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Clinica chimica acta
Elsevier
Clinica chimica acta

Elsevier

0009-8981

Clinica chimica acta/Journal Clinica chimica actaSCIISTPIC
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    Measurement uncertainty for practical use

    Coskun A.Theodorsson E.Oosterhuis W.P.Sandberg S....
    9页
    查看更多>>摘要：? 2022 Elsevier B.V.Uncertainty is an inseparable part of all kinds of measurements performed in clinical laboratories. Accreditation standards including the ISO/IEC 17025:2017 and ISO 15189:2012 require that laboratories have routines for calculating the measurement uncertainty of reported results. Various guidelines such as CLSI EP29, Nordest 537, and ISO 20914:2019 have proposed methods for this purpose. However, due to the conceived complexity of the proposed calculation methods, these guidelines have not been generally and effectively applied in clinical laboratories. High workload and measurand heterogeneity favor a pragmatic utilitarian approach. The purpose of this paper is to describe such an approach, including its advantages and disadvantages. Measurement uncertainty should include the most influential factors affecting patients’ test results. Since patients’ samples for the same measurand can be analyzed in one laboratory or several laboratories using different measuring systems, the measurement uncertainty should be calculated using results obtained from analyzing the same internal quality control material if commutable or patients pooled/split samples.
      原文链接:
    • NSTL
    • Elsevier

    Associations of maternal blood mercury with preeclampsia and birth outcomes

    Wang X.Pu Y.Ai S.Liu H....
    7页
    查看更多>>摘要：? 2022 Elsevier B.V.Background: Mercury (Hg) is a highly toxic substance, and its harmful effects on maternal and infant health have been reported. Yet, the associations of Hg exposure with preeclampsia (PE) and adverse birth outcomes are not well understood. Objective: The aim of this study was to investigate the potential effects of maternal Hg exposure on PE and birth outcomes. Methods: We conducted a case-control study with 84 participants in China. Logistic models were used to estimate odds ratios for PE risk and birth outcomes according to maternal blood Hg levels, adjusting for potential confounding factors. Results: Elevated blood Hg levels were associated with increased risks of mild PE (aOR, 7.03; 95% CI, 1.61, 30.62; P < 0.01) and severe PE (aOR, 47.55; 95% CI, 5.27, 429.05; P < 0.05). We also found that increased blood Hg levels were associated with low birth weight (aOR, 1.12; 95% CI, 1.00, 1.25; P < 0.05) and preterm birth (PTB) (aOR, 1.22; 95% CI, 1.08, 1.38; P < 0.05). Conclusions: Our study provided evidence that elevated blood Hg levels were significantly associated with an increased risk of PE. In addition, our findings support that increased blood Hg levels might be associated with low birth weight and PTB.
      原文链接:
    • NSTL
    • Elsevier

    Uric acid is associated with morpho-functional adipose tissue markers in apparently healthy subjects

    Reyes-Barrera J.Medina-Urrutia A.X.Jorge-Galarza E.Osorio-Alonso H....
    7页
    查看更多>>摘要：? 2022 Elsevier B.V.Background: Studies have focused on the search of novel biomarkers that allow to easily identify dysfunctional adipose tissue (AT). Uric acid (UA) could be produced and reabsorbed by AT. It has been suggested that the increases of UA concentrations participates in AT dysfunction. We investigated the association of UA with morpho-functional adipose tissue markers in apparently healthy subjects. Methods: Forty apparently healthy individuals were included. Dietary habits and anthropometrical features were evaluated. Circulating concentrations of UA, adiponectin, leptin, and plasminogen activator inhibitor-1 (PAI-1) were quantified. Periumbilical subcutaneous AT samples were obtained and adipocyte number, adipocyte area, and macrophages content were assessed. Results: The present study included 40 healthy subjects (67% women) with an average age of 57 ± 9 y, BMI of 26 ± 4 (kg/m2). UA showed a significant association with the number and mean area of adipocytes, macrophages number, adiponectin, and PAI-1. Although UA was independently associated with the number and mean area of adipocytes, macrophages number, adiponectin into the adjusted multivariable model. Conclusion: UA concentrations are associated with morpho-functional adipose tissue markers. Our results underscore the importance of UA as one earlier instigator of adipose tissue dysfunction in subjects without metabolic abnormalities.
      原文链接:
    • NSTL
    • Elsevier

    Novel methods of predicting ionized calcium status from routine data in critical care: External validation in MIMIC-III

    Yap E.Ouyang J.Puri I.Melaku Y....
    7页
    查看更多>>摘要：? 2022 Elsevier B.V.Background: Low ionized calcium (ICa) is prevalent and prognostic in critical care, but poorly detected by either total calcium (TCa) or albumin-corrected TCa (cTCa). We recently derived models of ICa (Pred-ICa) and low ICa (ProbHYPO) in critical care that adjust TCa for binding to albumin and small anions—represented by the anion gap's components. On internal validation, they outperformed cTCa in diagnosing low ICa. Two other new anion gap-based models of ICa, derived in renal patients, have not been validated. This study tested the external validity of these 4 new models in the Medical Information Mart for Intensive Care III (MIMIC-III) database. Methods: We identified 4105 patients in MIMIC-III with ICa measured on an arterial blood gas panel within 20 min of chemistry panel measurements of TCa, albumin, sodium, chloride, and total carbon dioxide. The 4 models and cTCa were assessed by their diagnostic discrimination for low ICa (<1.10 mmol/l) and high ICa (>1.32 mmol/l), and by the agreement between predicted and observed values. Results: Pred-ICa and ProbHYPO had the best discrimination and agreement. Conclusions: Pred-ICa and ProbHYPO were externally validated in MIMIC-III. They can help clinicians efficiently decide when to order direct ICa testing in critical care.
      原文链接:
    • NSTL
    • Elsevier

    To DGP-IgG or not? a comparison of TTG-IgA and DGP-IgG

    Pacheco M.C.Lee D.Dickerson J.
    4页
    查看更多>>摘要：? 2022 Elsevier B.V.Background: We assessed the diagnostic utility of deamidated gliadin peptide immunoglobulin G (DGP-IgG) in pediatric patients without immunoglobulin A deficiency who underwent tissue transglutaminase immunoglobulin A (TTG-IgA) screening and biopsy. Methods: Patients who had TTG-IgA performed in our laboratory had sample frozen over 1.5 y. If a patient underwent biopsy within 6 months of serology, DGP-IgG was performed on frozen sample. All testing was performed on the BioPlex 2200. Biopsies were assigned a modified Marsh-Oberhuber score. The sensitivity, specificity, and positive and negative predictive values were calculated for TTG-IgA and DGP-IgG for values ≥ 15 u/ml, 15–149 u/ml, and ≥ 150 u/ml using biopsy as gold standard. Results: A total of 458 patients were included. Sensitivity and specificity for DGP-IgG ≥ 15 u/ml and Marsh ≥ 2 was 76% and 87.5% and TTG-IgA ≥ 15 was notably higher at 93.3% and 92.2%. Sensitivity and specificity of DGP-IgG were 66% and 88.9% at moderate and 29.3% and 98.4% at high increases. The positive predictive value of DGP-IgG for celiac disease in TTG-IgA negative patients was 2.8%. Conclusions: Our study suggests DGP-IgG does not add significant value in patients screened for celiac disease.
      原文链接:
    • NSTL
    • Elsevier

    A spurious positive result on the Abbott Architect 4th generation HIV Ag/Ab combo assay in a low-risk patient

    Pepper M.A.Wiredja D.D.Patel P.M.Stevens B.A....
    3页
      原文链接:
    • NSTL
    • Elsevier

    Sex steroid hormones in urinary exosomes as biomarkers for the prediction of prostate cancer

    Chu L.Shu X.Huang Y.Chu T....
    10页
    查看更多>>摘要：? 2022Background: Although they are involved in the progression of PCa, the use of sex steroid hormones in urinary exosomes as biomarkers for PCa remains obscure. Here, the potential use of sex steroid hormones in urinary exosomes as biomarkers was investigated for the prediction of early-stage PCa to assist in clinical diagnosis. Methods: Two hundred and eighty-six participants were randomly recruited, 231 patients with PCa and 55 healthy controls. According to their Gleason scores (GSs), the patients with PCa were divided into two groups, mild PCa (GS6) (n = 116) and severe (≥GS7) group (n = 115). The concentrations of 8 sex steroid hormones in urinary exosomes were quantitated using liquid chromatography tandem mass spectrometry with atmospheric pressure chemical ionization (LC-APCI–MS/MS). Results: The results showed that the levels of 7 out of 8 sex steroids including dehydroepiandrosterone (DHEA), dehydroepiandrosteronesulfate (DHEAS), androstenedione (A4), testosterone (T), progesterone (P), dihydrotestosterone (DHT), and estrone (E1), but not estradiol (E2) in urinary exosomes, were not only distinguished the PCa patients from healthy controls, can also differentiate between patients with mild and severe PCa. Of the 8 selected urinary exosomal biomarkers, DHEA, DHEAS, T, and DHT were finally screened further to build the regression model, and the detection method of the 4 biomarkers-combined achieved an area under the ROC curve (AUC) of 0.854 and predictive accuracy of 78.2%. Conclusion: Our data showed the use of exosomal sex steroids in urine could be as biomarkers for predicting PCa for the first time. This finding would supply a novel insight for PCa diagnosis.
      原文链接:
    • NSTL
    • Elsevier

    The thrombodynamic ratio as a predictor of 28-day mortality in sepsis patients

    Guo X.Shuai X.-Y.Cai T.-T.Wu Z.-Y....
    7页
    查看更多>>摘要：? 2022 Elsevier B.V.Background: The thrombodynamic ratio (TDR) as a composite thromboelastography (TEG) parameter, has been proven to be valuable in multiple diseases. However, the association between TDR and mortality in sepsis has not been studied. Methods: One hundred forty-one patients were enrolled in this retrospectively study. TEG was performed immediately at admission. Two cox proportional hazards models were developed for the prediction of 28-day mortality. The C statistic, continuous net reclassification index (cNRI) and integrated discriminatory index (IDI) were calculated to compare the discrimination performance of clinical models with and without the TDR value. The integrated calibration index (ICI) and E50 were calculated to compare the calibration. Results: Patients with lower TDR were more likely to have organ impairments and increased 28-day mortality. The TDR value improved discrimination performance in both Model 1 (C statistic, 0.745 vs 0.735; cNRI 19.4%, p = 0.044; IDI 5.6%, p = 0.012) and Model 2 (C statistic, 0.761 vs 0.751; IDI, 5.1%, p = 0.012). Compared to the calibration curve of Model 1 without TDR, addition of TDR displayed better calibration (ICI, 0.023; E50, 0.021). Conclusion: TDR value significantly predicts 28-day mortality in patients with sepsis and could improve the discrimination and calibration performance of clinical prediction models.
      原文链接:
    • NSTL
    • Elsevier

    Annexin A protein family in atherosclerosis

    Li Y.-Z.Wang Y.-Y.Huang L.Zhao Y.-Y....
    12页
    查看更多>>摘要：? 2022Atherosclerosis, a silent chronic vascular pathology, is the cause of the majority of cardiovascular ischaemic events. Atherosclerosis is characterized by a series of deleterious changes in cellularity, including endothelial dysfunction, transmigration of circulating inflammatory cells into the arterial wall, pro-inflammatory cytokines production, lipid accumulation in the intima, vascular local inflammatory response, atherosclerosis-related cells apoptosis and autophagy. Proteins of Annexin A (AnxA) family, the well-known Ca2+ phospholipid-binding protein, have many functions in regulating inflammation-related enzymes and cell signaling transduction, thus influencing cell adhesion, migration, differentiation, proliferation and apoptosis. There is now accumulating evidence that some members of the AnxA family, such as AnxA1, AnxA2, AnxA5 and AnxA7, play major roles in the development of atherosclerosis. This article discusses the major roles of AnxA1, AnxA2, AnxA5 and AnxA7, and the multifaceted mechanisms of the main biological process in which they are involved in atherosclerosis. Considering these evidences, it has been proposed that AnxA are drivers- and not merely participator- on the road to atherosclerosis, thus the progression of atherosclerosis may be prevented by targeting the expression or function of the AnxA family proteins.
      原文链接:
    • NSTL
    • Elsevier

    Microparticles in diabetic kidney disease

    Koulmane Laxminarayana S.L.Kanakalakshmi S.T.Swaminathan S.M.Basthi Mohan P....
    8页
    查看更多>>摘要：? 2022Diabetic kidney disease (DKD) is the most common cause of renal failure and a major contributor to the socioeconomic burden in chronic kidney disease (CKD) patients worldwide. The pathogenesis of DKD involves all the structures in the nephron, and it is indicated by proteinuria, hypertension, and progressive decline in renal function, leading to substantial morbidity and mortality. Due to the limitations of currently available standard markers (albuminuria and glomerular filtration rate) in the diagnosis and clinical grading of DKD, it's time to have novel biomarkers for early detection, targeted and effective therapy to prevent the progression. Microparticles (MPs) are extracellular vesicles measuring 0.1–1 μm derived by cytoskeletal reorganization in the form of cytoplasmic blebs which alters the phospholipid cytochemistry of the cell membrane. They are shed during cell activation and apoptosis as well as plays an important role in cell-to-cell communication. Over the last few decades, both plasma and urinary MPs have been investigated, validated and the preliminary research looks promising. With alterations in their number and composition documented in clinical situations involving both Type1 and 2 diabetes mellitus, microparticles assay appears to be promising in early diagnosis and prognostication of DKD. We cover the basics of microparticles and their involvement in DKD in this review article.
      原文链接:
    • NSTL
    • Elsevier