Clinical chemistry最新文献_第8页

Commentary on Complex Hyponatremia in a Cancer Patient with Hypercholesterolemia. 癌症合并高胆固醇血症患者的复合低钠血症评论。

IF 6.3 2区医学

Clinical chemistry Pub Date : 2025-09-03 DOI: 10.1093/clinchem/hvaf050

Michel R Langlois

引用次数: 0

The Devil Is in the Details: Clinical Relevance of Serologic Antibody Titers to Predict the Diagnosis of Celiac Disease in Pediatric Type 1 Diabetes. 细节决定成败：血清学抗体滴度与儿童1型糖尿病乳糜泻诊断的临床相关性

IF 6.3 2区医学

Clinical chemistry Pub Date : 2025-09-03 DOI: 10.1093/clinchem/hvaf102

Andrew M Ford, Alberto Rubio Tapia

引用次数: 0

Modern Low-Density Lipoprotein Cholesterol Formulas Outperform Direct Methods in Patients with Hypertriglyceridemia and Low Levels of Low-Density Lipoprotein Cholesterol 现代低密度脂蛋白胆固醇配方在高甘油三酯血症和低水平低密度脂蛋白胆固醇患者中优于直接方法

IF 9.3 2区医学

Clinical chemistry Pub Date : 2025-09-03 DOI: 10.1093/clinchem/hvaf099

Jeffrey W Meeusen, Xin Yi, Steven W Cotten, Jacob B Nielsen, Leslie J Donato, Patricia M Jones, Alagar R Muthukumar, Rafael Zubirán, Alan T Remaley, Jing Cao

{"title":"Modern Low-Density Lipoprotein Cholesterol Formulas Outperform Direct Methods in Patients with Hypertriglyceridemia and Low Levels of Low-Density Lipoprotein Cholesterol","authors":"Jeffrey W Meeusen, Xin Yi, Steven W Cotten, Jacob B Nielsen, Leslie J Donato, Patricia M Jones, Alagar R Muthukumar, Rafael Zubirán, Alan T Remaley, Jing Cao","doi":"10.1093/clinchem/hvaf099","DOIUrl":"https://doi.org/10.1093/clinchem/hvaf099","url":null,"abstract":"Background Direct measurement of low-density lipoprotein cholesterol (LDL-C) is widely used and recommended by professional society guidelines despite its potential limitations in patients with hypertriglyceridemia and low LDL-C. This study evaluated the performance of 3 direct LDL-C (LDL-CD) assays, 2 modern LDL-C calculation methods [LDL-C Martin (LDL-CM), LDL-C modified Sampson (LDL-CS)] and the conventional Friedewald (LDL-CF) method against the reference method, beta-quantification (LDL-CBQ). Methods A total of 181 remnant sera from patients with standard lipid panel orders or from patients with LDL-CBQ orders with triglycerides (TG) ≥ 400 mg/dL (4.5 mmol/L), or with TG ≥ 150 mg/dL (1.69 mmol/L) and LDL-C &lt; 70 mg/dL (1.8 mmol/L) were included. LDL-CD and lipid panel data were gathered from Abbott Alinity, Roche Cobas, and Siemens Atellica platforms. Results LDL-CD among the 3 platforms showed a median CV of 11.2%. In patients with TG &lt;400 mg/dL, LDL-CM and LDL-CS demonstrated less bias and less misclassification at the clinical decision LDL-C levels than LDL-CF or LDL-CD. In the 400 to 800 mg/dL (9.0 mmol/L) TG group, LDL-CS was superior to LDL-CD or LDL-CM in accuracy. When TG is ≥ 800 mg/dL, LDL-CD (Roche) showed substantial bias from LDL-CBQ while LDL-CS (Roche) showed smaller but significant bias. Conclusions In summary, LDL-CD or LDL-CF showed little advantage over the 2 modern LDL-C calculation methods. LDL-CS showed the best overall correlation with LDL-CBQ and therefore is recommended to replace LDL-CF and potentially LDL-CD when making clinical decisions in patients with low LDL-C and hypertriglyceridemia.","PeriodicalId":10690,"journal":{"name":"Clinical chemistry","volume":"16 1","pages":""},"PeriodicalIF":9.3,"publicationDate":"2025-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144930694","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Complex Hyponatremia in a Cancer Patient with Hypercholesterolemia. 合并高胆固醇血症的癌症患者的复合低钠血症。

IF 6.3 2区医学

Clinical chemistry Pub Date : 2025-09-03 DOI: 10.1093/clinchem/hvaf038

Anna E Merrill, Jonathan R Day, Tanner J Simonson, Jeffrey W Meeusen, Leslie J Donato

引用次数: 0

A Defining Moment: A Consensus on the Diagnostic Criteria for Clinical Obesity. 决定性时刻：关于临床肥胖诊断标准的共识。

IF 6.3 2区医学

Clinical chemistry Pub Date : 2025-09-03 DOI: 10.1093/clinchem/hvaf058

Robert D Maynard

引用次数: 0

Machine Learning Algorithms for Predicting Urinary Tract Infections: Integration of Demographic Data and Dipstick Reflectance Results 预测尿路感染的机器学习算法：人口统计数据和测油尺反射结果的整合

IF 9.3 2区医学

Clinical chemistry Pub Date : 2025-08-26 DOI: 10.1093/clinchem/hvaf088

Julien Favresse, Julien Cabo, Maxime Bosse, Benjamin Lardinois, Julie Cadrobbi, Kim Laffineur, Marc Elsen, Jonathan Douxfils, Liam Roelandts, Sander De Bruyne

{"title":"Machine Learning Algorithms for Predicting Urinary Tract Infections: Integration of Demographic Data and Dipstick Reflectance Results","authors":"Julien Favresse, Julien Cabo, Maxime Bosse, Benjamin Lardinois, Julie Cadrobbi, Kim Laffineur, Marc Elsen, Jonathan Douxfils, Liam Roelandts, Sander De Bruyne","doi":"10.1093/clinchem/hvaf088","DOIUrl":"https://doi.org/10.1093/clinchem/hvaf088","url":null,"abstract":"Background Urinary tract infections (UTIs) are among the most common infections encountered in healthcare settings. Current diagnostic practices often require 24–48 h due to the time needed for culture results. Given that 70%–80% of cultures return negative, there is significant interest in rapidly identifying negative samples to reduce unnecessary antibiotic use. This study aimed to develop and evaluate 6 machine learning models to predict UTIs. Methods Urine samples from 22 961 patients, collected between September 28, 2023 and June 29, 2024, were analyzed. Six machine learning models were assessed for their ability to predict UTIs based on 5 definitions incorporating pyuria and culture outcomes. The dataset was randomly divided into a training set (70%, n = 16 072) and an independent test set (30%, n = 6889). Seventeen predictive parameters, including dipstick reflectance results and demographic variables, were evaluated. Results The CatBoost Classifier emerged as the best-performing model, achieving an area under the ROC curve of 92.0%–94.7% depending on the UTI definition, with a negative predictive value consistently exceeding 95%, and an average precision ranging from 68.2% to 81.6%. In comparison, the predictive performance of nitrite and/or leukocyte esterase was significantly lower. Conclusion Machine learning models, particularly the CatBoost Classifier, demonstrate high accuracy and offer a promising tool to aid clinicians in UTI diagnosis. Unlike traditional culture methods, these models deliver results within an hour. Further external validation with an independent dataset and prospective studies assessing the impact on antibiotic prescribing practices is recommended.","PeriodicalId":10690,"journal":{"name":"Clinical chemistry","volume":"15 1","pages":""},"PeriodicalIF":9.3,"publicationDate":"2025-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144899178","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Post-Translationally Modified Proteoforms as Biomarkers: From Discovery to Clinical Use. 翻译后修饰的蛋白质形式作为生物标志物：从发现到临床应用。

IF 6.3 2区医学

Clinical chemistry Pub Date : 2025-08-25 DOI: 10.1093/clinchem/hvaf094

Ruben Y Luo, Priscilla S W Yeung, Morgan W Mann, Lichao Zhang, Yifei K Yang, Andrew N Hoofnagle

{"title":"Post-Translationally Modified Proteoforms as Biomarkers: From Discovery to Clinical Use.","authors":"Ruben Y Luo, Priscilla S W Yeung, Morgan W Mann, Lichao Zhang, Yifei K Yang, Andrew N Hoofnagle","doi":"10.1093/clinchem/hvaf094","DOIUrl":"https://doi.org/10.1093/clinchem/hvaf094","url":null,"abstract":"Background: Protein biomarkers are routinely measured for disease diagnosis and prognosis in clinical laboratories. Since most assays focus on protein quantity, information about proteoforms is often not acquired. Proteoforms of a protein represent the complex integration of genetic polymorphism, alternative splicing of RNA transcripts, and post-translational modifications (PTMs) on the amino-acid backbone. A detailed analysis of the post-translationally modified proteoforms (PTMPs), which are influenced by pathophysiological conditions, may lead to more precise diagnosis and prognosis.Content: This article first discusses the methodologies used to accurately detect and characterize PTMPs, i.e., immunoassays, electrophoresis, chromatography, and intact and proteolysis-aided mass spectrometry techniques. Then it reviews specific examples of PTMP biomarkers that have been successfully translated from biomarker discovery to clinical use. The examples include β2-transferrin for cerebrospinal fluid leak diagnosis, phosphorylated tau proteoforms for Alzheimer disease diagnosis, and fucosylated alpha-fetoprotein for hepatocellular carcinoma prognosis. In addition, the article provides prospective views of novel analytical technologies and promising new PTMP biomarkers entering clinical practice.Summary: In summary, PTMs are controlled by biochemical processes to modulate the functions of proteins by expanding their chemical diversity. PTM alterations in proteins can be indicators for pathophysiological conditions. Advances in analytical technologies are deepening our understanding of PTMPs and paving the way for their translation to clinical use. As research continues to discover the clinical meaning of PTMP biomarkers, they are poised to become valuable additions to the clinical testing menu for precision medicine.","PeriodicalId":10690,"journal":{"name":"Clinical chemistry","volume":" ","pages":""},"PeriodicalIF":6.3,"publicationDate":"2025-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144945710","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

In Vitro Metabolic Profiling of 18 Semi-Synthetic Cannabinoids—Hexahydrocannabinol (HHC) and Its Analogs—with Identification in an Authentic Hexahydrocannabiphorol (HHCP) Urine Sample 18种半合成大麻素-六氢大麻酚（HHC）及其类似物的体外代谢分析及其在真实六氢大麻酚（HHCP）尿液样本中的鉴定

IF 9.3 2区医学

Clinical chemistry Pub Date : 2025-08-25 DOI: 10.1093/clinchem/hvaf087

Shimpei Watanabe, Takaya Murakami, Seiji Muratsu, Saito Takeshi, Yasuo Seto

{"title":"In Vitro Metabolic Profiling of 18 Semi-Synthetic Cannabinoids—Hexahydrocannabinol (HHC) and Its Analogs—with Identification in an Authentic Hexahydrocannabiphorol (HHCP) Urine Sample","authors":"Shimpei Watanabe, Takaya Murakami, Seiji Muratsu, Saito Takeshi, Yasuo Seto","doi":"10.1093/clinchem/hvaf087","DOIUrl":"https://doi.org/10.1093/clinchem/hvaf087","url":null,"abstract":"Background Hexahydrocannabinol (HHC) and its analogs are recent additions to semi-synthetic cannabinoids in the recreational drug market. Here, the metabolism of 18 HHC analogs was compared to gain a comprehensive understanding of the structure–metabolism relationship of HHC analogs and to identify urinary biomarkers. Additionally, an authentic urine sample obtained from a suspected hexahydrocannabiphorol (HHCP) user was analyzed. Methods Both 9(R)- and 9(S)-epimers of HHC and 8 analogs were separately incubated with human liver microsomes (HLMs) for 1 h. The resulting products and the urine sample were analyzed by liquid chromatography–high-resolution mass spectrometry in an untargeted approach. Results The metabolites were generated by hydroxylation, dehydrogenation, ketone formation, carboxylation, or hydrolysis, either alone or in combination. Concerning the HHC homologs, for 9(R)-epimers, metabolites with multiple biotransformations, e.g., dihydroxy metabolites, were generally more abundant, and the percentage of hydroxy metabolites tended to increase for the longer side-chain homologs, while the reverse was observed for dihydroxy metabolites. For 9(S)-epimers, a metabolite hydroxylated at the methylcyclohexyl moiety was by far the most abundant metabolite, with similar behaviors among hexahydrocannabivarin, hexahydrocannabutol, and HHC, and between hexahydrocannabihexol and HHCP. Acetylated analogs initially underwent hydrolysis to produce almost identical metabolic profiles as the non-acetylated analogs. Methyl ether analogs did not appear to show any particular metabolic trend. In the clinical urine sample, 3 HHCP (di-)hydroxylated metabolites were detected, matching the HLM results. Conclusions The revealed structure–metabolism relationship could serve as a reference for investigating the metabolism of similar cannabinoids, while the identified biomarkers could facilitate drug testing.","PeriodicalId":10690,"journal":{"name":"Clinical chemistry","volume":"40 1","pages":""},"PeriodicalIF":9.3,"publicationDate":"2025-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144899238","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

A Parametric Empirical Bayes Approach to Personalized Reference Intervals and Reference Change Values 个性化参考区间和参考变化值的参数化经验贝叶斯方法

IF 9.3 2区医学

Clinical chemistry Pub Date : 2025-08-22 DOI: 10.1093/clinchem/hvaf092

Eirik Åsen Røys, Kristin Viste, Christopher-John Farrell, Ralf Kellmann, Bashir Alaour, Marit Sverresdotter Sylte, Janniche Torsvik, Heidi Strand, Michael Marber, Torbjørn Omland, Elvar Theodorsson, Graham Ross Dallas Jones, Kristin Moberg Aakre

{"title":"A Parametric Empirical Bayes Approach to Personalized Reference Intervals and Reference Change Values","authors":"Eirik Åsen Røys, Kristin Viste, Christopher-John Farrell, Ralf Kellmann, Bashir Alaour, Marit Sverresdotter Sylte, Janniche Torsvik, Heidi Strand, Michael Marber, Torbjørn Omland, Elvar Theodorsson, Graham Ross Dallas Jones, Kristin Moberg Aakre","doi":"10.1093/clinchem/hvaf092","DOIUrl":"https://doi.org/10.1093/clinchem/hvaf092","url":null,"abstract":"Background Population-wide reference intervals (RIpop) are commonly used in laboratory medicine but may not reflect an individual’s tightly regulated homeostatic interval. Personalized reference intervals (RIper) could enhance diagnostic precision by accounting for individual variability. A parametric empirical Bayes (PEB) framework stabilizes individual estimates using population parameters, enabling reliable RIper even from a limited number of individual results. Methods We applied the PEB framework to estimate RIper for 9 biomarkers: albumin, creatinine, phosphate, cortisone, cortisol, testosterone, androstenedione, 17-hydroxyprogesterone, and 11-deoxycortisol. The PEB parameters tested were derived from both routine Laboratory Information System (LIS) data and a local biological variation (BV) study. Using serial samples from healthy adults, we assessed the proportion of results flagged with a 95% prediction interval and compared RIper to conventional RIpop and reference change values (RCVs). Results LIS parameters were based on data from 1986 to 185 488 patients. PEB-based RIper were consistently narrower than RIpop while maintaining or reducing the proportion of flagged results. For example, albumin flagging decreased from 4.7% (RIpop) to 0.3% (RIper), phosphate from 5.4% to 3.7%, and cortisone from 7.1% to 3.9%. Conversely, 17-hydroxyprogesterone increased from 0.0% to 5.5% but remained close to the expected 5%. PEB thresholds were narrower than standard RCV estimates by correcting for regression toward the mean without increasing flagged results. Conclusions The PEB framework effectively provides personalized cutoffs for laboratory tests even when few individual patient results are available. PEB parameters can be established using LIS or BV data, offering a feasible and cost-effective implementation pathway.","PeriodicalId":10690,"journal":{"name":"Clinical chemistry","volume":"15 1","pages":""},"PeriodicalIF":9.3,"publicationDate":"2025-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144899239","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Interdisciplinary Collaboration to Develop a Custom Genomic Analysis Pipeline for the Clinical Laboratory: Hepatitis B Virus and Cytomegalovirus Antiviral Resistance Genotyping 为临床实验室开发定制基因组分析管道的跨学科合作：乙型肝炎病毒和巨细胞病毒抗病毒耐药性基因分型

IF 9.3 2区医学

Clinical chemistry Pub Date : 2025-08-21 DOI: 10.1093/clinchem/hvaf093

Gordon Ritchie, Mahdi Mobini, Venkat S Malladi, Tanya Lawson, Matthew Young, Willson Jang, Helia Mohammadi, Michael Payne, Aleksandra Stefanovic, Patrick Tang, Marc G Romney, Daniel T Holmes, Nancy Matic, Christopher F Lowe

{"title":"Interdisciplinary Collaboration to Develop a Custom Genomic Analysis Pipeline for the Clinical Laboratory: Hepatitis B Virus and Cytomegalovirus Antiviral Resistance Genotyping","authors":"Gordon Ritchie, Mahdi Mobini, Venkat S Malladi, Tanya Lawson, Matthew Young, Willson Jang, Helia Mohammadi, Michael Payne, Aleksandra Stefanovic, Patrick Tang, Marc G Romney, Daniel T Holmes, Nancy Matic, Christopher F Lowe","doi":"10.1093/clinchem/hvaf093","DOIUrl":"https://doi.org/10.1093/clinchem/hvaf093","url":null,"abstract":"Background Next-generation sequencing for hepatitis B virus (HBV) and cytomegalovirus (CMV) antiviral drug resistance (AVDR) testing improves the sensitivity of variant detection, but availability of bioinformatics and analytical pipelines are key barriers to implementation. Methods Plasma was extracted on MagNA Pure 24 (Roche Diagnostics) and next-generation sequencing performed on GridION (Oxford Nanopore Technologies) with R.10.4.1 flowcells. An in-house bioinformatics pipeline was developed using Nextflow and deployed on Microsoft Azure to process FASTQ files and automate reporting of HBV genotype and AVDR, as well as CMV AVDR (UL97/54). Results A total of 71 samples for HBV genotyping and AVDR testing and 56 samples for CMV AVDR testing were analyzed and compared to reference pipelines (DeepChek® HBV and CMV). All HBV genotypes and resistant mutations were concordant. For CMV, 74 mutations were identified in the UL97/54 region by both pipelines. However, our in-house developed method identified an additional UL97 drug resistant mutation (del598-603) in one sample. Conclusions A custom bioinformatics pipeline was developed for HBV and CMV genotyping and AVDR sequencing, which could be adapted to other targets to enable our clinical laboratory to expand clinical testing using next-generation sequencing.","PeriodicalId":10690,"journal":{"name":"Clinical chemistry","volume":"50 1","pages":""},"PeriodicalIF":9.3,"publicationDate":"2025-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144899240","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0