Clinical biochemistry最新文献

{"title":"Linking gestational RBP4 to bone resorption via postprandial glycemic pathways: A cross-sectional mediation analysis","authors":"Xiaoji Feng ,&nbsp;Yuanting Tang ,&nbsp;Qing Li ,&nbsp;Yiduo Zhang ,&nbsp;Fan Yu","doi":"10.1016/j.clinbiochem.2025.110930","DOIUrl":"10.1016/j.clinbiochem.2025.110930","url":null,"abstract":"<div><h3>Background</h3><div>Retinol-binding protein 4 (RBP4), a key adipokine associated with glucose metabolism, is elevated during pregnancy and linked to gestational diabetes mellitus (GDM). However, its relationship with gestational bone resorption remains unclear. This study aimed to investigate the association between RBP4 and bone resorption (measured by β-C-terminal telopeptide of type I collagen [β-CTX]) and explore potential mediation pathways involving glycemic dysregulation in pregnancy.</div></div><div><h3>Methods</h3><div>In this cross-sectional study, we analyzed serum RBP4, β-CTX, glucose metrics (fasting blood glucose, 1-hour [GLU1h], 2-hour [GLU2h] post-load glucose), insulin resistance indices (IR), and GDM status in pregnant women. Mediation analyses were performed to identify statistical pathways connecting RBP4 and β-CTX.</div></div><div><h3>Results</h3><div>After adjusting for maternal age, gestational age, and body mass index, each 1 mg/L increase in RBP4 was associated with a 10.7 ng/L rise in β-CTX (explaining 7 % of variance). Single-mediator models indicated that GLU1h and GLU2h independently accounted for approximately 50 % of the RBP4-β-CTX association (indirect effects: 5.33 and 5.40, respectively). In serial mediation, the combined glycemic pathways mediated 0.502 of the total association (Indirect_All = 5.42), while individual paths were non-significant, suggesting potential interplay between postprandial phases. Notably, GDM status and IR showed no mediation, likely reflecting limitations of dichotomous diagnostic thresholds and pregnancy-adapted insulin resistance.</div></div><div><h3>Conclusion</h3><div>The association between RBP4 and bone resorption in pregnancy is largely linked to dynamic postprandial glucose fluctuations rather than categorical GDM. These findings highlight the importance of continuous glucose monitoring and tailored interventions in women with elevated RBP4, even below GDM thresholds, to address potential bone health risks.</div></div>","PeriodicalId":10172,"journal":{"name":"Clinical biochemistry","volume":"137 ","pages":"Article 110930"},"PeriodicalIF":2.5,"publicationDate":"2025-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143850631","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":"Plasma trimethylamine levels predict adverse cardiovascular events in sudden cardiac arrest Survivors: A prospective cohort study","authors":"Hao Huang ,&nbsp;Sijing Cheng ,&nbsp;Tianxin Long ,&nbsp;Bingqi Fu ,&nbsp;Juwei Yang ,&nbsp;Chi Cai ,&nbsp;Min Gu ,&nbsp;Hongxia Niu ,&nbsp;Xuhua Chen ,&nbsp;Wei Hua ,&nbsp;Shengwen Yang","doi":"10.1016/j.clinbiochem.2025.110928","DOIUrl":"10.1016/j.clinbiochem.2025.110928","url":null,"abstract":"<div><h3>Background</h3><div>The trimethylamine N-oxide (TMAO) pathway has been associated with multiple cardiovascular diseases, yet its prognostic value for sudden cardiac arrest (SCA) survivors remains unknown.</div></div><div><h3>Methods</h3><div>Patients who survived SCA and received implantable cardioverter defibrillators (ICDs) were prospectively enrolled. We evaluated the associations between plasma concentrations of TMAO-related metabolites and long-term adverse clinical events, including recurrent lethal ventricular arrhythmia (VA).</div></div><div><h3>Results</h3><div>A total of 75 SCA survivors were included in the study. During a median follow-up of 1099 days, 34 (45.3 %) patients experienced adverse clinical events, including 24 (32.2 %) with life-threatening VA, 12 (16.0 %) with heart failure rehospitalization, and 5 (6.7 %) with cardiovascular death. Trimethylamine (TMA), carnitine, choline, and creatinine showed strong correlations with clinically significant parameters such as left ventricular ejection fraction (LVEF), New York Heart Association functional class, and N-terminal pro-brain natriuretic peptide (NT-proBNP). These four metabolites demonstrated positive associations with adverse clinical events, with higher median level of TMA associated with more than a threefold increased risk after adjusting for age, sex, LVEF, kidney function, and NT-proBNP levels (hazard ratio = 3.36, 95 % confidence interval [CI]: 1.18–9.59; P = 0.024). A scoring system, <strong>VT-C3</strong>, incorporating L<strong>V</strong>EF, <strong>T</strong>MA, and the weighted sum of TMA-related metabolites (<strong>C</strong>holine, <strong>C</strong>arnitine, <strong>C</strong>reatinine), showed significant predictive capacity for both adverse events (area under the curve [AUC]: 0.75, 95 % CI: 0.64–0.85) and recurrent lethal VA (AUC: 0.73, 95 % CI: 0.62–0.84). No significant prognostic values were observed for TMAO and betaine.</div></div><div><h3>Conclusions</h3><div>Our findings suggest that plasma concentrations of TMA, choline, carnitine, and creatinine are associated with an increased risk of subsequent adverse clinical events among SCA survivors. A simple scoring system comprising LVEF and these biomarkers could enhance current risk stratification and improve secondary prevention strategies based on ICD implantation.</div></div>","PeriodicalId":10172,"journal":{"name":"Clinical biochemistry","volume":"137 ","pages":"Article 110928"},"PeriodicalIF":2.5,"publicationDate":"2025-04-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143891401","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":"Tumor-associated antigens are associated with primary Sjögren’s syndrome-related interstitial lung disease and disease activity","authors":"Xiaoxia Huang ,&nbsp;Xi Li ,&nbsp;Wei Zhou ,&nbsp;Liuyi Huang ,&nbsp;Haiqing Zhu ,&nbsp;Yuehong Lao ,&nbsp;Yanting Jiang ,&nbsp;Zhenjia Deng ,&nbsp;Yuting Tang ,&nbsp;Jian Wang","doi":"10.1016/j.clinbiochem.2025.110927","DOIUrl":"10.1016/j.clinbiochem.2025.110927","url":null,"abstract":"<div><h3>Objectives</h3><div>Tumor-associated antigens (TAAs) have been shown to be associated with a variety of connective tissue diseases. However, the role of TAAs in primary Sjögren’s syndrome (pSS) patients is still unclear. This study aims to explore the correlation between TAA levels and systemic clinical manifestations and disease activity in pSS patients.</div></div><div><h3>Methods</h3><div>Data were retrospectively collected from 108 patients with pSS (pSS group) and 100 healthy subjects (HCs group). Comparison of clinical characteristics and serological parameters between the TAA-positive group and the TAA-negative group. The independent risk factors of TAAs positivity were analyzed by univariate and multivariate regression, and the receiver operating characteristic curve was used to analyze the diagnostic performance of TAAs for pSS-associated interstitial lung disease (pSS-ILD).</div></div><div><h3>Results</h3><div>Compared with the control group, the positivity rates of CEA, CA125, CA15-3, and CYFRA21-1 were higher, and the levels of serum CA125, CA15-3, and CYFRA21-1were higher in the pSS group. The incidence of ILD, pleural effusion, pericardial effusion, and ESSDAI ≥5 in the TAA-positive group was higher than in the TAA-positive group. Multivariate logistic regression analysis showed that the incidence of ILD was identified as an independent risk factor for TAA positivity. The AUC of CEA, CYFRA21-1, and NSE in the diagnosis of pSS-ILD were 0.690, 0.840, and 0.872, respectively, and the combined diagnosis could reach 0.952.</div></div><div><h3>Conclusion</h3><div>Certain TAA-positive rates and serum levels were increased in pSS patients. The TAA-positive group is correlated with the ESSDAI scores. ILD was an independent risk factor for TAA positivity, and CYFRA21-1 and NSE had the best diagnostic value in patients with pSS-ILD.</div></div>","PeriodicalId":10172,"journal":{"name":"Clinical biochemistry","volume":"137 ","pages":"Article 110927"},"PeriodicalIF":2.5,"publicationDate":"2025-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143816908","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":"Building a sustainable laboratory culture: The power of awareness and strategic training programs","authors":"Güzin Aykal ,&nbsp;Kübra Kılıç Kartal ,&nbsp;Günay Yıldız ,&nbsp;Hamit Yaşar Ellidağ","doi":"10.1016/j.clinbiochem.2025.110924","DOIUrl":"10.1016/j.clinbiochem.2025.110924","url":null,"abstract":"<div><h3>Introduction</h3><div>Climate change, driven by human activities, poses a critical threat to global ecosystems and public health. Healthcare facilities, responsible for 4.4% of global carbon emissions, must adopt sustainable practices to mitigate their environmental impact. Laboratories, as significant energy consumers within this sector, play a pivotal role in promoting sustainability. This study aimed to enhance sustainability awareness through a targeted training program focusing on climate change, carbon footprint reduction, and green chemistry.</div></div><div><h3>Method</h3><div>A four-session training program covered topics such as energy efficiency, waste management, and eco-friendly laboratory practices. Delivered in both face-to-face and online formats, the program targeted diverse groups, including academicians, resident doctors, technicians, and administrative staff. Participants’ baseline knowledge was assessed using a pre-test, with training effectiveness evaluated through a post-test. A 14-question survey assessed knowledge gains, and statistical analyses were performed using SPSS.</div></div><div><h3>Results</h3><div>Post-training assessments revealed significant knowledge and awareness improvements across all participants, particularly among resident doctors and technicians. Resident doctors excelled in both pre-test and post-test scores. The training format (face-to-face or online) did not significantly impact learning outcomes (p=0.137).</div></div><div><h3>Discussion</h3><div>The program effectively increased sustainability awareness, demonstrating the value of structured educational interventions. These findings support integrating climate change education into healthcare curricula and highlight the equal effectiveness of flexible learning models.</div></div><div><h3>Conclusion</h3><div>This initiative underscores the importance of education in advancing sustainable laboratory practices. Its success led to the Antalya Training and Research Hospital’s Medical Biochemistry Laboratory receiving the Green and Sustainable Laboratory Certification from EFLM. Empowering laboratories through innovative training fosters environmental stewardship, supporting global efforts to combat climate change.</div></div>","PeriodicalId":10172,"journal":{"name":"Clinical biochemistry","volume":"137 ","pages":"Article 110924"},"PeriodicalIF":2.5,"publicationDate":"2025-04-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143806968","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":"Limited incremental value of growth differentiation factor 15 in the initial evaluation of low and intermediate risk acute chest pain patients","authors":"Iman Karaji ,&nbsp;Ole-Thomas Steiro ,&nbsp;Gard MS Myrmel ,&nbsp;Torbjørn Omland ,&nbsp;Hilde L Tjora ,&nbsp;Jørund Langørgen ,&nbsp;Rune Bjørneklett ,&nbsp;Øyvind Skadberg ,&nbsp;Vernon VS Bonarjee ,&nbsp;Øistein R Mjelva ,&nbsp;Paul Collinson ,&nbsp;Kjell Vikenes ,&nbsp;Terje H Larsen ,&nbsp;Kristin M Aakre ,&nbsp;Eva Ringdal Pedersen","doi":"10.1016/j.clinbiochem.2025.110926","DOIUrl":"10.1016/j.clinbiochem.2025.110926","url":null,"abstract":"<div><h3>Introduction</h3><div>Expression of the cytokine growth differentiation factor 15 (GDF-15) is up-regulated in conditions of tissue injury and stress. We evaluated if GDF-15 predicts obstructive coronary artery disease (CAD) or need for revascularization within 30 days and 12 months in low/intermediate risk patients with acute chest pain.</div></div><div><h3>Materials and Methods</h3><div>We included 537 hospitalized patients who had high-sensitivity troponin T (hs-cTnT) &lt; 99th percentile and underwent coronary CT angiography (CCTA). Odds ratios (ORs) and 95 % confidence intervals (CI) were calculated by logistic regression analyses and are reported per standard deviation increment of GDF-15 (log-transformed).</div></div><div><h3>Results</h3><div>The median (25th-75th percentile) age was 56 (49–65) years, 217 (40.4 %) were women, 83 (15.5 %) had obstructive CAD at CCTA. In total 49 (9.1 %) patients underwent revascularization within 30 days and 52 (9.7 %) within 12 months. In age and sex adjusted analysis GDF-15 was a significant predictor with ORs (95 % CI) of 1.35 (1.05–1.73), 1.39 (1.06–1.83) and 1.41 (1.07–1.84) for obstructive CAD, revascularization within 30 days and 12 months, respectively. However, after adjustment for clinical covariables, the ORs of GDF-15 were no longer statistically significant for either outcome (P ≥ 0.07). Adding hs-cTnT levels alone to the age and sex adjusted model also rendered the ORs of GDF-15 non-significant (P ≥ 0.31).</div></div><div><h3>Conclusions</h3><div>In patients with acute chest pain but without acute myocardial infarction, GDF-15 did not substantially improve the identification of obstructive CAD or need for revascularization within 30 days and 12 months. Our findings question the clinical usefulness of GDF-15 for prognostication of low-risk patients with acute chest pain.</div></div>","PeriodicalId":10172,"journal":{"name":"Clinical biochemistry","volume":"137 ","pages":"Article 110926"},"PeriodicalIF":2.5,"publicationDate":"2025-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143794816","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":"Serum levels of advanced glycation end products negatively correlates with activity of Paraoxonase1 and Lecithin-Cholesterol Acyltransferase in diabetic retinopathy; A cross-sectional case-control study","authors":"Akram Arabi ,&nbsp;Soghra Rabizadeh ,&nbsp;Saeed Mirmoosavi ,&nbsp;Hossein Mirmiranpour ,&nbsp;Firouzeh Heidari ,&nbsp;Fatemeh Mohammadi ,&nbsp;Alireza Esteghamati ,&nbsp;Manouchehr Nakhjavani","doi":"10.1016/j.clinbiochem.2025.110925","DOIUrl":"10.1016/j.clinbiochem.2025.110925","url":null,"abstract":"<div><h3>Background</h3><div>Development of diabetic retinopathy (DR) is closely linked to oxidative stress triggered by various metabolic pathways. Paraoxonase 1 (PON1) and Lecithin-Cholesterol Acyltransferase (LCAT) have protective roles in DR that remain poorly understood. Higher AGEs levels and its role in vascular complications of type 2 diabetes has been shown in previous studies. This case-control study aimed to assess LCAT and PON1 activity and their correlation with advanced glycation end products (AGEs) in patients with diabetes with or without retinopathy.</div></div><div><h3>Method</h3><div>45 healthy individuals and 88 diabetic patients were enrolled, categorized as No Diabetic Retinopathy (NDR), Non-Proliferative Diabetic Retinopathy (NPDR), and Proliferative Diabetic Retinopathy (PDR).</div></div><div><h3>Results</h3><div>PON1 and LCAT activity conversely correlated with serum levels of advanced glycation end products in patients with diabetic retinopathy. There was not such a correlation in patients without DR nor in controls. The correlation was stronger between PON1 and AGEs in comparison to LCAT.</div><div>PON1 activity was significantly lower in type 2 diabetes patients compared to healthy controls (45.39 ± 16.48 and 203.75 ± 8.92, respectively, P &lt; 0.001). Activity further decreased in NPDR and PDR compared to NDR (23.99 ± 9.79 and 21.28 ± 8.22, respectively, P &lt; 0.001). LCAT activity was significantly lower in diabetic patients compared to controls (33.16 ± 5.98 and 44.35 ± 2.26, respectively, P &lt; 0.001). However, LCAT activity was not lower in diabetic retinopathy compared to NDR (P &gt; 0.05).</div></div><div><h3>Conclusion</h3><div>Serum PON1 activity negatively correlated with AGEs levels in patients with diabetes but not in controls. The LCAT-AGEs correlation however was only significant in PDR patients. These findings emphasize the potential importance of AGES and PON1 in diabetic retinopathy development and progression.</div></div>","PeriodicalId":10172,"journal":{"name":"Clinical biochemistry","volume":"137 ","pages":"Article 110925"},"PeriodicalIF":2.5,"publicationDate":"2025-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143787929","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":"The diagnostic value of citrullinated antigens with multiple citrulline similar motif in patients with rheumatoid arthritis","authors":"Guihua Wu,&nbsp;Long Cai,&nbsp;Libin Liu,&nbsp;Yongxia Liu,&nbsp;Li zhang,&nbsp;Zhihui Li","doi":"10.1016/j.clinbiochem.2025.110921","DOIUrl":"10.1016/j.clinbiochem.2025.110921","url":null,"abstract":"<div><h3>Background and aims</h3><div>Anti-cyclic citrulline peptide (anti-CCP) antibodies are among the most critical biomarkers for the diagnosis of rheumatoid arthritis (RA), with citrullinated antigens being pivotal in triggering their production. This study aimed to explore the potential diagnostic value of multiple citrulline similar-motif antigen (MCSM) in RA.</div></div><div><h3>Material and methods</h3><div>A retrospective study was conducted on 135 patients with RA, 112 patients with other joint diseases (non-RA group), and 67 healthy controls from the Hangzhou Red Cross Hospital. The levels of MCSM in the peripheral blood were measured. The diagnostic value of MCSM in RA patients was assessed by receiver operating characteristic (ROC) curve analysis.</div></div><div><h3>Results</h3><div>MCSM in serum were significantly higher in RA patients than in non-RA patients (Signal-to-Cutoff ratio (S/CO): 3.2 vs 0.5, P &lt; 0.0001) and healthy controls (S/CO: 3.2 vs 0.4, P &lt; 0.0001). ROC analysis showed an area under the curve (AUC) of 0.932 for MCSM. Individually, MCSM outperformed anti-CCP and rheumatoid factor (RF), achieving sensitivity of 91.1 % and specificity of 95.5 %. Notably, MCSM detection rates were significantly higher in RA patients with pain duration under one year compared to anti-CCP (89.47 % vs. 52.65 %, P &lt; 0.05).</div></div><div><h3>Conclusion</h3><div>MCSM demonstrate high sensitivity and specificity in diagnosing RA, with significant complementary value to anti-CCP and RF, and can increase the detection rate among RA patients with a disease duration of less than one year.</div></div>","PeriodicalId":10172,"journal":{"name":"Clinical biochemistry","volume":"137 ","pages":"Article 110921"},"PeriodicalIF":2.5,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143779324","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":"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}