrogenase in plasma but not in serum 一种新的检测方法会错误地增加血浆中的乳酸脱氢酶,但不会增加血清中的乳酸脱氢酶
IF 2.5 3区 医学 Q2 MEDICAL LABORATORY TECHNOLOGY Pub Date : 2024-07-28 DOI: 10.1016/j.clinbiochem.2024.110804
Mads Skytte Rasmussen , Lise Pedersen

Introduction

Serum is the International Federation of Clinical Chemistry (IFCC)-recommended matrix for the measurement of lactate dehydrogenase (LD); however, many laboratories opt for lithium heparin plasma to achieve quicker turnaround times and minimize tube usage.

When introducing the new Sigma-Strong IFCC-recommended LDH2 assay from Abbott Laboratories on lithium-heparin collected samples, we observed a rise in the patient median LD activity as well as several samples exhibiting falsely elevated values.

Materials and methods

120 + serum and plasma samples from consenting patients were collected and evaluated for complete blood count and lactate dehydrogenase using two different assays. Aggregated patient results before and after introduction of the LDH2 assay were compared.

Results

Mean LD was 14% higher in plasma than in serum when using the LDH2 assay but only 5% higher when using the previous LDH legacy assay from Abbott Laboratories. Similarly, platelets and leukocytes were 10–30 times higher in plasma than in serum. Aggregated lactate dehydrogenase patient results demonstrated a dramatic increase in patient median following introduction of the LDH2 assay. Various experiments were tried to reduce cellular interference, but the only viable solution we found, apart from reverting to the LDH legacy assay, was to utilize serum tubes.

Conclusion

We conclude that lithium-heparin plasma leads to falsely elevated lactate dehydrogenase activity when using the LDH2 assay. These errors can be prevented by using serum collected in gel separator tubes.

导言:血清是国际临床化学联合会(IFCC)推荐用于测定乳酸脱氢酶(LD)的基质;然而,许多实验室选择使用肝素锂血浆,以实现更快的周转时间并最大限度地减少试管用量。在将雅培实验室新推出的 Sigma-Strong IFCC 推荐的 LDH2 检测法引入锂肝素采集的样本时,我们观察到患者 LD 活性的中位数有所上升,而且有几个样本的值出现了假性升高。材料与方法 120 + 经患者同意采集的血清和血浆样本,并使用两种不同的检测法对其进行全血细胞计数和乳酸脱氢酶评估。结果 使用 LDH2 检测法时,血浆中的平均乳酸脱氢酶比血清中高 14%,而使用雅培实验室以前的 LDH 传统检测法时仅高 5%。同样,血浆中的血小板和白细胞也比血清中高 10-30 倍。患者的乳酸脱氢酶聚集结果表明,采用 LDH2 检测法后,患者的中位数急剧增加。我们尝试了各种实验来减少细胞干扰,但除了重新使用 LDH 传统测定法外,我们发现唯一可行的办法就是使用血清试管。使用凝胶分离管收集血清可以避免这些错误。
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引用次数: 0
Over-expression of KRT17 and MDK genes at mRNA levels in urine-exfoliated cells is associated with early non-invasive diagnosis of non-muscle-invasive bladder cancer 尿液脱落细胞中 KRT17 和 MDK 基因 mRNA 水平的过度表达与非肌层浸润性膀胱癌的早期非侵入性诊断有关。
IF 2.5 3区 医学 Q2 MEDICAL LABORATORY TECHNOLOGY Pub Date : 2024-07-26 DOI: 10.1016/j.clinbiochem.2024.110808
Parisa Dayati , Nasser Shakhssalim , Abdolamir Allameh

Introduction

Current diagnostic approaches for bladder cancer (BLCA) are often invasive or lack the required sensitivity and specificity. This underscores the need for an early non-invasive diagnostic test for BLCA. This work aimed to explore the potential of molecular markers in urine-exfoliated cells for the diagnosis of non-muscle-invasive bladder cancer (NMIBC).

Materials and methods

Urine specimens (n = 140) were collected from NMIBC patients (n = 68) and control subjects (31 healthy volunteers and 41 non-cancer patients with common urological diseases [CUD]. Total RNA was extracted from the cells isolated from urine specimens. mRNA expression of selected genes: CDC20, KRT15, FOXM1, CXCR2, UPK1B, MDK, KRT20, and KRT17 was determined using RT-qPCR. The receiver operating characteristic (ROC) curve was then plotted to obtain the area under the curve (AUC), specificity, and sensitivity of the urinary mRNA markers.

Results

The expression of CDC20, MDK, UPK1B, FOXM1, KRT17, and KRT20 was up-regulated in samples obtained from low- and high-grade pathological grades of NMIBC compared to that measured in healthy subjects. Notably, MDK and KRT17 mRNA levels in the low- and high-grade cases were substantially higher than in normal and CUD groups. The AUC of the KRT17 and MDK combination in diagnosing NMIBC was 0.92, surpassing that of single genes. The sensitivity and specificity of the KRT17 and MDK combination were 74% and 94%, respectively. In diagnosing low-grade from healthy and CUD groups, analysis of the KRT17 and MDK combination yielded AUCs of 0.94 and 0.95, respectively, with sensitivities of 85% and 97%, and specificities of 93% and 85%.

Conclusion

The findings of this study revealed that KRT17 and MDK together are potential urine-based biomarkers for early diagnosis of NMIBC.

导言:目前诊断膀胱癌(BLCA)的方法通常都是侵入性的,或者缺乏所需的灵敏度和特异性。这凸显了对膀胱癌早期非侵入性诊断测试的需求。这项工作旨在探索尿液脱落细胞中分子标记物诊断非肌层浸润性膀胱癌(NMIBC)的潜力:收集非肌层浸润性膀胱癌患者(68 人)和对照组(31 名健康志愿者和 41 名患有常见泌尿系统疾病的非癌症患者 [CUD])的尿液标本(140 人)。从尿液标本中分离的细胞中提取总 RNA:采用 RT-qPCR 测定 CDC20、KRT15、FOXM1、CXCR2、UPK1B、MDK、KRT20 和 KRT17 等选定基因的 mRNA 表达。然后绘制接收者操作特征曲线(ROC),得出尿液 mRNA 标记的曲线下面积(AUC)、特异性和灵敏度:结果:与健康人相比,低度和高度病理性NMIBC样本中CDC20、MDK、UPK1B、FOXM1、KRT17和KRT20的表达上调。值得注意的是,低级别和高级别病例中的 MDK 和 KRT17 mRNA 水平大大高于正常组和 CUD 组。KRT17 和 MDK 组合诊断 NMIBC 的 AUC 为 0.92,超过了单个基因。KRT17和MDK组合的灵敏度和特异度分别为74%和94%。在从健康组和 CUD 组诊断低级别时,对 KRT17 和 MDK 组合的分析得出的 AUC 分别为 0.94 和 0.95,敏感性分别为 85% 和 97%,特异性分别为 93% 和 85%:本研究结果表明,KRT17和MDK组合是早期诊断NMIBC的潜在尿液生物标记物。
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引用次数: 0
Serum lactate/creatinine ratio and acute kidney injury in cardiac arrest patients 心脏骤停患者的血清乳酸/肌酐比率和急性肾损伤。
IF 2.5 3区 医学 Q2 MEDICAL LABORATORY TECHNOLOGY Pub Date : 2024-07-26 DOI: 10.1016/j.clinbiochem.2024.110806
Liangen Lin , Congcong Sun , Yuequn Xie , Yuanwen Ye , Peng Zhu , Keyue Pan , Linglong Chen

Objectives

Serum lactate and creatinine levels upon admission in cardiac arrest (CA) patients significantly correlate with acute kidney injury (AKI) post-restoration of autonomic circulation. However, the association between serum lactate/creatinine ratio (LCR) and AKI in this population remains unclear. This study aimed to explore the relationship between LCR at admission and cardiac arrest-associated acute kidney injury (CA-AKI).

Design and methods

We conducted a secondary analysis of previously published data on CA patient resuscitation, categorizing them into tertiles based on LCR levels. Univariate and multivariate logistic regression models and subgroup analyses were employed to investigate the association between LCR and CA-AKI. Non-linear correlations were explored using restricted cubic splines, and a two-piece wise logistic proportional hazards model for both sides of the inflection point was constructed.

Results

A total of 374 patients (72.19 % male) were included, with intensive care unit mortality, in-hospital mortality, and neurologic dysfunction rates of 51.87 %, 56.95 %, and 39.57 %, respectively. The overall CA-AKI incidence was 59.09 %. Multivariate logistic proportional hazards analysis revealed a negative association between LCR and CA-AKI incidence (adjusted odds ratio [OR] 0.85, 95 % confidence intervals [CI] = 0.78–0.93, P=0.001). Triple spline restriction analysis depicted an L-shaped correlation between baseline LCR and CA-AKI incidence. Particularly, a baseline LCR<0.051 was negatively associated with CA-AKI incidence (OR 0.494, 95 % CI=0.319–0.764, P=0.002). Beyond the LCR turning point, estimated dose–response curves remained consistent with a horizontal line.

Conclusions

Baseline LCR in CA patients exhibits an L-shaped correlation with AKI incidence following restoration of autonomic circulation. The threshold for CA-AKI is 0.051. This finding suggests that LCR may aid in identifying CA patients at high risk of AKI.

目的:心脏骤停(CA)患者入院时的血清乳酸和肌酐水平与自主循环恢复后的急性肾损伤(AKI)密切相关。然而,该人群的血清乳酸/肌酐比值(LCR)与急性肾损伤之间的关系仍不清楚。本研究旨在探讨入院时乳酸/肌酐比值与心脏骤停相关急性肾损伤(CA-AKI)之间的关系:我们对之前发表的 CA 患者复苏数据进行了二次分析,根据 LCR 水平将其分为三等分。采用单变量和多变量逻辑回归模型以及亚组分析来研究 LCR 与 CA-AKI 之间的关系。使用限制性立方样条探索了非线性相关性,并构建了拐点两侧的双片式逻辑比例危险模型:共纳入 374 名患者(72.19% 为男性),重症监护室死亡率、院内死亡率和神经功能障碍发生率分别为 51.87%、56.95% 和 39.57%。CA-AKI 总发生率为 59.09%。多变量逻辑比例危险度分析显示,LCR与CA-AKI发生率呈负相关(调整后赔率比[OR] 0.85,95%置信区间[CI] = 0.78-0.93,P=0.001)。三重样条限制分析显示,基线 LCR 与 CA-AKI 发生率呈 L 型相关。尤其是基线 LCR:CA 患者的基线 LCR 与恢复自主循环后的 AKI 发生率呈 L 型相关。CA-AKI的阈值为0.051。这一发现表明,LCR 可能有助于识别 AKI 高风险 CA 患者。
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引用次数: 0
Long term false positive hsTnI on Alinity I probably caused by macrotroponin complex: Case report 可能由巨凝乳蛋白复合物引起的阿利特I长期假阳性hsTnI:病例报告。
IF 2.5 3区 医学 Q2 MEDICAL LABORATORY TECHNOLOGY Pub Date : 2024-07-24 DOI: 10.1016/j.clinbiochem.2024.110802
Tamara Sušić , Marijana Miler , Nora Nikolac Gabaj , Andrea Tešija Kuna , Krešimir Kordić , Vedrana Ilić , Ozren Vinter

Elevated troponin levels are often indicative of various cardiac diseases; however, analytical interference can lead to false positive troponin concentrations. We present the case of a 48-year-old female patient with persistently falsely elevated high sensitivity troponin I (hsTnI) probably caused by the presence of macrotroponin. Laboratory testing included determination of hsTnI using various analytical methods, serial dilutions and determination of heterophilic antibodies and other autoimmune antibodies. Only precipitation with polyethylene glycol (PEG) indicated the presence of an interference by causing a significant decrease in hsTnI concentration.

Our results suggest that the falsely elevated hsTnI concentration could be due to interference with the macrotroponin complex.

肌钙蛋白水平升高通常是各种心脏疾病的征兆;然而,分析干扰可导致肌钙蛋白浓度假阳性。我们介绍了一例 48 岁女性患者的病例,她的高敏肌钙蛋白 I(hsTnI)持续假性升高,可能是由大肌钙蛋白的存在引起的。实验室检测包括使用各种分析方法测定 hsTnI、连续稀释以及测定嗜异性抗体和其他自身免疫抗体。只有聚乙二醇(PEG)沉淀才会导致 hsTnI 浓度显著下降,从而表明存在干扰。我们的结果表明,hsTnI 浓度的假性升高可能是由于大促红细胞生成素复合物的干扰所致。
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引用次数: 0
Utility of fractional excretion of magnesium in diagnosing renal magnesium wasting in pediatric nephrology practice 在儿科肾病学实践中,镁的分数排泄量在诊断肾性镁耗竭中的实用性。
IF 2.5 3区 医学 Q2 MEDICAL LABORATORY TECHNOLOGY Pub Date : 2024-07-24 DOI: 10.1016/j.clinbiochem.2024.110807
Midori Awazu, Kazuya Matsumura

Background

Fractional excretion of magnesium (FEMg) is commonly used to diagnose of renal magnesium (Mg) wasting, but it can be affected by serum Mg (SMg) and serum creatinine concentration (SCr). We investigated the sensitivity and specificity of FEMg to diagnose Mg wasting in subgroups with different SMg and eGFR (estimated glomerular filtration rate) in pediatric nephrology practice.

Methods

One hundred and nineteen patients (59 males and 60 females, median 15 years) seen in our pediatric clinic were investigated for FEMg, SMg, eGFR, and urine Mg-to-creatinine ratio (Mg/Cr). Normal eGFR was defined as ≥ 90 ml/min/1.73 m2 or for infants SCr < chronic kidney disease stage 2. Urine Mg/Cr was compared with age-specific reference values.

Results

Sixteen of all patients (13 %) had hypomagnesemia. All had FEMg greater than the cut-off value of 2 %. Only 4 patients had elevated urine Mg/Cr. Of 65 patients with normal SMg and eGFR, 19 had FEMg above the cut-off value of 4 %. Of these, 13 patients had elevated urine Mg/Cr i.e. Mg wasting (sensitivity and specificity of FEMg, 93 % and 88 %, respectively). Among 38 patients with normal SMg and low eGFR, 30 had FEMg > 4 %, but only 6 had elevated urine Mg/Cr (sensitivity 100 % and specificity 25 %). Overall, hypomagnesemic patients and normomagnesemic patients with elevated urine Mg/Cr were diagnosed with Mg wasting (36/119, 30 %).

Conclusions

FEMg has variable sensitivity and specificity depending on SMg and eGFR in the diagnosis of Mg wasting. Mg wasting is not uncommon in pediatric nephrology practice.

背景:镁的分数排泄量(FEMg)通常用于诊断肾性镁(Mg)消耗,但它会受到血清镁(SMg)和血清肌酐浓度(SCr)的影响。我们研究了在儿科肾脏病实践中,FEMg 在不同 SMg 和 eGFR(估计肾小球滤过率)亚群中诊断镁消耗的敏感性和特异性:在儿科门诊就诊的 119 名患者(59 名男性,60 名女性,中位数 15 岁)接受了 FEMg、SMg、eGFR 和尿镁肌酐比(Mg/Cr)的检查。正常 eGFR 的定义是≥ 90 ml/min/1.73 m2 或婴儿 SCr 结果:所有患者中有 16 人(13%)患有低镁血症。所有患者的血镁均高于 2% 的临界值。只有 4 名患者尿镁/钙升高。在 65 名 SMg 和 eGFR 正常的患者中,19 名患者的 FEMg 超过了 4% 的临界值。其中,13 名患者的尿液 Mg/Cr 升高,即镁消耗(FEMg 的敏感性和特异性分别为 93% 和 88%)。在 38 名 SMg 正常且 eGFR 低的患者中,有 30 人的 FEMg > 4%,但只有 6 人的尿 Mg/Cr 升高(灵敏度为 100%,特异性为 25%)。总体而言,尿镁/铬升高的低镁血症患者和正常镁血症患者被诊断为镁消耗(36/119,30%):FEMg在诊断镁消耗方面具有不同的敏感性和特异性,具体取决于SMg和eGFR。镁消耗在儿科肾病中并不少见。
{"title":"Utility of fractional excretion of magnesium in diagnosing renal magnesium wasting in pediatric nephrology practice","authors":"Midori Awazu,&nbsp;Kazuya Matsumura","doi":"10.1016/j.clinbiochem.2024.110807","DOIUrl":"10.1016/j.clinbiochem.2024.110807","url":null,"abstract":"<div><h3>Background</h3><p>Fractional excretion of magnesium (FE<sub>Mg</sub>) is commonly used to diagnose of renal magnesium (Mg) wasting, but it can be affected by serum Mg (SMg) and serum creatinine concentration (SCr). We investigated the sensitivity and specificity of FE<sub>Mg</sub> to diagnose Mg wasting in subgroups with different SMg and eGFR (estimated glomerular filtration rate) in pediatric nephrology practice.</p></div><div><h3>Methods</h3><p>One hundred and nineteen patients (59 males and 60 females, median 15 years) seen in our pediatric clinic were investigated for FE<sub>Mg</sub>, SMg, eGFR, and urine Mg-to-creatinine ratio (Mg/Cr). Normal eGFR was defined as ≥ 90 ml/min/1.73 m<sup>2</sup> or for infants SCr &lt; chronic kidney disease stage 2. Urine Mg/Cr was compared with age-specific reference values.</p></div><div><h3>Results</h3><p>Sixteen of all patients (13 %) had hypomagnesemia. All had FE<sub>Mg</sub> greater than the cut-off value of 2 %. Only 4 patients had elevated urine Mg/Cr. Of 65 patients with normal SMg and eGFR, 19 had FE<sub>Mg</sub> above the cut-off value of 4 %. Of these, 13 patients had elevated urine Mg/Cr i.e. Mg wasting (sensitivity and specificity of FE<sub>Mg</sub>, 93 % and 88 %, respectively). Among 38 patients with normal SMg and low eGFR, 30 had FE<sub>Mg</sub> &gt; 4 %, but only 6 had elevated urine Mg/Cr (sensitivity 100 % and specificity 25 %). Overall, hypomagnesemic patients and normomagnesemic patients with elevated urine Mg/Cr were diagnosed with Mg wasting (36/119, 30 %).</p></div><div><h3>Conclusions</h3><p>FE<sub>Mg</sub> has variable sensitivity and specificity depending on SMg and eGFR in the diagnosis of Mg wasting. Mg wasting is not uncommon in pediatric nephrology practice.</p></div>","PeriodicalId":10172,"journal":{"name":"Clinical biochemistry","volume":"131 ","pages":"Article 110807"},"PeriodicalIF":2.5,"publicationDate":"2024-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141765668","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
期刊
Clinical biochemistry
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