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Pre-analytical diagnostic differences despite high adherence to guidelines for gestational diabetes mellitus. 尽管高度遵守妊娠糖尿病指南,但分析前诊断仍存在差异。
IF 2.1 4区 医学 Q4 MEDICINE, RESEARCH & EXPERIMENTAL Pub Date : 2024-02-01 Epub Date: 2024-02-06 DOI: 10.1080/00365513.2024.2312152
Cathrine Scavenius, Eva Rabing Brix Petersen, Dorte Møller Jensen, Lene Ringholm, Jakoba Sevdal Danielsen, Elisabeth Reinhardt Mathiesen, David McIntyre, Peter Damm, Martin Overgaard, Tine Dalsgaard Clausen

Regional variations in the prevalence of gestational diabetes mellitus (GDM) have been found across Denmark. The objectives of this exploratory survey were to evaluate adherence to the national guideline for screening and diagnosing GDM and to identify variations in pre-analytical or analytical factors, which could potentially contribute to variations in GDM prevalence across regions. In a national interview-based survey, obstetric departments and laboratories throughout Denmark handling GDM screening or diagnostic testing were invited to participate. Survey questionnaires were completed through personal interviews. In total, 21 of 22 identified obstetric departments and 44 of 45 identified laboratories participated. Adherence to guideline among obstetric departments ranged 67-100% and uniformity in laboratory procedures was high. However, the gestational age at the time of late diagnostic testing with oral glucose tolerance test (OGTT) varied considerably, with 48% (10/21) of departments testing outside the recommended 24-28 weeks' gestation. Procedural heterogeneity was most pronounced for the parts not described in current guidelines, with choice of laboratory equipment being the most diverse factor ranging 3-39% nationally. In conclusion, the overall adherence to the national guidelines was high across regions, and obstetric departments and laboratories had high uniformity in the procedures for screening and diagnosing GDM. Uniformity was generally high for procedures included in the guideline and low if not included. However, a high proportion of GDM testing was performed outside the recommended gestational window in late pregnancy, which may be a pre-analytical contributor to regional differences in GDM prevalence.

丹麦各地的妊娠糖尿病(GDM)发病率存在地区差异。这项探索性调查的目的是评估妊娠糖尿病筛查和诊断国家指南的遵守情况,并找出可能导致各地区妊娠糖尿病患病率差异的分析前或分析因素的变化。在一项以访谈为基础的全国性调查中,丹麦全国各地处理 GDM 筛查或诊断检测的产科部门和实验室均受邀参与。调查问卷通过个人访谈完成。总共有 22 个确定的产科部门中的 21 个和 45 个确定的实验室中的 44 个参与了调查。产科部门对指南的遵守率为 67%-100%,实验室程序的统一性也很高。然而,使用口服葡萄糖耐量试验(OGTT)进行晚期诊断测试时的妊娠年龄差异很大,48%(10/21)的部门在建议的妊娠 24-28 周之外进行测试。程序异质性在现行指南中未描述的部分最为明显,实验室设备的选择是差异最大的因素,在全国范围内占 3-39%。总之,各地区对国家指南的总体遵守程度较高,产科部门和实验室在筛查和诊断 GDM 的程序上具有较高的一致性。指南中包含的程序的统一性普遍较高,而未包含的程序的统一性较低。然而,有很大一部分 GDM 检测是在妊娠晚期推荐的妊娠窗外进行的,这可能是造成 GDM 患病率地区差异的一个分析前因素。
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引用次数: 0
A case of platelet δ-granule defect identified by decreased CD63 expression and decreased serotonin release measured by flow cytometry and liquid chromatography tandem mass spectrometry. 一例通过流式细胞仪和液相色谱串联质谱法测量 CD63 表达减少和血清素释放减少而确定的血小板 δ 颗粒缺陷病例。
IF 2.1 4区 医学 Q4 MEDICINE, RESEARCH & EXPERIMENTAL Pub Date : 2024-02-01 DOI: 10.1080/00365513.2024.2309613
Peter H Nissen, Torben Stamm Mikkelsen, Carsten Schriver Højskov, Johanne Andersen Højbjerg
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引用次数: 0
Abbott D-dimer assay: analytical performance and diagnostic accuracy in management of venous thromboembolism. 雅培 D-二聚体测定:静脉血栓栓塞症治疗中的分析性能和诊断准确性。
IF 2.1 4区 医学 Q4 MEDICINE, RESEARCH & EXPERIMENTAL Pub Date : 2024-02-01 Epub Date: 2024-02-16 DOI: 10.1080/00365513.2024.2318616
Ivana Lapić, Anamarija Bogić, Ivana Stojan, Dunja Rogić

This study aimed to assess analytical characteristics and diagnostic accuracy in management of venous thromboembolism (VTE) in the Emergency Department (ED) of the Abbott D-dimer assay applied on the Alinity c clinical chemistry analyzer (Abbott Laboratories, Chicago, IL) compared to the INNOVANCE D-dimer assay (Siemens Healthineers, Marburg, Germany). Precision was determined at three concentration levels following the CLSI EP15-A3 protocol. Method comparison and diagnostic accuracy were assessed using samples obtained from 85 patients who were referred for diagnostic imaging and D-dimer testing due to clinically suspected VTE. Within-run coefficients of variation (CVs) were 3.0%, 0.5% and 0.5% at D-dimer concentrations of 0.54, 1.42 and 2.68 mg/L FEU, while respective between-run CVs were 2.0%, 3.4% and 2.7%, hence fulfilling the desirable biological variation criteria for imprecision (<12.6%). Passing-Bablok regression analysis yielded a small proportional difference between the two compared assays (y = 1.09 (95% confidence interval (CI): 1.01-1.18) x + 0.09 (95%CI: -0.09 to 0.16)), while Bland-Altman analysis showed significant negative absolute (-0.6 mg/L FEU, 95%CI: -0.9 to -0.3) and relative mean bias (-14.1%, 95%CI: -20.3 to -7.9). Spearman's ρ was 0.979 (95%CI: 0.967-0.986). Inter-assay agreement relative to the cut-off was 92% (kappa coefficient = 0.547 (95%CI: 0.255-0.839)). Diagnostic sensitivity, specificity, positive and negative predictive values of the Abbott assay were 100%, 9.2%, 25.3% and 100%, respectively, compared to the following data for the INNOVANCE assay: 95.0%, 15.4%, 25.7% and 90.9%. Abbott D-dimer assay has shown excellent analytical precision, high comparability with the INNOVANCE D-dimer and high NPV at manufacturer's cut-off.

本研究旨在评估在Alinity c临床化学分析仪(雅培实验室,伊利诺伊州芝加哥市)上应用的雅培D-二聚体测定法与INNOVANCE D-二聚体测定法(西门子医疗集团,德国马尔堡市)在急诊科静脉血栓栓塞症(VTE)管理中的分析特性和诊断准确性。精确度按照 CLSI EP15-A3 协议在三个浓度水平上进行测定。方法比较和诊断准确性的评估使用了从 85 位因临床疑似 VTE 而转诊进行影像诊断和 D-二聚体检测的患者身上获得的样本。在 D-二聚体浓度为 0.54、1.42 和 2.68 毫克/升 FEU 时,运行内变异系数(CV)分别为 3.0%、0.5% 和 0.5%,而运行间变异系数分别为 2.0%、3.4% 和 2.7%,因此符合不精确性的理想生物变异标准(y = 1.0%)。布兰-阿尔特曼分析表明,绝对偏差(-0.6 毫克/升 FEU,95%CI:-0.9 至-0.3)和相对平均偏差(-14.1%,95%CI:-20.3 至-7.9)均呈显著负值。斯皮尔曼指数为 0.979(95%CI:0.967-0.986)。相对于临界值,测定间的一致性为 92%(卡帕系数 = 0.547 (95%CI: 0.255-0.839))。雅培检测法的诊断灵敏度、特异性、阳性预测值和阴性预测值分别为 100%、9.2%、25.3% 和 100%,而 INNOVANCE 检测法的数据如下:95.0%、15.4%、25.7% 和 90.9%。雅培 D-二聚体检测法显示出卓越的分析精确度,与 INNOVANCE D-二聚体检测法具有很高的可比性,并且在制造商设定的临界值下具有很高的 NPV。
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引用次数: 0
IgE-kappa multiple myeloma with kappa free light chain: a case report. 伴有卡帕游离轻链的 IgE 卡帕多发性骨髓瘤:一份病例报告。
IF 2.1 4区 医学 Q4 MEDICINE, RESEARCH & EXPERIMENTAL Pub Date : 2024-02-01 Epub Date: 2024-02-08 DOI: 10.1080/00365513.2024.2309611
Yuyi Hu, Wenqi Shao, Baishen Pan, Beili Wang, Wei Guo
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引用次数: 0
Effect of physical exercise in people with hypothyroidism: systematic review and meta-analysis. 体育锻炼对甲状腺功能减退患者的影响:系统回顾和荟萃分析。
IF 2.1 4区 医学 Q4 MEDICINE, RESEARCH & EXPERIMENTAL Pub Date : 2023-12-01 Epub Date: 2024-01-24 DOI: 10.1080/00365513.2023.2286651
Iratxe Duñabeitia, Daniel González-Devesa, Silvia Varela-Martínez, Jose Carlos Diz-Gómez, Carlos Ayán-Pérez

This study aimed to systematically revise the available evidence on the effects of physical exercise training programmes on people with hypothyroidism. Comparative studies were searched in six electronic databases until April 2023. The Physiotherapy Evidence Database and the Methodological Index for Non-Randomized Studies were used to determine the methodological quality of the randomized controlled trials and comparative studies respectively. A total of 10 studies were found showing a low to moderate methodological quality. Most of them were performed in women with subclinical hypothyroidism. Exercise seemed to be safe, with aerobic and resistance training leading to improvements in outcomes related to physical and mental health. The performed meta-analysis with data from 120 participants indicated that exercise showed a non-significant trend towards reducing thyroid-stimulating hormone levels (Hedges'g -0.96; 95% CI -2.71; 0.79, p = 0.160; I2 = 92%). When the analysis was performed by comparing the experimental, and control groups with data from 180 participants the results remained non-significant (SMD -1.09; CI 95% -2.88; 0.70, p = 0.23; I2 = 95%). Similar findings were obtained when pooling data for FT3 and FT4 levels. Exercise does not have a significant impact on thyroid function, although its practice can lead to secondary outcomes related to physical and mental health.

本研究旨在系统地修订关于体育锻炼计划对甲状腺功能减退患者影响的现有证据。截至2023年4月,在6个电子数据库中检索了比较研究。使用物理治疗证据数据库和非随机研究方法学指数分别确定随机对照试验和比较研究的方法学质量。总共有10项研究显示出低到中等的方法学质量。大多数是在亚临床甲状腺功能减退的妇女中进行的。运动似乎是安全的,有氧和阻力训练可以改善与身心健康相关的结果。对来自120名参与者的数据进行的荟萃分析表明,运动对降低促甲状腺激素水平没有显著的趋势(Hedges'g -0.96;95% ci -2.71;0.79, p = 0.160;i2 = 92%)。当通过比较实验组和对照组180名参与者的数据进行分析时,结果仍然不显著(SMD -1.09;Ci 95% -2.88;0.70, p = 0.23;i2 = 95%)。当合并FT3和FT4水平的数据时,也得到了类似的发现。运动对甲状腺功能没有显著影响,尽管运动可能导致与身心健康相关的次要后果。
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引用次数: 0
Validation of the Hem-Col capillary blood collection system for routine laboratory analyses. 验证用于常规实验室分析的 Hem-Col 毛细管采血系统。
IF 2.1 4区 医学 Q4 MEDICINE, RESEARCH & EXPERIMENTAL Pub Date : 2023-12-01 Epub Date: 2024-01-24 DOI: 10.1080/00365513.2024.2301779
Steef Kurstjens, Marjon J den Besten, Dorien A M van Dartel, Marloes C C van Gend, Lizzy Meerts, Rein M J Hoedemakers

At home collection of capillary blood using Hem-Col tubes (Labonovum) could offer a solution to patients with chronic conditions, who require frequent laboratory analyses. The collection tubes contain a conservation buffer to stabilize analytes for up to 5 days. In this validation study it was investigated whether analytes are measured accurately in Hem-Col tubes 5 days after collection. Forty-six healthy volunteers donated blood via venepuncture as well as capillary blood by finger prick using Hem-Col tubes. The analytes were measured within 2 h for the venepuncture and after 120 h for the Hem-Col method. The results of each analyte were analysed using Passing-Bablok regression analyses. The analytes that met the predefined acceptance criteria were total cholesterol, LDL-cholesterol, thyroid stimulating hormone (TSH) and glycated haemoglobin (HbA1c). HDL-cholesterol, C-reactive protein (CRP), ferritin, bilirubin total, creatinine, gGT and triglycerides met two out of three acceptance criteria. All other analytes did not meet the predefined criteria. The Hem-Col method is suitable for the measurement of total cholesterol, LDL-cholesterol, thyroid stimulating hormone (TSH) and glycated haemoglobin (HbA1c). However, due to this limited set of valid tests and practical limitations, routine application of this novel collection system in daily practice is limited.

使用 Hem-Col 管(Labonovum)在家采集毛细血管血液可为需要经常进行实验室分析的慢性病患者提供一种解决方案。采集管中含有保存缓冲液,可使分析物稳定长达 5 天。在这项验证研究中,我们调查了 Hem-Col 管在采集 5 天后是否能准确测量分析物。46 名健康志愿者使用 Hem-Col 管进行了静脉穿刺献血和毛细管刺血。静脉穿刺法在 2 小时内测定分析物,Hem-Col 法在 120 小时后测定分析物。采用 Passing-Bablok 回归分析法对每种分析物的结果进行分析。符合预定接受标准的分析物是总胆固醇、低密度脂蛋白胆固醇、促甲状腺激素(TSH)和糖化血红蛋白(HbA1c)。高密度脂蛋白胆固醇、C 反应蛋白 (CRP)、铁蛋白、总胆红素、肌酐、谷丙转氨酶和甘油三酯符合三项接受标准中的两项。所有其他分析物均不符合预定标准。Hem-Col 方法适用于测量总胆固醇、低密度脂蛋白胆固醇、促甲状腺激素 (TSH) 和糖化血红蛋白 (HbA1c)。然而,由于有效检测项目有限且存在实际局限性,这种新型采集系统在日常实践中的常规应用受到了限制。
{"title":"Validation of the Hem-Col capillary blood collection system for routine laboratory analyses.","authors":"Steef Kurstjens, Marjon J den Besten, Dorien A M van Dartel, Marloes C C van Gend, Lizzy Meerts, Rein M J Hoedemakers","doi":"10.1080/00365513.2024.2301779","DOIUrl":"10.1080/00365513.2024.2301779","url":null,"abstract":"<p><p>At home collection of capillary blood using Hem-Col tubes (Labonovum) could offer a solution to patients with chronic conditions, who require frequent laboratory analyses. The collection tubes contain a conservation buffer to stabilize analytes for up to 5 days. In this validation study it was investigated whether analytes are measured accurately in Hem-Col tubes 5 days after collection. Forty-six healthy volunteers donated blood via venepuncture as well as capillary blood by finger prick using Hem-Col tubes. The analytes were measured within 2 h for the venepuncture and after 120 h for the Hem-Col method. The results of each analyte were analysed using Passing-Bablok regression analyses. The analytes that met the predefined acceptance criteria were total cholesterol, LDL-cholesterol, thyroid stimulating hormone (TSH) and glycated haemoglobin (HbA1c). HDL-cholesterol, C-reactive protein (CRP), ferritin, bilirubin total, creatinine, gGT and triglycerides met two out of three acceptance criteria. All other analytes did not meet the predefined criteria. The Hem-Col method is suitable for the measurement of total cholesterol, LDL-cholesterol, thyroid stimulating hormone (TSH) and glycated haemoglobin (HbA1c). However, due to this limited set of valid tests and practical limitations, routine application of this novel collection system in daily practice is limited.</p>","PeriodicalId":21474,"journal":{"name":"Scandinavian Journal of Clinical & Laboratory Investigation","volume":" ","pages":"604-607"},"PeriodicalIF":2.1,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139404233","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"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
Preanalytical impact on the accuracy of measurements of glucagon, GLP-1 and GIP in clinical trials. 分析前对临床试验中胰高血糖素、GLP-1 和 GIP 测量准确性的影响。
IF 2.1 4区 医学 Q4 MEDICINE, RESEARCH & EXPERIMENTAL Pub Date : 2023-12-01 Epub Date: 2024-01-24 DOI: 10.1080/00365513.2023.2294470
Christine Rasmussen, Michael M Richter, Nicole J Jensen, Niklas Heinz, Bolette Hartmann, Jens J Holst, Sasha A S Kjeldsen, Nicolai J Wewer Albrechtsen

Background: Plasma concentrations of glucagon, GLP-1 and GIP are reported in numerous clinical trials as outcome measures but preanalytical guidelines are lacking. We addressed the impact of commonly used blood containers in metabolic research on measurements of glucagon, GLP-1 and GIP in humans.

Methods: Seventeen overweight individuals were subjected to an overnight fast followed by an intravenous infusion of amino acids to stimulate hormonal secretion. Blood was sampled into five containers: EDTA-coated tubes supplemented with DMSO (control), a neprilysin inhibitor, aprotinin (a kallikrein inhibitor) or a DPP-4 inhibitor, and P800 tubes. Plasma was kept on ice before and after centrifugation and stored at -80 Celsius until batch analysis using validated sandwich ELISAs or radioimmunoassays (RIA).

Results: Measures of fasting plasma glucagon did not depend on sampling containers, whether measured by ELISA or RIA. Amino acid-induced hyperglucagonemia was numerically higher when blood was collected into P800 tubes or tubes with aprotinin. The use of p800 tubes resulted in higher concentrations of GLP-1 by RIA compared to control tubes but not for measurements with sandwich ELISA. Plasma concentrations of GIP measured by ELISA were higher in control tubes and negatively affected by P800 and the addition of aprotinin.

Conclusions: The choice of blood containers impacts on measurements of plasma concentrations of glucagon, GLP-1 and GIP, and based on this study, we recommend using EDTA-coated tubes without protease inhibitors or P800 tubes for measurements of glucagon, GLP-1 and GIP in clinical trials.

背景:许多临床试验都将胰高血糖素、GLP-1 和 GIP 的血浆浓度作为结果指标进行报告,但缺乏分析前指南。我们研究了代谢研究中常用的血液容器对人体胰高血糖素、GLP-1 和 GIP 测量的影响:方法:对 17 名超重者进行一夜禁食,然后静脉注射氨基酸以刺激荷尔蒙分泌。在五个容器中采血:EDTA涂层试管中分别加入二甲基亚砜(对照组)、肾蛋白酶抑制剂、阿普罗宁(凯利克林抑制剂)或DPP-4抑制剂,以及P800试管。血浆在离心前后均置于冰上,并储存在零下 80 摄氏度的环境中,直到使用经过验证的夹心酶联免疫吸附试验或放射免疫分析法(RIA)进行批量分析:结果:无论是采用酶联免疫吸附法还是放射免疫分析法,空腹血浆胰高血糖素的测量值都与采样容器无关。用 P800 管或含阿普丁的管采血时,氨基酸诱发的高胰高血糖素血症在数量上更高。与对照试管相比,使用p800试管通过RIA测定的GLP-1浓度更高,但使用夹心ELISA测定的GLP-1浓度则不高。用酶联免疫吸附法测定的血浆中 GIP 浓度在对照试管中更高,而 P800 和添加阿普罗宁会对其产生负面影响:血液容器的选择会影响胰高血糖素、GLP-1 和 GIP 的血浆浓度测量,根据这项研究,我们建议在临床试验中使用不含蛋白酶抑制剂的 EDTA 涂层试管或 P800 试管来测量胰高血糖素、GLP-1 和 GIP。
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引用次数: 0
Evaluation of the Premier Hb9210 instrument for HbA1c determination. Premier Hb9210检测HbA1c仪器的评价
IF 2.1 4区 医学 Q4 MEDICINE, RESEARCH & EXPERIMENTAL Pub Date : 2023-12-01 Epub Date: 2024-01-24 DOI: 10.1080/00365513.2023.2281400
David Núñez-Jurado, Jorge Montenegro-Martínez, Ricardo Rubio-Sánchez, Manuel Conde-Sánchez, Inmaculada Domínguez-Pascual

Background: Glycated hemoglobin measurements are a valuable tool for long-term blood glucose monitoring and the diagnosis of diabetes. Its widespread use has been made possible due to the development of new analytical methods with improved performances and standardization with reference materials. The aim of the present study was to evaluate the Trinity Biotech Premier Hb9210 analyzer for the measurement of HbA1c.Methods: The precision was assessed using the CLSI EP-15A3 and EP-10A3 protocols. The latter was also used to investigate linearity, carryover, and linear drift. The comparison study was performed between Premier Hb910 and Tosoh HLC-723 G8 through Passing-Bablok regression and the Bland-Altman plot. The Fleiss Kappa index was used to assess the degree of agreement. The interference of Hb variants was investigated using samples with Hb variants S, C, D, E, J, and Seville.Results: Within-run and between-run imprecision fell between 0.37% and 1.16%. No statistically significant nonlinearity, carry-over, and/or drift were observed. The resulting regression line of the Passing-Bablok analysis was y = 0.00 + 1.00x. The Pearson correlation coefficient was 0.997. In the Bland-Altman plot, the relative bias was 0.01%. The overall Fleiss Kappa index was 0.9. No interference from hemoglobin variants was observed.Conclusion: The Premier Hb9210 demonstrated a high degree of automation, reproducibility, good agreement, minimal carry-over effect, and excellent linearity across the wide range of HbA1c levels commonly found in diabetic patients and was not influenced by Hb variants.

背景:糖化血红蛋白测量是长期血糖监测和糖尿病诊断的重要工具。由于新的分析方法的发展,其性能得到了改善,并与参考物质进行了标准化,因此它的广泛使用成为可能。本研究的目的是评估Trinity Biotech Premier Hb9210分析仪测量HbA1c的效果。方法:采用CLSI EP-15A3和EP-10A3标准进行精密度评估。后者也用于调查线性,结转和线性漂移。通过pass - bablok回归和Bland-Altman图对Premier Hb910与Tosoh HLC-723 G8进行比较研究。采用Fleiss Kappa指数评价一致性程度。使用Hb变异S、C、D、E、J和Seville样本研究Hb变异的干扰。结果:运行内和运行间不精确度在0.37% ~ 1.16%之间。未观察到统计学上显著的非线性、携带和/或漂移。Passing-Bablok分析的回归线为y = 0.00 + 1.00x。Pearson相关系数为0.997。在Bland-Altman图中,相对偏差为0.01%。整体Fleiss Kappa指数为0.9。未观察到血红蛋白变异的干扰。结论:Premier Hb9210在糖尿病患者常见的广泛HbA1c水平范围内表现出高度的自动化、可重复性、良好的一致性、最小的携带效应和良好的线性,并且不受Hb变异的影响。
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引用次数: 0
Cystatin C and eGFRCKD-EPI-CysC: novel biomarkers for renal impairment diagnosis and two-year progression-free survival in multiple myeloma. 胱抑素 C 和 eGFRCKD-EPI-CysC:诊断多发性骨髓瘤肾功能损伤和两年无进展生存期的新型生物标记物。
IF 2.1 4区 医学 Q4 MEDICINE, RESEARCH & EXPERIMENTAL Pub Date : 2023-12-01 Epub Date: 2024-01-24 DOI: 10.1080/00365513.2023.2297364
Jian Niu, Jiajia Yu, Huifang Huang, Jinfang Shi, Dong Zheng, Jun Qiu

To evaluate cystatin C (CysC) and estimation of glomerular filtration rate (GFR) calculated using the formula, CKD-EPI-CysC (eGFRCKD-EPI-CysC) for renal impairment diagnosis and predicting the prognosis of patients with multiple myeloma (MM). One hundred-fourteen patients with MM and 38 healthy individuals were recruited for the study. Data on clinical characteristics and renal function-related biochemical indicators were collected and analyzed. Patients with MM had increased levels of CysC (1.25 (0.97-2.31) vs. 0.84 (0.80-0.92), respectively, p < 0.001) and decreased levels of eGFRCKD-EPI-CysC (53.0 (24.4-81.1) vs. 97.2 (87.0-104.5), respectively, p < 0.001), compared with healthy individuals. There were significantly more patients with elevated CysC levels than with elevated sCr levels (64.9% vs. 41.2%, respectively, p < 0.001). The CKD-EPI-CysC formula detected more patients with eGFR < 60 ml/(min × 1.73 m2) than the CKD-EPI-sCr formula (52.63% vs. 37.72%, respectively, p < 0.001). Correlation analysis found that only CysC, eGFRCKD-EPI-CysC, and eGFRCKD-EPI-sCr-CysC strongly correlated with β2-microglobulin in group ISS-I. Logistic regression analysis was used to screen CysC (OR = 1.495, 95% CI = 1.097-2.038, p = 0.011) and eGFRCKD-EPI-CysC (OR = 0.980, 95% CI = 0.967-0.993, p = 0.003) as independent prognostic indicators for 2-year-progression-free survival (PFS) of patients with MM. Receiver operating characteristic curve analysis found that CysC values >1.70 mg/L had 67.6% sensitivity and 65.2% specificity and eGFRCKD-EPI-CysC values <38.62 ml/(min × 1.73 m2) had 65.2% sensitivity and 67.6% specificity for 2-year PFS of patients with MM. In summary, CysC and eGFRCKD-EPI-CysC were more sensitive than sCr and eGFRCKD-EPI-sCr for predicting renal impairment in patients newly diagnosed with MM. Increased CysC and decreased eGFRCKD-EPI-CysC levels were effective predictors of 2-year PFS of patients with MM.

目的:评估胱抑素C(CysC)和使用CKD-EPI-CysC(eGFRCKD-EPI-CysC)公式计算的肾小球滤过率(GFR)估算值,用于多发性骨髓瘤(MM)患者的肾功能损害诊断和预后预测。研究共招募了 14 名 MM 患者和 38 名健康人。研究收集并分析了临床特征和肾功能相关生化指标的数据。MM患者的CysC(1.25 (0.97-2.31) vs. 0.84 (0.80-0.92), p CKD-EPI-CysC(53.0 (24.4-81.1) vs. 97.2 (87.0-104.5),分别 p p 2)比 CKD-EPI-sCr 公式(52.63% vs. 37.72%,分别 p CKD-EPI-CysC,eGFRCKD-EPI-sCr-CysC 与 ISS-I 组的β2-微球蛋白密切相关。利用逻辑回归分析筛选出 CysC(OR = 1.495,95% CI = 1.097-2.038,p = 0.011)和 eGFRCKD-EPI-CysC(OR = 0.980,95% CI = 0.967-0.993,p = 0.003)作为 MM 患者 2 年无进展生存期(PFS)的独立预后指标。接收者操作特征曲线分析发现,CysC值>1.70 mg/L对MM患者2年无进展生存期的敏感性为67.6%,特异性为65.2%;eGFRCKD-EPI-CysC值2)对MM患者2年无进展生存期的敏感性为65.2%,特异性为67.6%。总之,CysC 和 eGFRCKD-EPI-CysC 比 sCr 和 eGFRCKD-EPI-sCr 对预测新诊断为 MM 患者的肾功能损害更敏感。CysC水平升高和eGFRCKD-EPI-CysC水平降低可有效预测MM患者的2年PFS。
{"title":"Cystatin C and eGFR<sub>CKD-EPI-CysC</sub>: novel biomarkers for renal impairment diagnosis and two-year progression-free survival in multiple myeloma.","authors":"Jian Niu, Jiajia Yu, Huifang Huang, Jinfang Shi, Dong Zheng, Jun Qiu","doi":"10.1080/00365513.2023.2297364","DOIUrl":"10.1080/00365513.2023.2297364","url":null,"abstract":"<p><p>To evaluate cystatin C (CysC) and estimation of glomerular filtration rate (GFR) calculated using the formula, CKD-EPI-CysC (eGFR<sub>CKD-EPI-CysC</sub>) for renal impairment diagnosis and predicting the prognosis of patients with multiple myeloma (MM). One hundred-fourteen patients with MM and 38 healthy individuals were recruited for the study. Data on clinical characteristics and renal function-related biochemical indicators were collected and analyzed. Patients with MM had increased levels of CysC (1.25 (0.97-2.31) vs. 0.84 (0.80-0.92), respectively, <i>p</i> < 0.001) and decreased levels of eGFR<sub>CKD-EPI-CysC</sub> (53.0 (24.4-81.1) vs. 97.2 (87.0-104.5), respectively, <i>p</i> < 0.001), compared with healthy individuals. There were significantly more patients with elevated CysC levels than with elevated sCr levels (64.9% vs. 41.2%, respectively, <i>p</i> < 0.001). The CKD-EPI-CysC formula detected more patients with eGFR < 60 ml/(min × 1.73 m<sup>2</sup>) than the CKD-EPI-sCr formula (52.63% vs. 37.72%, respectively, <i>p</i> < 0.001). Correlation analysis found that only CysC, eGFR<sub>CKD-EPI-CysC</sub>, and eGFR<sub>CKD-EPI-sCr-CysC</sub> strongly correlated with β<sub>2</sub>-microglobulin in group ISS-I. Logistic regression analysis was used to screen CysC (<i>OR</i> = 1.495, 95% <i>CI</i> = 1.097-2.038, <i>p</i> = 0.011) and eGFR<sub>CKD-EPI-CysC</sub> (<i>OR</i> = 0.980, 95% <i>CI</i> = 0.967-0.993, <i>p</i> = 0.003) as independent prognostic indicators for 2-year-progression-free survival (PFS) of patients with MM. Receiver operating characteristic curve analysis found that CysC values >1.70 mg/L had 67.6% sensitivity and 65.2% specificity and eGFR<sub>CKD-EPI-CysC</sub> values <38.62 ml/(min × 1.73 m<sup>2</sup>) had 65.2% sensitivity and 67.6% specificity for 2-year PFS of patients with MM. In summary, CysC and eGFR<sub>CKD-EPI-CysC</sub> were more sensitive than sCr and eGFR<sub>CKD-EPI-sCr</sub> for predicting renal impairment in patients newly diagnosed with MM. Increased CysC and decreased eGFR<sub>CKD-EPI-CysC</sub> levels were effective predictors of 2-year PFS of patients with MM.</p>","PeriodicalId":21474,"journal":{"name":"Scandinavian Journal of Clinical & Laboratory Investigation","volume":" ","pages":"599-603"},"PeriodicalIF":2.1,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139032566","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"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
Dysmagnesemia as a predictor of developing diabetic levels of hemoglobin A1c. 作为糖尿病血红蛋白 A1c 发展水平预测因子的镁异常血症。
IF 2.1 4区 医学 Q4 MEDICINE, RESEARCH & EXPERIMENTAL Pub Date : 2023-12-01 Epub Date: 2024-01-24 DOI: 10.1080/00365513.2024.2303707
Solav Aziz Ali, Anna Elise Engell, Bent Struer Lind, Henrik Løvendahl Jørgensen

The aim of this study was to assess the possible association between P-Mg and subsequent high levels of HbA1c. The study involves data from primary health care patients and data from patients treated in hospitals located in the capital region of Denmark. P-Mg and HbA1c levels were analyzed from 121,575 patients in the period 2010-2022. Patients were categorized in a diabetic and non-diabetic group. Out of 121,575 patients, 8,532 were categorized as diabetic. A reverse J-shaped association between P-Mg and HbA1c levels ≥ 48 mmol/mol was observed with nadir at P-Mg of 0.90 mmol/L. The unadjusted hazard ratio (HR) for having a first HbA1c measurement ≥ 48 mmol/mol is 1.54 (95% Cl 1.50; 1.57) per 0.1 mmol/L decrease in P-Mg when P-Mg is lower than 0.90 mmol/L. After adjusting for age and gender, the HR remained significant at 1.45 (95% Cl 1.41; 1.48).For P-Mg levels above 0.90 mmol/L, the unadjusted HR per 0.1 mmol/L increase in P-Mg was 1.04 (95% Cl 1.02; 1.06). After adjusting for age and gender the HR remained significant at 1.06 (95% Cl 1.05; 1.08). In conclusion, this study found that patients with dysmagnesemia have a higher risk of developing diabetes even after adjusting for age and gender. Hyper- or hypomagnesemia in patients could be a biomarker for predicting the risk of developing diabetes.

这项研究的目的是评估 P-Mg 与随后的高 HbA1c 之间可能存在的关联。研究涉及初级医疗保健患者的数据和在丹麦首都地区医院接受治疗的患者的数据。研究分析了 2010-2022 年间 121,575 名患者的 P-Mg 和 HbA1c 水平。患者被分为糖尿病组和非糖尿病组。在121,575名患者中,有8,532人被归类为糖尿病患者。P-Mg 与 HbA1c 水平≥ 48 mmol/mol 之间呈反向 J 型关系,P-Mg 为 0.90 mmol/L 时为最低点。当 P-Mg 低于 0.90 mmol/L 时,P-Mg 每下降 0.1 mmol/L,首次 HbA1c 测量值≥ 48 mmol/mol 的未调整危险比(HR)为 1.54(95% Cl 1.50;1.57)。当 P-Mg 水平高于 0.90 mmol/L 时,P-Mg 每增加 0.1 mmol/L 的未调整 HR 为 1.04 (95% Cl 1.02; 1.06)。根据年龄和性别进行调整后,HR 仍为 1.06(95% Cl 1.05;1.08)。总之,本研究发现,即使对年龄和性别进行了调整,镁血症患者患糖尿病的风险仍然较高。患者的高镁或低镁血症可能是预测糖尿病发病风险的生物标志物。
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Scandinavian Journal of Clinical & Laboratory Investigation
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