Clinica Chimica Acta最新文献

{"title":"Plasma ceramides decreased in Gilbert's syndrome associated with healthy blood lipid phenotypes: A cross-sectional study","authors":"Haitian Yu ,&nbsp;Chen Liang ,&nbsp;Shan Tang ,&nbsp;Dacheng Sheng ,&nbsp;Jianxia Dong ,&nbsp;Xinyue Chen ,&nbsp;Zhongjie Hu ,&nbsp;Zhongping Duan ,&nbsp;Wei Hou ,&nbsp;Sujun Zheng","doi":"10.1016/j.cca.2026.120867","DOIUrl":"10.1016/j.cca.2026.120867","url":null,"abstract":"<div><h3>Background</h3><div>Sphingolipids play an important role in the development of multiple metabolic disease. However, no study explored the impact of bilirubin on sphingolipid metabolism in human. This study aims to investigate the plasma sphingolipid profiles and their association with blood lipids in mild hyperbilirubinemia (Gilbert's syndrome; GS) individuals.</div></div><div><h3>Methods</h3><div>This cross-sectional study enrolled 224 participants including 112 individuals with GS and 112 age- and gender-matched healthy controls. Liquid chromatography-mass spectrometry was employed to quantify 53 plasma sphingolipid metabolites in a subset of 55 GS and 55 age- and gender-matched healthy controls. OPLS-DA model was constructed using SIMCA 14.1 software to identify distinct plasma sphingolipid metabolites between two groups.</div></div><div><h3>Results</h3><div>The median age of 224 subjects was 35 years, with males comprising 29.5%. The GS group exhibited higher levels of total bilirubin and high-density lipoprotein cholesterol, along with lower levels of triglycerides (all <em>P</em> &lt; 0.05). Analysis of plasma sphingolipid revealed significant differences in 14 sphingolipids between two groups. Compared to the healthy control group, the GS group had lower levels of Cer(d18:1/16:0), Cer(d18:1/18:0), Cer(d18:1/25:0), Cer(d18:1/26:0), Cer(d18:2/16:0), CerP(d18:1/22:0), HexCer(d18:1/22:0), HexCer(d18:1/24:1), HexCer(d18:1/24:0), LacCer(d18:1/16:0), as well as higher levels of CerP(d18:1/12:0), LacCer(d18:1/24:0), sphingosine-1-phosphate, and sphinganine (all <em>P</em> &lt; 0.05). Correlation analysis of 110 subjects indicated that Cer(d18:1/25:0), Cer(d18:1/26:0), Cer(d18:2/16:0), CerP(d18:1/22:0), HexCer(d18:1/22:0), HexCer(d18:1/24:0) were positively correlated with total cholesterol. Additionally, sphinganine was positively correlated with high-density lipoprotein cholesterol and sphingosine 1-phosphate was negatively correlated with triglycerides (all <em>P</em> &lt; 0.05).</div></div><div><h3>Conclusion</h3><div>This study demonstrated that plasma ceramide levels decreased in Gilbert's syndrome, which correlates with a favorable blood lipid profile.</div></div>","PeriodicalId":10205,"journal":{"name":"Clinica Chimica Acta","volume":"584 ","pages":"Article 120867"},"PeriodicalIF":2.9,"publicationDate":"2026-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146060511","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 non-targeted metabolomics unveils the metabolic signatures of trans-right ventricle in pulmonary arterial hypertension associated with atrial septal defect","authors":"Xifeng Qian ,&nbsp;Yuanrui Deng ,&nbsp;Tingting Guo ,&nbsp;Xin Huang ,&nbsp;Chaowu Yan ,&nbsp;Xin Gao ,&nbsp;Yan Wu ,&nbsp;Song Hu ,&nbsp;Jiangshan Tan ,&nbsp;Lingtao Chong ,&nbsp;Shengsong Zhu ,&nbsp;Mingjie Ma ,&nbsp;Mengting Ye ,&nbsp;Xiaojian Wang ,&nbsp;Jian Cao ,&nbsp;Lu Hua","doi":"10.1016/j.cca.2026.120849","DOIUrl":"10.1016/j.cca.2026.120849","url":null,"abstract":"<div><h3>Background</h3><div>Understanding metabolic evolution of right ventricle (RV) of pulmonary arterial hypertension associated with atrial septal defect (PAH-ASD) helps elucidate the underlying pathobiology and reveal disease-specific biomarkers. However, the exact metabolic profile of RV of PAH-ASD is scarce.</div></div><div><h3>Objectives</h3><div>This study aimed to unveil precisely the metabolic signatures of trans-RV of PAH-ASD through non-targeted metabolomics.</div></div><div><h3>Methods</h3><div>Participants with PAH-ASD were recruited and their blood samples were obtained from superior vena cava (SVC) and pulmonary artery (PA) through right cardiac catheterization. Non-targeted metabolomics analysis on the basis of UHPLC-MS/MS was utilized to generate the metabolomic signature of trans-RV by comparing the metabolites change from SVC to PA.</div></div><div><h3>Results</h3><div>1060 metabolites were detected from blood samples from 40 PAH-ASD participants. A total of 44 differential metabolites were identified based on screening criteria after flowing through the RH, including 10 metabolites with decreased levels and 34 metabolites with increased levels. Among them, phosphatidylcholines, sphingomyelins, AICARP, XMP, inosine 5’-Monophosphate, prostaglandin A1, oleoyl ethanolamide, tyramine, 2-phenylethylamine, 23-nordeoxycholic acid, LPI 20:4, and LPE 22:6 were discovered. Moreover, distinct metabolic perturbations, such as the change of sphingomyelins, inosine 5’-Monophosphate and LPE 22:6, was correlated with the significant clinical variables indicating RV dysfunction in clinical association analysis.</div></div><div><h3>Conclusion</h3><div>Our study correctly defined metabolic signatures indicating towards a metabolic pathogenesis of trans-RV of PAH-ASD, emphasizing the importance of these metabolites in promoting of RV dysfunction and devising therapeutic strategies.</div></div>","PeriodicalId":10205,"journal":{"name":"Clinica Chimica Acta","volume":"584 ","pages":"Article 120849"},"PeriodicalIF":2.9,"publicationDate":"2026-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146040223","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":"Analytical performance evaluation and reference limits establishment of a new chemiluminescence growth stimulation expressed Gene 2 Assay","authors":"Litao Zhang ,&nbsp;Chenbin Zhang ,&nbsp;Xin Shu ,&nbsp;Jiajia Zhu ,&nbsp;Hui Wang ,&nbsp;Ting Deng ,&nbsp;Yisha Jing ,&nbsp;Haiyan Liu ,&nbsp;Zhenlu Zhang","doi":"10.1016/j.cca.2026.120850","DOIUrl":"10.1016/j.cca.2026.120850","url":null,"abstract":"<div><h3>Background and objectives</h3><div>Growth stimulation expressed gene 2 (ST2) is an established biomarker for assessing myocardial fibrosis and ventricular remodeling in heart disease. This study aimed to comprehensively evaluate the analytical performance of a novel chemiluminescent immunoassay (CLIA) for ST2 and to establish its reference limits.</div></div><div><h3>Methods</h3><div>Analytical performance, including precision, detection capability, linearity, interference, and sample type correlation, was validated according to CLSI guidelines. A method comparison was conducted with the Presage ST2 ELISA (Critical Diagnostics). Sex-specific 99th percentile upper reference limits (URLs) were established from 1592 healthy adults.</div></div><div><h3>Results</h3><div>The ST2 (CLIA) assay demonstrated high precision, with both repeatability and reproducibility CVs &lt; 5%. The limits of blank (LoB), detection (LoD), and quantitation (LoQ) were within the claimed specifications. The assay showed excellent linearity from 2.00 to 2000 ng/mL (<em>r</em> &gt; 0.99). No significant interference was observed, and correlations between different sample types were high (<em>r</em> &gt; 0.99). Method comparison with the Presage ST2 assay yielded a regression equation of y = 1.0365x - 1.9307 (<em>r</em> = 0.9760). The 99th percentile URLs were 42.3 ng/mL for males, 36.2 ng/mL for females, and 37.7 ng/mL for the overall cohort.</div></div><div><h3>Conclusions</h3><div>The Mindray ST2 chemiluminescent immunoassay exhibits robust analytical performance, meeting the demands of clinical practice with high precision, sensitivity, and specificity. The established reference intervals support its application for precise patient stratification.</div></div>","PeriodicalId":10205,"journal":{"name":"Clinica Chimica Acta","volume":"584 ","pages":"Article 120850"},"PeriodicalIF":2.9,"publicationDate":"2026-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146043849","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":"Validating CALIPER pediatric reference intervals in a U.S. population using retrospective outpatient data and RefineR","authors":"Jillian Kodger ,&nbsp;Thomas J.S. Durant ,&nbsp;Nalan Yurtsever ,&nbsp;Joe M. El-Khoury","doi":"10.1016/j.cca.2026.120846","DOIUrl":"10.1016/j.cca.2026.120846","url":null,"abstract":"<div><h3>Background</h3><div>Accurate pediatric reference intervals (RIs) are critical for proper interpretation of laboratory results, yet their development is challenged by age-related physiological variation, limited sample sizes, and preanalytical variability. This study evaluates the applicability of the Canadian Laboratory Initiative on Pediatric Reference Intervals (CALIPER) RIs to a US-based, diverse pediatric outpatient population using both the RefineR inverse modeling approach and the Clinical and Laboratory Standards Institute (CLSI) EP28-A3c recommended approach.</div></div><div><h3>Methods</h3><div>Outpatient laboratory data from 51,863 patients under 19 years of age were collected from a single institution between January 2023 and December 2024. Nine commonly ordered chemistry analytes were evaluated. RIs were derived using both RefineR and CLSI guidelines with bootstrap resampling. These were compared to CALIPER RIs using a color-coded flagging system based on 95% confidence intervals and total allowable error (TAE).</div></div><div><h3>Results</h3><div>RefineR-based RIs aligned with CALIPER values in 86 out of 88 age- and gender-specific analyte groups, whereas CLSI-derived RIs aligned in 79 out of 88. Notable discrepancies involved alanine aminotransferase, aspartate aminotransferase, alkaline phosphatase, and blood urea nitrogen, often influenced by known preanalytical and physiological variables such as sample type, body mass index (BMI), and hydration status.</div></div><div><h3>Conclusions</h3><div>RefineR demonstrated superior alignment with CALIPER RIs compared to CLSI guidelines, highlighting its robustness in outpatient pediatric populations. Given its tolerance to mixed data and skewed distributions, RefineR offers a more practical and accurate method for deriving population-specific RIs in pediatric laboratory medicine, and helps verify the implementation of external RIs, such as CALIPER.</div></div>","PeriodicalId":10205,"journal":{"name":"Clinica Chimica Acta","volume":"584 ","pages":"Article 120846"},"PeriodicalIF":2.9,"publicationDate":"2026-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146017669","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":"ALT-triggered reflex AST testing in health check-ups: A decision curve analysis","authors":"Shu-Mei Bai ,&nbsp;Xu-Xiao Guo ,&nbsp;Guo-Ming Zhang","doi":"10.1016/j.cca.2026.120848","DOIUrl":"10.1016/j.cca.2026.120848","url":null,"abstract":"<div><h3>Background</h3><div>Aspartate aminotransferase (AST) is frequently co-ordered with alanine aminotransferase (ALT) in routine health check-ups, although universal AST testing may have a low clinical yield in asymptomatic individuals. We evaluated ALT-triggered reflex AST testing via decision curve analysis (DCA) to identify implementable screening policies.</div></div><div><h3>Methods</h3><div>We retrospectively analysed adult health check-up records with paired ALT and AST results. Reflex strategies were simulated in which AST was measured only when ALT exceeded predefined thresholds (15–60 U/L). Pathological AST was defined via sex-specific upper reference limits (URL). Clinical utility was assessed via DCA, where threshold probability (pt) represents the trade-off between unnecessary testing and missed pathological results. The primary analysis prespecified pt. = 1%, with pt. = 1%–5% examined in sensitivity analyses.</div></div><div><h3>Results</h3><div>Among 46,059 participants (20,489 females; 25,570 males), AST ≥ URL was observed in 5.52% of females and 7.35% of males. At pt. = 1%, DCA supported sex-specific ALT triggers of ≥19 U/L for females and ≥ 26 U/L for males. These policies reduced AST testing to 34.8% and 46.7%, respectively, while maintaining sensitivities of 97.9% and 98.0%, respectively. The number of individuals with pathological AST who would be missed under the reflex policy was 11.7 and 14.9 per 10,000 screened. Across low pt. ranges, reflex strategies consistently achieved greater net benefits than did universal testing.</div></div><div><h3>Conclusions</h3><div>ALT-triggered reflex AST testing can substantially reduce low-yield AST measurements during health check-ups with minimal loss of screening sensitivity. The DCA provides a transparent framework for selecting sex-specific, screening-oriented policy thresholds<strong>.</strong></div></div>","PeriodicalId":10205,"journal":{"name":"Clinica Chimica Acta","volume":"584 ","pages":"Article 120848"},"PeriodicalIF":2.9,"publicationDate":"2026-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146028638","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":"Advancing Prostate Cancer Diagnostics: The Potential of Paper-Based Biosensors for Point-of-Care Testing","authors":"Wei Yin Lim ,&nbsp;Wee Jian Chin ,&nbsp;Gopinath Packirisamy ,&nbsp;Pavai Sthaneshwar ,&nbsp;Narayanan Ramakrishnan ,&nbsp;Choon-Hian Goh","doi":"10.1016/j.cca.2026.120872","DOIUrl":"10.1016/j.cca.2026.120872","url":null,"abstract":"<div><div>Prostate cancer remains one of the most frequently diagnosed malignancies among men and continues to be a major cause of cancer-related deaths worldwide. Early and accurate detection is crucial for improving patient survival and enabling timely and appropriate treatment. Although the prostate-specific antigen (PSA) test is widely used for screening, its limited specificity—particularly within the diagnostic “gray zone”—often results in unnecessary biopsies, overdiagnosis, and missed detection of early-stage disease. Consequently, growing attention has turned to novel biomarkers with greater sensitivity and specificity that can complement or even replace PSA in clinical settings. Recent advances in biosensor technology have facilitated the development of rapid, cost-effective, and portable diagnostic tools. Among them, paper-based biosensors have emerged as a promising platform due to their low fabrication cost, simplicity, biodegradability, and compatibility with point-of-care (POC) testing. These devices enable highly sensitive and quantitative detection, where performance largely depends on the selection and engineering of sensing materials. The integration of nanomaterials and surface modification strategies has further enhanced target recognition, signal transduction efficiency, and sensor stability. This review provides an overview of recent progress in biosensor platforms for prostate cancer detection. It emphasizes the potential of advanced materials to improve analytical performance, highlights promising biomarkers beyond PSA, and discusses the major challenges impeding clinical translation. Addressing these barriers will be crucial for enabling paper-based biosensors to transition from research prototypes to reliable, field-ready tools for early prostate cancer diagnosis and monitoring.</div></div>","PeriodicalId":10205,"journal":{"name":"Clinica Chimica Acta","volume":"584 ","pages":"Article 120872"},"PeriodicalIF":2.9,"publicationDate":"2026-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146084353","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":"Oxidative stress in diabetic retinopathy","authors":"Qiang Zou ,&nbsp;Niu Niu ,&nbsp;Leilei Sun ,&nbsp;Xiaoyan Xu ,&nbsp;Yu Wang ,&nbsp;Hong Qin","doi":"10.1016/j.cca.2026.120871","DOIUrl":"10.1016/j.cca.2026.120871","url":null,"abstract":"<div><div>Diabetic retinopathy (DR) remains a leading cause of blindness, with oxidative stress as a central pathogenic driver. However, the translation of this mechanistic knowledge into clinical diagnostics and targeted therapies has been hampered by inconsistent biomarkers and a simplistic view of redox balance. This critical review moves beyond cataloging oxidative markers to evaluate their biological specificity, analytical robustness, and compartmentalization between systemic circulation and the ocular microenvironment. We dissect the technical challenges of direct reactive species measurement and appraise established markers of macromolecular damage, lipid peroxidation adducts, protein carbonyls, and oxidized nucleic acids, emphasizing that analytical rigor is paramount for interpretability. Furthermore, we explore integrative pathways linking glycoxidation, inflammation, and VEGF in a feed-forward loop. A key translational hurdle is the poor correlation between systemic biomarkers and intraretinal oxidative events. We propose a future roadmap featuring a tiered “DR oxidative stress profile” that combines scalable systemic screening with pathway-specific panels and advanced ocular imaging. This refined approach aims to enable precision phenotyping, enriching clinical trials for mechanism-targeted therapies and ultimately paving the way for personalized antioxidant strategies tailored to the dominant oxidative axis in individual patients.</div></div>","PeriodicalId":10205,"journal":{"name":"Clinica Chimica Acta","volume":"584 ","pages":"Article 120871"},"PeriodicalIF":2.9,"publicationDate":"2026-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146075484","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 oxalobiome: unraveling the role of gut microbiota in oxalate metabolism and its implications for kidney health and disease management","authors":"David Mburu ,&nbsp;Sumeet Kumar ,&nbsp;Yanzhe Wang ,&nbsp;Asadoor Amirkhani Namagerdi ,&nbsp;Karoona Bai ,&nbsp;Bilal Ali ,&nbsp;Ahmed Minalla ,&nbsp;Karina Ordaya Gonzales ,&nbsp;Khalid A. Abdelhalim","doi":"10.1016/j.cca.2026.120852","DOIUrl":"10.1016/j.cca.2026.120852","url":null,"abstract":"<div><div>The oxalobiome, comprising microbial communities involved in oxalate metabolism, plays a critical role in maintaining oxalate homeostasis and preventing associated health issues, particularly calcium oxalate nephrolithiasis. Key organisms, notably <em>Oxalobacter formigenes,</em> are essential for degrading oxalate, yet their abundance is influenced by factors such as diet, genetics, and antibiotic use. Recent advances in research have elucidated the complex interactions between the gut microbiome and oxalate metabolism, highlighting the potential for therapeutic interventions. Innovative strategies, including RNA interference therapies (e.g., lumasiran, nedosiran), engineered probiotics, and gene-editing technologies, show promise in managing conditions like primary hyperoxaluria. However, challenges remain, including limitations in oxalate measurement techniques and variability in microbial populations. Multi-omics approaches and metagenomic analyses have enhanced our understanding of the oxalobiome, revealing novel microbial taxa and metabolic pathways involved in oxalate degradation. Despite the potential of emerging therapies, clinical translation is still in its infancy, necessitating further research to establish efficacy and safety. Future studies should focus on mechanistic insights, standardized methodologies, and targeted microbiome-based therapies to optimize management strategies for hyperoxaluria and related systemic diseases. A comprehensive understanding of the oxalobiome is essential for developing precision medicine approaches that effectively address oxalate dysregulation and improve patient outcomes.</div></div>","PeriodicalId":10205,"journal":{"name":"Clinica Chimica Acta","volume":"584 ","pages":"Article 120852"},"PeriodicalIF":2.9,"publicationDate":"2026-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146050678","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":"Development of machine learning-driven non-invasive diagnostic models for idiopathic membranous nephropathy in Chinese patients","authors":"Qian Wang ,&nbsp;Xiaolong Wang ,&nbsp;Shibin Su ,&nbsp;Weiguang Zhang ,&nbsp;Quan Hong ,&nbsp;Qiang Lyu ,&nbsp;Shuwei Duan ,&nbsp;Ying Zheng ,&nbsp;Guichun Tang ,&nbsp;Pu Chen ,&nbsp;Jiaona Liu ,&nbsp;Chengliang Yin ,&nbsp;Jinlong Shi ,&nbsp;Guangyan Cai ,&nbsp;Xiangmei Chen ,&nbsp;Zheyi Dong","doi":"10.1016/j.cca.2026.120882","DOIUrl":"10.1016/j.cca.2026.120882","url":null,"abstract":"<div><h3>Background</h3><div>Idiopathic membranous nephropathy (IMN) is a major cause of nephrotic syndrome and end-stage renal disease, but the gold-standard diagnostic method is invasive. This study aims to develop a non-invasive diagnostic model for IMN, focus on the diagnostic value of anti-phospholipase A2 receptor antibody (anti-PLA2R-Ab).</div></div><div><h3>Patients and methods</h3><div>In this single-center retrospective study,we included 9524 patients with chronic kidney disease patients who received renal biopsies, extracted 139 clinicopathological data from their records, and divided them into two groups based on pathological results.Renal biopsy cases were collected to form an independent external validation cohort.Seven machine learning methods were used to develop and verify models, and anti-PLA2R-Ab data were used to optimize and evaluate these models. Seventy percent of the patients were used for training, and the other 30% for verification. The area under the receiver operating characteristic curve, F1-score, accuracy, and confusion matrix were used to evaluate the diagnostic performance of the models.</div></div><div><h3>Results</h3><div>We analyzed 8840 patients and 10 indicators, excluding anti-PLA2R-Ab, to develop and validate diagnostic models, and then analyzed 2457 patients and 6 indicators, including anti-PLA2R-Ab, to develop and validate optimized models. With or without anti-PLA2R-Ab, the CatBoost model provided more accurate diagnosis of IMN (internal vs. external verification AUC:0.921 vs.0.901 and 0.950 vs.0.904, respectively) than anti-PLA2R-Ab alone (AUC: 0.867).</div></div><div><h3>Conclusion</h3><div>The CatBoost model was an accurate and non-invasive method that provided better diagnosis of IMN than anti-PLA2R-Ab in Chinese patients. This model is especially when anti-PLA2R-Ab testing and kidney biopsy are difficult or impossible.</div></div>","PeriodicalId":10205,"journal":{"name":"Clinica Chimica Acta","volume":"584 ","pages":"Article 120882"},"PeriodicalIF":2.9,"publicationDate":"2026-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146118200","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":"Combining conventional hemogram and reticulocyte metrics enhances iron deficiency detection in asymptomatic individuals","authors":"Mugdha Gautam ,&nbsp;Prashant Sharma ,&nbsp;Arnab Pal ,&nbsp;Pulkit Rastogi ,&nbsp;Praveen Sharma ,&nbsp;Alka Rani Khadwal ,&nbsp;Manu Jamwal ,&nbsp;Minakshi Gupta ,&nbsp;Reena Das","doi":"10.1016/j.cca.2026.120877","DOIUrl":"10.1016/j.cca.2026.120877","url":null,"abstract":"<div><h3>Introduction</h3><div>Iron deficiency (ID) is the most common micronutrient deficiency globally, often underdiagnosed due to nonspecific symptoms and limitations of standard laboratory tests. Reticulocyte-derived indices from modern hematology analyzers offer enhanced early detection of iron-restricted erythropoiesis.</div></div><div><h3>Methods</h3><div>We studied 103 self-reported asymptomatic healthy adults who underwent complete blood counts and reticulocyte analysis on XN-2000 analyzers (Sysmex Corp., Kobe, Japan). Detailed biochemical iron profile and vitamin B12/folate testing were done. Diagnostic performance of hematologic parameters was assessed and combinatorial logistic regression models and discriminant indices were developed.</div></div><div><h3>Results</h3><div>Participants' median age was 28 years (range 22–79); 69.9% (<em>n</em> = 72) were women. 54.4% (<em>n</em> = 56) had ID and 21.4% (<em>n</em> = 22) were anemic. Latent ID was detected in 34.9% (36/103). B12 and folate deficiencies were present in 41% and 40%, respectively - extensively overlapping with ID. Key individual indices for ID included RET-He, RET-Y, and RET-RBC-Y, each with area under the ROC curve (AUC) &gt;85%. A comprehensive 21-variable logistic regression model yielded AUC 93.7% (95% C.I. 88.9–98.5), sensitivity 89.1%, and specificity 70.2%. A pared-down 3-variable model achieved AUC 90.1% (95% C.I. 84.1–96.1), sensitivity 87.5%, and specificity 70.9%. Of the two heuristic composite indices tested, one – [RDW-CV × PLT × 10⁵] / [RET-He × RET-RBC-Y × IRF-Y × RET-Y] - showed AUC 89.8% (95% C.I. 83.7–95.9), sensitivity 87%, and specificity 72.3%.</div></div><div><h3>Conclusion</h3><div>In a cohort with high rates of nutritional deficiency, cost-effective equations combining conventional and advanced reticulocyte indices demonstrated strong diagnostic utility for screening ID, with potential for broader application in resource-limited settings.</div></div>","PeriodicalId":10205,"journal":{"name":"Clinica Chimica Acta","volume":"584 ","pages":"Article 120877"},"PeriodicalIF":2.9,"publicationDate":"2026-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146096651","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}