Clinical biochemistry最新文献

{"title":"Reference intervals for serum immunoglobulin A, G, and M in a Danish paediatric population-based cohort","authors":"Mathilde Løk ,&nbsp;Fie Erecius Dandanell ,&nbsp;Christine Frithioff-Bøjsøe ,&nbsp;Morten Asp Vonsild Lund ,&nbsp;Maria Martens Fraulund ,&nbsp;Ulrik Lausten-Thomsen ,&nbsp;Nicolai Sandau ,&nbsp;Jennifer L. Baker ,&nbsp;Torben Hansen ,&nbsp;Jens-Christian Holm","doi":"10.1016/j.clinbiochem.2025.110923","DOIUrl":"10.1016/j.clinbiochem.2025.110923","url":null,"abstract":"<div><h3>Objectives</h3><div>To determine age- and sex-specific reference values for serum immunoglobulins (IgA, IgG, and IgM) in a population-based cohort of 6 to 18 years old Danish children and adolescents and investigate if immunoglobulin concentrations vary with body mass index standard deviation score (BMI SDS).</div></div><div><h3>Materials and methods</h3><div>A total of 2171 school children and adolescents (median age 12.0 years) were recruited. BMI SDS was calculated, and health status was assessed by questionnaire and blood samples. Fasting serum concentrations of IgA, IgG, and IgM were determined by immunonephelometry.</div><div>Sex- and age-specific percentiles were generated and partitioned following the Clinical and Laboratory Standards Institute (CLSI) EP28-A3c guidelines. Multiple linear regression models were used to investigate associations between<!--> <!-->IgA, IgG, IgM, and BMI SDS adjusted for age and sex.</div></div><div><h3>Results</h3><div>Concentrations of IgA increased with age but did not differ between boys and girls. An age-dependent increase was also detected for concentrations of IgG and IgM, although for IgG it was more pronounced in boys than girls. Girls had higher concentrations of IgG and IgM than boys at all ages. Concentrations of IgM were inversely associated with BMI SDS independent of age and sex.</div></div><div><h3>Conclusions</h3><div>We generated age- and sex-specific reference intervals for IgA, IgG, and IgM based on children and adolescents from a Danish/North-European Caucasian population-based cohort. The findings can help evaluate alterations seen in primary and secondary immunodeficiencies and autoimmune diseases.</div></div>","PeriodicalId":10172,"journal":{"name":"Clinical biochemistry","volume":"137 ","pages":"Article 110923"},"PeriodicalIF":2.5,"publicationDate":"2025-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143759027","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":"Vascular endothelial growth factor A, a potential non-invasive biomarker for metabolic dysfunction-associated steatotic liver disease progression","authors":"Cecilia Jönsson ,&nbsp;Showgy Ma’ayeh ,&nbsp;Boxi Zhang ,&nbsp;Stergios Kechagias ,&nbsp;Mathias Liljeblad ,&nbsp;Patrik Nasr ,&nbsp;Sara F. Hansson ,&nbsp;Mattias Ekstedt","doi":"10.1016/j.clinbiochem.2025.110920","DOIUrl":"10.1016/j.clinbiochem.2025.110920","url":null,"abstract":"<div><h3>Introduction and Objectives</h3><div>Liver fibrosis is the primary predictor of complications in patients with metabolic dysfunction-associated steatotic liver disease (MASLD). However, there are currently no non-invasive prognostic tests to stratify patients at risk for hepatic fibrosis progression. This study aimed to explore whether plasma proteins could serve as non-invasive biomarkers for monitoring MASLD disease progression.</div></div><div><h3>Materials and Methods</h3><div>Blood plasma protein analysis was performed on samples from a long-term follow-up study of patients with MASLD with repeated liver biopsies. Over 1100 proteins covering a broad range of biological processes were analyzed using 13 Olink® Target 96 panels. Protein level changes were compared between the different time points and between patients with or without an increase in the liver fibrosis stage between the two biopsies.</div></div><div><h3>Results</h3><div>Increased vascular endothelial growth factor A (VEGFA) plasma levels were significantly associated with liver fibrosis progression in patients with a histologically assessed increase in the fibrosis stage.</div></div><div><h3>Conclusions</h3><div>These findings suggest that the plasma protein VEGFA may be an effective biomarker for monitoring fibrosis progression in patients with MASLD.</div></div>","PeriodicalId":10172,"journal":{"name":"Clinical biochemistry","volume":"137 ","pages":"Article 110920"},"PeriodicalIF":2.5,"publicationDate":"2025-03-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143699511","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}

{"title":"Reducing unnecessary free thyroid hormone testing by the reinforcement of a reflexive algorithm in an outpatient environment","authors":"Shravan Murthy ,&nbsp;Joel Scott ,&nbsp;Song Lu ,&nbsp;Dan Zhang ,&nbsp;Jason R. Vanstone ,&nbsp;Warren E. Berry ,&nbsp;Fergall Magee ,&nbsp;Jawahar Kalra ,&nbsp;Devon Houdek ,&nbsp;Pouneh Dokouhaki ,&nbsp;Ahmed Mostafa ,&nbsp;Fang Wu","doi":"10.1016/j.clinbiochem.2025.110919","DOIUrl":"10.1016/j.clinbiochem.2025.110919","url":null,"abstract":"<div><h3>Background</h3><div>Thyroid dysfunction is one of the most common endocrine disorders. Thyroid function tests, including TSH, Free T4, and Free T3, are essential for diagnosis and patient management. Current guidelines recommend TSH as the first-line test, with additional testing for Free T4 and Free T3 only when TSH is abnormal or in specific clinical scenarios. Despite guideline recommendations, inappropriate ordering of free hormone tests is prevalent, leading to increased healthcare costs, diagnostic inefficiencies, and potential patient burden. In this study, we aimed to assess thyroid function testing utilization in the Saskatoon Health Region and identify opportunities to enhance test appropriateness.</div></div><div><h3>Methods</h3><div>A retrospective analysis of thyroid function test utilization was conducted in the Saskatoon Health Region to identify gaps in guideline adherence. Inappropriate Free T4 and Free T3 testing was defined as tests ordered with TSH results in the laboratory reference range. Interventions were developed, including reinforcing the reflexive testing algorithm in outpatient settings and restricting free hormone testing to pre-approved specialists. Metrics for evaluation included testing volume trends, physician satisfaction, and cost savings.</div></div><div><h3>Results</h3><div>Pre-intervention analysis revealed significant increases in thyroid function testing volumes from 2016 to 2019: TSH orders increased by 34.5 %, Free T4 by 36.4 %, and Free T3 by 18.8 %. A substantial proportion of tests involved normal TSH ordered in combination with Free T4 and/or Free T3, which is unnecessary. Compared to baseline volumes, post-intervention Free T4 and Free T3 testing volumes decreased by approximately 60 % and 40 %, respectively.</div></div><div><h3>Conclusion</h3><div>Implementing and reinforcing a reflexive thyroid testing algorithm substantially reduced inappropriate Free T4 and Free T3 testing. Utilization management improved diagnostic efficiency, reduced unnecessary healthcare costs, and minimized patient harm.</div></div>","PeriodicalId":10172,"journal":{"name":"Clinical biochemistry","volume":"137 ","pages":"Article 110919"},"PeriodicalIF":2.5,"publicationDate":"2025-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143673395","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":"Establishing ELISA-derived 99th percentile reference ranges for aCL and anti-β2GPI antibodies in northern Chinese population: Diagnostic value assessed through P-APS/SLE case-control study","authors":"Xiaomin Shi ,&nbsp;Zhuoli Zhang ,&nbsp;Lanlan Ji ,&nbsp;Xiaoning Li","doi":"10.1016/j.clinbiochem.2025.110918","DOIUrl":"10.1016/j.clinbiochem.2025.110918","url":null,"abstract":"","PeriodicalId":10172,"journal":{"name":"Clinical biochemistry","volume":"137 ","pages":"Article 110918"},"PeriodicalIF":2.5,"publicationDate":"2025-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143654741","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":"Small dense low-density lipoprotein as biomarker in the elderly","authors":"Taina T. Katajamäki ,&nbsp;Marja-Kaisa Koivula ,&nbsp;Marika J. Salminen ,&nbsp;Tero Vahlberg ,&nbsp;Elisa T.M. Heikkilä ,&nbsp;Anna M. Viljanen ,&nbsp;Minna K. Löppönen ,&nbsp;Raimo E. Isoaho ,&nbsp;Sirkka-Liisa Kivelä ,&nbsp;Matti Viitanen ,&nbsp;Jorma Viikari ,&nbsp;Laura Viikari ,&nbsp;Kari J. Pulkki ,&nbsp;Kerttu M. Irjala","doi":"10.1016/j.clinbiochem.2025.110916","DOIUrl":"10.1016/j.clinbiochem.2025.110916","url":null,"abstract":"<div><h3>Objectives</h3><div>Small dense low-density lipoprotein (sdLDL) is atherogenic and associated with atherosclerotic cardiovascular diseases (ASCVD). The aim of this study was to perform the prospective evaluation of sdLDL-c in new ASCVD over 18 years of follow up, and to compare the association of sdLDL-c and conventional lipids and apolipoproteins with ASCVD in the elderly.</div></div><div><h3>Methods</h3><div>This prospective study included a total of 1770 subjects ≥ 64 years of age with an 18-year follow-up period. The determination of sdLDL-c was measured by a homogenous, selective enzymatic method. Levels of total cholesterol (TC), high-density lipoprotein cholesterol (HDL-c) and triglycerides (TG) were determined by enzymatic methods. Apolipoproteins, ApoA1 and ApoB, were analyzed by immunonephelometric methods. Low-density lipoprotein cholesterol (LDL-c) levels were calculated using the Friedewald formula.</div></div><div><h3>Results</h3><div>According to Pearson’s correlation coefficients, sdLDL-c concentration was positively correlated with LDL-c, nonHDL-c, TC and ApoB concentrations. During follow up, sdLDL-c was significantly associated with new ASCVD in men aged 64–76 years in both unadjusted and adjusted Cox regression models. The adjusted hazard ratio (95 % CI) for sdLDL-c was 1.61 (1.13–2.28). No significant associations between sdLDL-c and ASCVD were observed in men aged 77–97 years, nor in women aged 64–79 or 80–100 years.</div></div><div><h3>Conclusions</h3><div>Lipid and apolipoprotein concentrations of the elderly were high compared to the recommended target values. In addition, lipid and apolipoprotein baseline concentrations were not higher in the ASCVD group than in the control group. Our results indicated that sdLDL-c is as good a marker as ApoB and better than LDL-c.</div></div>","PeriodicalId":10172,"journal":{"name":"Clinical biochemistry","volume":"137 ","pages":"Article 110916"},"PeriodicalIF":2.5,"publicationDate":"2025-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143662297","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}

{"title":"Evaluating accelerations across multiple routes of a pneumatic tube system to ensure sample integrity for LDH measurement","authors":"Yun Huang ,&nbsp;Christiana Adewale ,&nbsp;Ryanne O’Sullivan ,&nbsp;Donnah Pocius","doi":"10.1016/j.clinbiochem.2025.110917","DOIUrl":"10.1016/j.clinbiochem.2025.110917","url":null,"abstract":"<div><h3>Objectives</h3><div>Lactate dehydrogenase (LDH) concentrations can falsely increase due to the acceleration forces generated in the pneumatic tube system (PTS) during blood sample transport, potentially leading to altered medical decisions. This study evaluated the accelerations and elevated LDH concentrations in 11 routes during PTS transport in an academic hospital.</div></div><div><h3>Methods</h3><div>Three blood samples were collected from each healthy volunteer and transported via hand carrier, PTS carrier, and PTS carrier with an additional foam insert. Five samples were included in the same carrier for every transport. An accelerometer was placed with the samples to record pressure, acceleration and transport time for each PTS route. The samples were then tested for hemoglobin and LDH concentrations on core laboratory chemistry analyzers. Three acceleration parameters were calculated.</div></div><div><h3>Results</h3><div>Transport time across the 11 routes varied widely from 78 to 455 s. Hemoglobin concentrations showed a slight increase during PTS transport, which was associated with a significant increase in LDH concentrations (r 0.716, p &lt; 0.001). On average, LDH increased from 9.5 to 59.2 % during PTS transport. Total accelerations, percentages of acceleration &gt; 5 g, and maximum accelerations ranged from 172.7 to 617.9 g, 3.5 to 14.7 %, and 15.31 to 24.28 g, respectively. When routes were scored based on any of the three parameters exceeding their average, routes with an LDH increase &gt; 15 % had higher scores than those with an LDH increase ≤ 15 %.</div></div><div><h3>Conclusions</h3><div>This study supports using accelerometers to validate and monitor the accelerations of each route generated during PTS blood sample transport and to identify the routes unsuitable for LDH measurement. Further studies are warranted to determine appropriate acceleration parameters and their thresholds to ensure sample integrity.</div></div>","PeriodicalId":10172,"journal":{"name":"Clinical biochemistry","volume":"137 ","pages":"Article 110917"},"PeriodicalIF":2.5,"publicationDate":"2025-03-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143656369","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":"Therapeutic drug monitoring of levetiracetam – Is dried blood spot sampling suitable?","authors":"Camilla Linder ,&nbsp;Victoria Barclay ,&nbsp;Mihaela Oana Romanitan ,&nbsp;Stanislav Beniaminov ,&nbsp;Isabella Ekheden","doi":"10.1016/j.clinbiochem.2025.110913","DOIUrl":"10.1016/j.clinbiochem.2025.110913","url":null,"abstract":"<div><h3>Background</h3><div>Therapeutic drug monitoring helps prevent seizures and minimize side effects in epilepsy patients. Phlebotomy is the gold standard for blood collection but can be difficult for children, pregnant women, and patients in remote areas. We previously validated dried blood spot (DBS) sampling for carbamazepine, lamotrigine, levetiracetam (LEV), and valproic acid. Uncertainties in LEV comparisons from the previous validation were further investigated in this study by increasing sample numbers and comparing results using both immunochemistry and LC-MS/MS methods. Additionally, capillary and venous DBS were compared, and the stability of samples during mail transport was assessed.</div></div><div><h3>Aim</h3><div>To compare LEV concentrations in capillary DBS and plasma, and to assess the stability of capillary DBS during transportation.</div></div><div><h3>Method</h3><div>Capillary and venous blood samples were collected from 40 LEV-treated patients. Concentrations were measured using immunochemistry and liquid chromatography tandem mass spectrometry methods. Comparisons between matrices and methods were analyzed with Passing-Bablok regression and Bland-Altman plots.</div></div><div><h3>Results</h3><div>No proportional bias was found in regression analysis and Bland-Altman plots showed no bias between methods. For capillary DBS versus plasma concentrations, 92.1 % of values were within 20 % of the mean. No bias was detected between capillary and venous DBS, with deviations within acceptable limits. Sample stability was maintained during mail transport.</div></div><div><h3>Conclusion</h3><div>The concentrations obtained for LEV in capillary DBS versus plasma showed that therapeutic drug monitoring of LEV can be performed as at-home self-sampling with DBS mailed to the laboratory for analysis.</div></div>","PeriodicalId":10172,"journal":{"name":"Clinical biochemistry","volume":"137 ","pages":"Article 110913"},"PeriodicalIF":2.5,"publicationDate":"2025-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143639548","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}

{"title":"Establishing sustainable quality improvement in the clinical laboratory: Redesign of the total testing process and digital transformation of routine quality assurance activities","authors":"Angela W.S. Fung","doi":"10.1016/j.clinbiochem.2025.110915","DOIUrl":"10.1016/j.clinbiochem.2025.110915","url":null,"abstract":"<div><div>Healthcare services contribute 5 to 10% of global carbon emissions and environmental burden on the planet. Sustainability in health care and laboratory medicine is gaining global momentum emphasizing a holistic approach to reduce carbon footprint, improve the delivery and quality of care, while optimizing operational efficiency and effectiveness. Digital transformation has the potential of achieving these goals simultaneously. Clinical laboratories should assess and mitigate their environmental impact through digital technologies. In this article, opportunities and challenges in establishing sustainable quality improvement in the clinical laboratory will be discussed with a focus on the redesign of the total testing process and digital transformation of routine quality assurance activities.</div></div>","PeriodicalId":10172,"journal":{"name":"Clinical biochemistry","volume":"137 ","pages":"Article 110915"},"PeriodicalIF":2.5,"publicationDate":"2025-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143639544","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}

{"title":"The case of a bloody mess – Bictegravir/emtricitabine/tenofovir alafenamide induced colitis","authors":"Meshach Asare-Werehene ,&nbsp;Mary Kathryn Bohn ,&nbsp;Allison Ming-Freckleton ,&nbsp;Rajeevan Selvaratnam","doi":"10.1016/j.clinbiochem.2025.110910","DOIUrl":"10.1016/j.clinbiochem.2025.110910","url":null,"abstract":"<div><h3>Background</h3><div>Fecal calprotectin is a marker used to differentiate inflammatory bowel disease versus irritable bowel syndrome and is relevant in the diagnosis of ulcerative colitis and Crohn’s disease. Markedly elevated calprotectin from stool samples provides evidence of colonic inflammation to support the diagnosis of pancolitis. This report is the first to demonstrate the clinical significance of fecal calprotectin in supporting the diagnosis of pancolitis induced by the anti-viral drug, Biktarvy (bictegravir/emtricitabine/tenofovir alafenamide).</div></div><div><h3>Case report</h3><div>A 62-year-old male on Biktarvy for his HIV diagnosis was admitted to internal medicine with abdominal pain, bloody diarrhea and pancolitis. His white blood cell count was 15.8 (4.0–11.0x10⁹/L), neutrophil count was 9.7 (2.0–7.5 × 10⁹/L), monocyte count was 1.2 (0.2–0.8 × 10⁹/L), granulocyte count was 1.5 (≤0.1 × 10⁹/L) and hemoglobin was 163 (140–180 g/L). The patient had a C-reactive protein of 229 (≤11.0 mg/L). Serology and blood culture were negative for microbial testing and abdomino-pelvic computed tomography findings were unremarkable. A bloody stool collected had a fecal calprotectin level of 1,159 (&lt;50 µg/g).</div></div><div><h3>Conclusions</h3><div>This case highlights how anti-retroviral therapies such as Biktarvy may elicit medication-induced gastrointestinal symptoms, which may underlie the cause of bloody diarrhea and pancolitis, and consequently a grossly elevated fecal calprotectin.</div></div>","PeriodicalId":10172,"journal":{"name":"Clinical biochemistry","volume":"137 ","pages":"Article 110910"},"PeriodicalIF":2.5,"publicationDate":"2025-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143633922","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}

{"title":"The pitfalls and significance of using ratios and calculated parameters in laboratory medicine","authors":"Loralie J. Langman ,&nbsp;Christine LH Snozek ,&nbsp;Andre Mattman","doi":"10.1016/j.clinbiochem.2025.110914","DOIUrl":"10.1016/j.clinbiochem.2025.110914","url":null,"abstract":"","PeriodicalId":10172,"journal":{"name":"Clinical biochemistry","volume":"137 ","pages":"Article 110914"},"PeriodicalIF":2.5,"publicationDate":"2025-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143633928","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}