Method comparison of diabetes mellitus associated autoantibodies in serum specimens.

IF 3.7 2区 医学 Q1 MEDICAL LABORATORY TECHNOLOGY
Alexander Lenard, Andreas Rapp, Steffen Busch, Peter Findeisen
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引用次数: 0

Abstract

Objectives: Autoantibodies against structure elements of the pancreas are an essential part of laboratory diagnosis of diabetes mellitus. The heterogeneity of current methods and difficult inter-assay comparability of results poses challenges to both clinical interpretation as well as research integrity.

Methods: We conducted a method validation study comparing the measurement of autoantibodies against glutamic acid decarboxylase (GADA), islet antigen 2 (IA-2A), and zinc transporter 8 (ZnT8A) on three commercially available platforms (EUROLabWorkstation analyzer, enzyme-linked immunosorbent assay (ELISA); iFlash 1800 (chemiluminescence immunoassay (CLIA); Maglumi 800 (CLIA)).

Results: Compared to the results from EUROLabWorkstation analyzer that was routinely used in our laboratory, the Maglumi demonstrated an acceptable agreement and deviation for GADA (75.4-35.8 %) and IA-2A (71.7-50.3 %). The iFlash displayed less favorable results with agreement and deviation for GADA (51.5-108.8 %) and IA-2A (68-32.5 %). While the iFlash showed excellent agreement for ZnT8A, the Maglumi produced almost exclusively negative results below a 200 U/mL threshold which results in severe underestimation of results on the Maglumi. Overall, no consistent agreement was observed across all three parameters among the CLIA devices tested.

Conclusions: Our study reveals significant and clinically relevant discrepancies in the detection of GADA and IA-2A when comparing CLIA devices to the ELISA method routinely used in our laboratory. For individual antibodies up to 65 % of patients who tested positive using ELISA showed negative or borderline results on at least one CLIA device. These deviations are unpredictable and cannot be detected through standard calibration and internal control procedures.

方法比较血清标本中糖尿病相关自身抗体。
目的:针对胰腺结构因子的自身抗体是糖尿病实验室诊断的重要组成部分。当前方法的异质性和测定间结果的难以比较性对临床解释和研究完整性都提出了挑战。方法:我们进行了一项方法验证研究,比较了在三种市售平台(EUROLabWorkstation分析仪、酶联免疫吸附法(ELISA);iFlash 1800(化学发光免疫分析(CLIA);Maglumi 800 (CLIA))结果:与我们实验室常规使用的EUROLabWorkstation分析仪的结果相比,Maglumi对GADA(75.4-35.8 %)和IA-2A(71.7-50.3 %)的一致性和偏差都是可以接受的。iFlash显示GADA(51.5-108.8 %)和IA-2A(68-32.5 %)的一致性和偏差较差。虽然iFlash对ZnT8A表现出极好的一致性,但在低于200 U/mL的阈值下,Maglumi几乎完全产生了阴性结果,这导致了对Maglumi结果的严重低估。总的来说,在测试的CLIA设备中,没有观察到所有三个参数的一致一致。结论:我们的研究表明,在比较CLIA设备与我们实验室常规使用的ELISA方法时,GADA和IA-2A的检测存在显著和临床相关的差异。对于单个抗体,高达65% 使用ELISA检测阳性的患者在至少一种CLIA设备上显示阴性或边缘结果。这些偏差是不可预测的,无法通过标准校准和内部控制程序检测到。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Clinical chemistry and laboratory medicine
Clinical chemistry and laboratory medicine 医学-医学实验技术
CiteScore
11.30
自引率
16.20%
发文量
306
审稿时长
3 months
期刊介绍: Clinical Chemistry and Laboratory Medicine (CCLM) publishes articles on novel teaching and training methods applicable to laboratory medicine. CCLM welcomes contributions on the progress in fundamental and applied research and cutting-edge clinical laboratory medicine. It is one of the leading journals in the field, with an impact factor over 3. CCLM is issued monthly, and it is published in print and electronically. CCLM is the official journal of the European Federation of Clinical Chemistry and Laboratory Medicine (EFLM) and publishes regularly EFLM recommendations and news. CCLM is the official journal of the National Societies from Austria (ÖGLMKC); Belgium (RBSLM); Germany (DGKL); Hungary (MLDT); Ireland (ACBI); Italy (SIBioC); Portugal (SPML); and Slovenia (SZKK); and it is affiliated to AACB (Australia) and SFBC (France). Topics: - clinical biochemistry - clinical genomics and molecular biology - clinical haematology and coagulation - clinical immunology and autoimmunity - clinical microbiology - drug monitoring and analysis - evaluation of diagnostic biomarkers - disease-oriented topics (cardiovascular disease, cancer diagnostics, diabetes) - new reagents, instrumentation and technologies - new methodologies - reference materials and methods - reference values and decision limits - quality and safety in laboratory medicine - translational laboratory medicine - clinical metrology Follow @cclm_degruyter on Twitter!
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