Clinical biochemistry最新文献

{"title":"Autoantibody testing in neuromuscular medicine: assay technologies, interpretation, and clinical utility","authors":"Tony Zhang ,&nbsp;John R. Mills ,&nbsp;Divyanshu Dubey ,&nbsp;Christopher J. Klein","doi":"10.1016/j.clinbiochem.2026.111092","DOIUrl":"10.1016/j.clinbiochem.2026.111092","url":null,"abstract":"<div><div>Neuromuscular autoantibody testing is an essential component in the diagnosis and management of autoimmune neuromuscular disorders. These immune-mediated diseases target antigens found in nerves, muscles, and neuromuscular junctions, and may occasionally involve the central nervous system, resulting in complex clinical presentations. Developments in antibody identification and validation have provided clinically relevant biomarkers for diagnostic, therapeutic, and prognostic purposes. Among antibody-associated neuromuscular disorders, paraneoplastic onconeural autoantibodies are of particular significance, as their presence may direct search for specific underlying malignancies. Appropriate ordering and interpretation of these tests should be integrated with clinical and electrodiagnostic (CEDX) findings. Given that these disorders are often rare, estimating an optimal pre-test probability is important to improve test accuracy and reduce false positive outcomes. Online clinical calculators are available to help clinicians determine appropriate testing strategies for some disorders. This review summarizes principal neuromuscular antibodies, current testing approaches, and the influence of laboratory data on patient care.</div></div>","PeriodicalId":10172,"journal":{"name":"Clinical biochemistry","volume":"142 ","pages":"Article 111092"},"PeriodicalIF":2.1,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146112400","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}

{"title":"Evidence-based extension of reagent shelf-life beyond expiry using patient-based moving averages, westgard sigma rules, and CLSI EP25","authors":"Mohamed Mokhtar Khelil ,&nbsp;Tony Badrick","doi":"10.1016/j.clinbiochem.2026.111094","DOIUrl":"10.1016/j.clinbiochem.2026.111094","url":null,"abstract":"<div><h3>Background</h3><div>Reagent stability is a significant determinant of analytical reliability in clinical laboratories. Post-expiry reagent use is often discouraged due to the potential risk of systematic bias; however, empirical data supporting or refuting such restrictions are limited.</div></div><div><h3>Methods</h3><div>This study evaluated the post-expiry performance of free T3 (FT3) and free T4 (FT4) immunoassays on the Abbott Architect i1000SR analyzer using an integrated framework combining three complementary approaches: (i) a simulation-optimized moving average (MA) model based on real patient data (ii) Westgard Sigma rules quality control, and (iii) Clinical and Laboratory Standards Institute EP25-A drift analysis. The MA was optimised via Monte Carlo simulations using a step-shift bias model, which defined the optimal window size (N) for 90% detection power and 0% false rejection rate. Stability was then assessed across three reagent lots per analyte, spanning both pre- and post-expiration phases.</div></div><div><h3>Results</h3><div>Westgard rules provided the earliest analytical alerts, while EP25 confirmed sustained drift relative to allowable total error. The MA detected progressive instability, showing strong concordance with EP25 after lag correction (N × cadence). FT4 indicated extended stability of up to 19 months post-expiry, while FT3 showed limited stability (&lt;4 months). These differences reflected distinct assay robustness and kinetics.</div></div><div><h3>Conclusions</h3><div>The combination of Westgard sigma rules, EP25, and simulation-optimized MA provides a reproducible, data-driven framework for post-expiry reagent stability assessment. Optimizing MA with real patient data enhances detection performance, bridging theoretical quality-control design and routine laboratory application. This integrated approach enables laboratories to make scientifically justified, cost-effective decisions regarding reagent reuse beyond manufacturer expiry dates.</div></div>","PeriodicalId":10172,"journal":{"name":"Clinical biochemistry","volume":"142 ","pages":"Article 111094"},"PeriodicalIF":2.1,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146112382","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}

{"title":"Corrigendum to “Improving the environmental impact paradox of clinical medical laboratories” [Clin. Biochem. 141 (2026) 111063]","authors":"Pernilla Sörme,&nbsp;Scott Weitze","doi":"10.1016/j.clinbiochem.2026.111091","DOIUrl":"10.1016/j.clinbiochem.2026.111091","url":null,"abstract":"","PeriodicalId":10172,"journal":{"name":"Clinical biochemistry","volume":"142 ","pages":"Article 111091"},"PeriodicalIF":2.1,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146194146","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}

{"title":"Interference and failure: The challenge of high-concentration IgM monoclonal protein in capillary zone electrophoresis","authors":"Yanhua Zhao,&nbsp;Minjie Zhang,&nbsp;Wei Gan","doi":"10.1016/j.clinbiochem.2026.111099","DOIUrl":"10.1016/j.clinbiochem.2026.111099","url":null,"abstract":"<div><h3>Background</h3><div>Capillary zone electrophoresis (CZE) is a standard method for serum protein separation, but its performance can be compromised by IgM monoclonal proteins, leading to false-negative results.</div></div><div><h3>Methods</h3><div>We report a case of Waldenström macroglobulinemia (IgM 56.05 g/L) with repeated CZE failure. Immunofixation electrophoresis (IFE) confirmed an IgM kappa monoclonal protein. Four pretreatment protocols were evaluated: 1) 37°C incubation; 2) dilution with distilled water; 3) dilution with 0.9% saline; and 4) pretreatment with β‑mercaptoethanol (BME). Gel-based serum protein electrophoresis (SPE) and immunosubtraction CZE were also performed to investigate the interference mechanism.</div></div><div><h3>Results</h3><div>Initial CZE failed to yield an interpretable electrophoretogram. Incubation at 37°C showed no improvement. Dilution with distilled water induced visible precipitation and resulted in a false-negative electrophoretic pattern with a marked drop in measured total protein. Dilution with saline prevented precipitation but still failed to reveal a distinct monoclonal spike, despite biochemical measurements consistent with high globulin levels. In contrast, pretreatment with BME successfully restored a clear monoclonal spike in the β‑γ region on CZE, demonstrating restored solubility and proper migration. IFE corroborated the presence of the IgM kappa monoclonal protein. Gel-based SPE successfully showed a distinct M-protein band without interference, while immunosubtraction CZE failed under both temperature conditions, supporting cryoglobulin-related interference.</div></div><div><h3>Conclusions</h3><div>Very high IgM concentrations, particularly with cryoglobulin activity, can cause complete CZE failure not resolved by standard dilution or heating. The interference likely involves capillary obstruction from protein aggregation or temperature-dependent re-precipitation within the capillary. BME pretreatment is a critical intervention for unmasking IgM monoclonal proteins when CZE results are inconsistent with other laboratory findings, thereby preventing diagnostic errors.</div></div>","PeriodicalId":10172,"journal":{"name":"Clinical biochemistry","volume":"142 ","pages":"Article 111099"},"PeriodicalIF":2.1,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146212277","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}

{"title":"Assessing precision, bias, and sigma metrics of 22 measurands using Ricos and EFLM specifications and implementation of internal quality control procedure in clinical chemistry laboratory","authors":"Khouloud Hkimi ,&nbsp;Sonia Gara","doi":"10.1016/j.clinbiochem.2026.111108","DOIUrl":"10.1016/j.clinbiochem.2026.111108","url":null,"abstract":"<div><h3>Background</h3><div>The European Federation of Clinical Chemistry and Laboratory Medicine (EFLM) biological variation (BV) database is currently the reference source for BV-based specifications, providing evidence-based and more stringent limits than the historical Ricos database.</div></div><div><h3>Objective</h3><div>This study aimed to assess the impact of the transition from old to updated BV goals on sigma metrics in our laboratory.</div></div><div><h3>Methods</h3><div>The study was conducted at the National Institute of Salah Azaiz medical biology laboratory over an 8-month period. It included 22 biological parameters for which coefficients of variation and biases were calculated using internal and external quality control materials. Sigma metrics were determined using Ricos and the EFLM desirable specifications.</div></div><div><h3>Results</h3><div>Using Ricos desirable specifications, 27.3% of analytes (ALT, CK, iron, total bilirubin, triglycerides, and CA19-9) achieved sigma ≥ 6, 36.4% had sigma between 3 and 6 (AST, LDH, urea, uric acid, AFP, CEA, CA125, and CA15-3), and 36.4% had sigma &lt; 3 (calcium, creatinine, glucose, magnesium, potassium, sodium, total cholesterol, total protein). With the stricter EFLM targets, 6 sigma performers decreased to 19.1% (CK, iron, total bilirubin, triglycerides). 28.5% of analytes had sigma between 3 and 6 (ALT, AST, urea, uric acid, CEA, CA19-9), and 52.4% had sigma &lt; 3 (calcium, creatinine, glucose, LDH, magnesium, potassium, sodium, total cholesterol, total protein, AFP and CA125). The resulting internal quality control strategy hence differed. The quality goal index indicated that imprecision was the main limitation for most analytes.</div></div><div><h3>Conclusions</h3><div>Updating performance specifications from the historical Ricos database to the evidence-based EFLM resulted in more stringent BV goals that are challenging to achieve with current routine technologies. Intensified root-cause analysis, closer collaboration with manufacturers, and ongoing performance reassessment are necessary for poor performers.</div></div>","PeriodicalId":10172,"journal":{"name":"Clinical biochemistry","volume":"142 ","pages":"Article 111108"},"PeriodicalIF":2.1,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147343409","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}

{"title":"Novel fibrinogen mutations in pediatric patients: implications for neonatal coagulation screening and family genetic counseling","authors":"Jie Jiang","doi":"10.1016/j.clinbiochem.2026.111102","DOIUrl":"10.1016/j.clinbiochem.2026.111102","url":null,"abstract":"","PeriodicalId":10172,"journal":{"name":"Clinical biochemistry","volume":"142 ","pages":"Article 111102"},"PeriodicalIF":2.1,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146218862","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}

{"title":"Outlook on ACADSB variants shaping metabolomic patterns and clinical outcomes − experience from a Central European country","authors":"Andrej Bandura ,&nbsp;Ján Chandoga ,&nbsp;Jerguš Vengríni ,&nbsp;Miriama Juhosová ,&nbsp;Alžbeta Vavrová ,&nbsp;Elena Gregová ,&nbsp;Miroslava Lysinová ,&nbsp;Zuzana Mydlová ,&nbsp;Katarína Brennerová ,&nbsp;Jana Šaligová ,&nbsp;Danka Maceková ,&nbsp;Daniel Böhmer","doi":"10.1016/j.clinbiochem.2026.111105","DOIUrl":"10.1016/j.clinbiochem.2026.111105","url":null,"abstract":"<div><h3>Background</h3><div>Short/branched-chain acyl-CoA dehydrogenase deficiency (SBCADD) is an autosomal recessive defect of L-isoleucine catabolism caused by pathogenic variants in the <em>ACADSB</em> gene. While early reports described neurological symptoms, expanded newborn screening cohorts have revealed predominantly asymptomatic individuals, raising questions regarding the clinical significance and optimal management.</div></div><div><h3>Methods</h3><div>We performed an evaluation of three probands with a biochemical profile consistent with SBCADD identified in a Central European country. Acylcarnitines were measured by liquid chromatography with tandem mass spectrometry, urinary organic acids by gas chromatography with mass spectrometry, and <em>ACADSB</em> was sequenced. Clinical data were collected from regional paediatric follow-up.</div></div><div><h3>Results</h3><div>Three individuals with a biochemical profile consistent with SBCADD were identified in Slovakia. Two were detected through newborn screening, whereas one was diagnosed at 5 years of age. All three showed elevated C5-acylcarnitine; the C5/C8 ratio was increased in two patients, while in the third it remained within the reference range despite persistently elevated C5. Urinary 2-methylbutyrylglycine and 2-ethyl-3-hydroxypropionate were elevated in all cases and showed intra-individual variability; in one sample, 2-methylbutyrylglycine remained increased while 2-ethyl-3-hydroxypropionate had normalised. Two patients carried pathogenic <em>ACADSB</em> variants (one homozygous splice-site variant c.303 + 1G &gt; A, one compound heterozygous for p.Thr148Ile and p.Glu387Lys), whereas genetic testing was not performed in the third case. Over the available follow-up period, no episodes of metabolic decompensation were observed; two patients remained clinically well, and one patient had autism spectrum disorder. Free carnitine concentrations were within the reference range in all probands.</div></div><div><h3>Conclusions</h3><div>Our findings support SBCADD as a primarily biochemical phenotype with a largely benign course, while illustrating variability of urinary biomarkers and C5/C8 ratios. Accurate differentiation from isovaleric acidemia and careful integration of biochemical, genetic and clinical data remain essential.</div></div>","PeriodicalId":10172,"journal":{"name":"Clinical biochemistry","volume":"142 ","pages":"Article 111105"},"PeriodicalIF":2.1,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146776021","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}

{"title":"Advantages and application of a decision tree algorithm combined with the Harris-Boyd criterion in the construction of dynamic reference intervals for coagulation indicators during pregnancy","authors":"Xiaosong Lin ,&nbsp;Zhi Lin ,&nbsp;Liangjie Xu ,&nbsp;Feng Zhao ,&nbsp;Yuying Weng","doi":"10.1016/j.clinbiochem.2026.111087","DOIUrl":"10.1016/j.clinbiochem.2026.111087","url":null,"abstract":"<div><h3>Introduction</h3><div>Reference intervals (RIs) based on fixed gestationals may not accurately reflect the dynamic changes of the hypercoagulable state. This study aimed to evaluate the rationality of integrating a decision tree algorithm (DTA) with the Harris-Boyd criterion (DTAHBC) to establish dynamic RIs for coagulation indicators during pregnancy.</div></div><div><h3>Materials and methods</h3><div>Dynamic data of prothrombin time (PT), international normalized ratio (INR), activated partial thromboplastin time (APTT), thrombin time (TT), fibrinogen (Fib), D-dimer (D-d), and fibrin degradation product (FDP) were retrospectively analyzed in 4,698 healthy pregnant women. Scatter plots were drawn to observe changes regarding each indicator during pregnancy. DTAs were used to identify dynamic inflection points, which were validated using the Harris-Boyd criterion. Moreover, 2.5th and 97.5th percentiles and their 90% confidence intervals were calculated. New RIs were compared to traditional trimester-based RIs and validated by coincidence rates within the cohort.</div></div><div><h3>Results</h3><div>The study showed that PT, INR, APTT, and TT values were stable across gestation weeks. However, Fib, D-d, and FDP values increased rapidly. The DTA analysis found inflection points misaligned with traditional trimester-based nodes. Compared to traditional methods, the new method identified the initial stage of coagulation activation in the second trimester (FDP exceeding non-pregnant ranges at 14–21 weeks) and the aggravation stage of hypercoagulability in the late trimester (median FDP exceeding non-pregnant upper limits at 34–40 weeks). Validation in the same cohort revealed compliance rates &gt;90% for new RIs, whereas traditional TT (82.11%) and D-d (87.89%) measurements obtained at 14–27 weeks failed validation.</div></div><div><h3>Conclusion</h3><div>DTAHBC-based RIs do not follow the traditional trimester division, can effectively reflect dynamic changes in coagulation indicators, and provide a new solution for coagulation-function evaluation during pregnancy.</div></div>","PeriodicalId":10172,"journal":{"name":"Clinical biochemistry","volume":"142 ","pages":"Article 111087"},"PeriodicalIF":2.1,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146017566","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}

{"title":"Prognostic value of human serum alpha-klotho concentrations in patients with heart failure with reduced ejection fraction","authors":"Ajay Mahenthiran ,&nbsp;Silvio Augusto Nunes Jr ,&nbsp;Chia-Feng Liu ,&nbsp;Steven Leon ,&nbsp;Jennifer Wilcox ,&nbsp;W.H. Wilson Tang","doi":"10.1016/j.clinbiochem.2026.111086","DOIUrl":"10.1016/j.clinbiochem.2026.111086","url":null,"abstract":"<div><h3>Objective</h3><div>Heart Failure (HF) is a major health problem with high prevalence and mortality. Identifying new biomarkers involved in controlling heart failure progression has become particularly important. This study evaluated the association between serum α-klotho concentrations and long-term all-cause mortality in patients with stable HF.</div></div><div><h3>Design and methods</h3><div>We analyzed serum α-klotho levels in 230 adults (135 patients with HF with reduced ejection fraction and 95 age and sex-matched healthy controls). A classification and regression tree analysis was used to stratify patients by α-klotho concentration, using all-cause mortality within a 5-year follow-up as the primary endpoint. Differences in log-NT-proBNP levels across α-klotho groups were assessed using the Kruskal-Wallis test with Dunn’s post-hoc comparisons. Kaplan-Meier survival analysis evaluated the association between α-klotho stratified groups and 5-year all-cause mortality.</div></div><div><h3>Results</h3><div>Patients with higher serum α-klotho levels had significantly lower mortality and lower log NT-proBNP across α-klotho groups (χ²(2) = 8.05, p = 0.018) when compared to lower α-klotho concentration levels. Kaplan-Meier curves show the significant difference in survival across α-klotho stratification (log-rank p &lt; 0.01).</div></div><div><h3>Conclusion</h3><div>Patients with higher serum α-klotho concentrations were associated with lower log-NT-proBNP levels and better 5-year survival in all patients as well as in patients with heart failure, compared to those with lower. These findings support the role of α-klotho as a promising cardioprotective biomarker for risk stratification in patients with HF.</div></div>","PeriodicalId":10172,"journal":{"name":"Clinical biochemistry","volume":"142 ","pages":"Article 111086"},"PeriodicalIF":2.1,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146017552","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}

{"title":"Fibroblast growth factor 23-induced hypophosphatemia in a malignant phosphaturic mesenchymal tumor: presentation of a rare case","authors":"Diver Alexis Chicangana Tuquerres ,&nbsp;Andrés David Sastre Martínez ,&nbsp;Carlos Mário Barrios Herrera ,&nbsp;Paula Andrea Torres Pérez ,&nbsp;Carlos Fernando Acuña Roldán ,&nbsp;Gabriel Jaime Varela Aguirre ,&nbsp;Andres Felipe García Ramos","doi":"10.1016/j.clinbiochem.2026.111090","DOIUrl":"10.1016/j.clinbiochem.2026.111090","url":null,"abstract":"<div><h3>Introduction</h3><div>Tumor-induced osteomalacia is a rare paraneoplastic disorder caused by excess fibroblast growth factor 23 (FGF23), most often produced by phosphaturic mesenchymal tumors. Delayed diagnosis may result in severe metabolic and skeletal complications.</div></div><div><h3>Case presentation</h3><div>We report the case of a 32-year-old woman with a three-year history of progressive weakness and a rapidly enlarging thoracic mass. Imaging revealed an 18 × 13 cm highly vascularized thoracic lesion with multiple lytic bone metastases. Laboratory evaluation showed severe hypophosphatemia (0.9 mg/dL), renal phosphate wasting (fractional excretion of phosphate 24.5%), elevated intact parathyroid hormone, low vitamin D levels, and markedly increased serum FGF23 (7926 kRU/L). Histopathological examination and immunohistochemistry demonstrated a malignant phosphaturic mesenchymal tumor with positivity for CD56, SATB2, and SSTR2A.</div></div><div><h3>Discussion</h3><div>This case highlights the aggressive clinical behavior that malignant phosphaturic mesenchymal tumors may exhibit, including extensive local invasion, metastatic disease, and profound metabolic derangements. The diagnosis of tumor-induced osteomalacia requires a high index of suspicion and an integrated approach combining biochemical evaluation, functional imaging, and detailed pathological assessment.</div></div><div><h3>Conclusions</h3><div>Tumor-induced osteomalacia should be considered in patients with persistent hypophosphatemia and phosphate wasting. Early recognition is essential, as complete surgical resection remains the only curative option. In advanced or unresectable disease, management is challenging and may be limited by tumor burden and access to targeted therapies, including anti-FGF23 agents, which offer biochemical and symptomatic benefit in selected cases.</div></div>","PeriodicalId":10172,"journal":{"name":"Clinical biochemistry","volume":"142 ","pages":"Article 111090"},"PeriodicalIF":2.1,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146060482","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}