Annals of Clinical Biochemistry最新文献_第3页

Usefulness of the 3-hydroxykynurenine/kynurenic acid ratio as a diagnostic biomarker for diffuse larger B-cell lymphoma. 3-hydroxykynurenine/kynurenic acid 比率作为弥漫性大 B 细胞淋巴瘤诊断生物标志物的实用性。

IF 2.1 4区医学

Annals of Clinical Biochemistry Pub Date : 2025-03-01 Epub Date: 2024-11-11 DOI: 10.1177/00045632241297873

Yasuko Yamamoto, Naoe Goto, Kengo Kambara, Suwako Fujigaki, Hidetsugu Fujigaki, Masao Takemura, Toshitaka Nabeshima, Akihiro Tomita, Kuniaki Saito

{"title":"Usefulness of the 3-hydroxykynurenine/kynurenic acid ratio as a diagnostic biomarker for diffuse larger B-cell lymphoma.","authors":"Yasuko Yamamoto, Naoe Goto, Kengo Kambara, Suwako Fujigaki, Hidetsugu Fujigaki, Masao Takemura, Toshitaka Nabeshima, Akihiro Tomita, Kuniaki Saito","doi":"10.1177/00045632241297873","DOIUrl":"10.1177/00045632241297873","url":null,"abstract":"ObjectivesReports have shown that the kynurenine pathway, one of the pathways by which tryptophan is metabolized, is activated in patients with diffuse large B-cell lymphoma (DLBCL). Activation of the kynurenine pathway triggers the production of various metabolites, such as kynurenine (Kyn), 3-hydroxykynurenine (3-HK), 3-hydroxyanthranilic acid (3-HAA), kynurenic acid (KA), and anthranilic acid (AA), which contribute to immune tolerance. The current study aimed to investigate the changes in metabolites of kynurenine pathway in DLBCL patients and evaluate their performance predicting DLBCL.MethodsChanges in metabolites of kynurenine pathway were examined using high-performance liquid chromatography in 35 DLBCL patients (age 61.2 ± 13.5 years) and 44 healthy controls (age 58.5 ± 12.5 years).ResultsDLBCL patients had significantly higher levels of 3-HK, AA, and 3-HAA but lower levels of tryptophan (Trp) and KA compared to healthy controls. Given that the ratio of each metabolite represents the change in the Kyn pathway, the 3-HK/KA ratio was examined. Notably, DLBCL patients had a significantly higher 3-HK/KA ratio compared to healthy controls. In DLBCL, the area under the receiver operative characteristic (ROC) curve for 3-HK/KA (0.999) was higher than that for lactate dehydrogenase (0.885) and comparable to that for soluble interleukin-2 receptor (sIL-2R) (0.997). Based on ROC curve analysis, the 3-HK/KA ratio was found to be useful biomarker for the diagnosis of DLBCL.ConclusionOur results suggest that the 3-HK/KA ratio is a clinically useful biomarker of DLBCL. Moreover, its combination with existing markers, such as sIL-2R, can improve its effectiveness of diagnosing DLBCL.","PeriodicalId":8005,"journal":{"name":"Annals of Clinical Biochemistry","volume":" ","pages":"109-117"},"PeriodicalIF":2.1,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142493406","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"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

Familial hypercholesterolaemia with high triglycerides: A diagnostic challenge. 伴有高甘油三酯的家族性高胆固醇血症：诊断难题。

IF 2.1 4区医学

Annals of Clinical Biochemistry Pub Date : 2025-03-01 Epub Date: 2024-10-10 DOI: 10.1177/00045632241289275

Suha Ahmed, Marwa Elgizouli, Eric S Kilpatrick, Timothy J Morris

{"title":"Familial hypercholesterolaemia with high triglycerides: A diagnostic challenge.","authors":"Suha Ahmed, Marwa Elgizouli, Eric S Kilpatrick, Timothy J Morris","doi":"10.1177/00045632241289275","DOIUrl":"10.1177/00045632241289275","url":null,"abstract":"Combined or mixed hyperlipidaemia is characterised by hypercholesterolaemia together with high triglyceride concentrations. It is found in approximately 1 in 100 people in the United Kingdom. Most cases are secondary to an underlying condition such as the metabolic syndrome, diabetes mellitus (especially poorly controlled) or individuals with a high alcohol intake. Mixed hyperlipidaemia is also a feature of some primary hyperlipidaemia conditions such familial combined hyperlipidaemia (FCH) or type III hyperlipidaemia (dysbetalipoproteinaemia). One differential diagnosis for mixed hyperlipidaemia that can easily be overlooked is a patient with an underlying diagnosis of familial hypercholesterolaemia (FH) who also has a hypertriglyceridaemia due to any other cause. Those patients may have very high total and low-density lipoprotein cholesterol concentrations (LDL-C) with a moderately elevated triglyceride concentration. In this article, we report 4 cases of familial hypercholesterolaemia, confirmed by genetic testing, in patients initially presenting with hypertriglyceridaemia in addition to high total cholesterol and LDL-C. This article discusses the diagnostic challenges associated with this presentation and highlights the key role of directly measuring LDL-C to aid diagnosis in these specific situations.","PeriodicalId":8005,"journal":{"name":"Annals of Clinical Biochemistry","volume":" ","pages":"143-147"},"PeriodicalIF":2.1,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142399193","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"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

Ubiquitin C-terminal hydrolase-L1 and glial fibrillary acidic protein tandem brain biomarker test in the prediction of CT evident brain injury: A prospective evaluation in the emergency department.

IF 2.1 4区医学

Annals of Clinical Biochemistry Pub Date : 2025-02-28 DOI: 10.1177/00045632251326483

Jemima M Curran, Katherine Onions, Jessica Watts, Arnab Rana, Emma Hughes, James Allison, Jamie G Cooper

{"title":"Ubiquitin C-terminal hydrolase-L1 and glial fibrillary acidic protein tandem brain biomarker test in the prediction of CT evident brain injury: A prospective evaluation in the emergency department.","authors":"Jemima M Curran, Katherine Onions, Jessica Watts, Arnab Rana, Emma Hughes, James Allison, Jamie G Cooper","doi":"10.1177/00045632251326483","DOIUrl":"10.1177/00045632251326483","url":null,"abstract":"Background: Patients with features of mild traumatic brain injury (mTBI) frequently present to the emergency department (ED) and often meet recognized criteria for CT head imaging. Observational studies suggest that use of a tandem ubiquitin C-terminal hydrolase-L1 (UCH-L1) and glial fibrillary acidic protein (GFAP) brain biomarker test may significantly reduce need for CT scanning in this population, though data on patient flow are lacking.Methods: A prospective cohort evaluation of adult ED patients (≥18 years) with features of mTBI who met criteria for CT imaging within 12 hours of head injury had blood drawn for laboratory UCH-L1/GFAP testing. The diagnostic performance for CT-evident brain injury was expressed through the calculation of sensitivity and negative predictive value (NPV) with 95% confidence intervals (95% CI). Times from venepuncture to biomarker result availability, and from CT request to result availability were compared.Results: A laboratory UCH-L1/GFAP test identified 21 of 89 (24%) patients as low-risk for CT-evident TBI with a sensitivity of 100% (95% CI 76%-100%) and NPV of 100% (95% CI 85%-100%). The median time to biomarker and CT results were 88 minutes and 89 minutes, respectively. However, 68 (76%) of patients with a positive biomarker test would then progress to CT imaging, significantly prolonging ED length of stay, and restricting usefulness in adoption into clinical pathways.Conclusion: Evaluation of a laboratory UCH-L1/GFAP test in a UK population with mTBI demonstrates excellent performance for the exclusion of CT-evident brain injury. However, adoption into clinical patient pathways is likely to be limited until the test is available in whole blood at the point-of-care, and evidence of safe rationalization of CT imaging confirmed in randomized studies.","PeriodicalId":8005,"journal":{"name":"Annals of Clinical Biochemistry","volume":" ","pages":"45632251326483"},"PeriodicalIF":2.1,"publicationDate":"2025-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143531189","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"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 multicenter study comparing a point-of-care blood glucose metre with a blood gas analyser in infants by the Shikoku Neonatal Medical Research Group.

IF 2.1 4区医学

Annals of Clinical Biochemistry Pub Date : 2025-02-28 DOI: 10.1177/00045632251326460

Toru Kuboi, Masashiro Sugino, Takaaki Sadamura, Nana Kawaguchi, Yoko Tadatomo, Kosei Takada, Natsumi Okamoto, Kiwako Miyamoto, Akiko Nakano, Noriko Miura, Yusei Nakata, Kenichi Suga, Masaaki Ota, Shinji Nakamura, Kosuke Koyano, Takashi Kusaka

{"title":"A multicenter study comparing a point-of-care blood glucose metre with a blood gas analyser in infants by the Shikoku Neonatal Medical Research Group.","authors":"Toru Kuboi, Masashiro Sugino, Takaaki Sadamura, Nana Kawaguchi, Yoko Tadatomo, Kosei Takada, Natsumi Okamoto, Kiwako Miyamoto, Akiko Nakano, Noriko Miura, Yusei Nakata, Kenichi Suga, Masaaki Ota, Shinji Nakamura, Kosuke Koyano, Takashi Kusaka","doi":"10.1177/00045632251326460","DOIUrl":"10.1177/00045632251326460","url":null,"abstract":"BackgroundThere have been no reports on blood glucose metres for measurements in a wide variety of infant patients, from very preterm infants to mature infants and from the early neonatal period onwards. In this study, we evaluated the accuracy of the Glutest Mint II, a point-of-care blood glucose metre, by comparing blood glucose levels measured by this device with those measured by a blood gas analyser in infants of all gestational ages and birth weights at a number of time points after birth.MethodsInfants aged 22 weeks and 0 days of gestation or older who were born at any of six tertiary neonatal intensive care units between March 2022 and January 2023 and needed blood glucose monitoring were enrolled. Samples were collected into capillary tubes when the physician determined that a blood glucose test was necessary and could be taken at any time after birth and any number of times from the same individual. Blood glucose was measured using a Glutest Mint II and then using a blood gas analyser.ResultsIn total, 2943 blood glucose points were measured in 285 infants. Blood glucose levels measured using the Glutest Mint II were significantly correlated with those measured using a blood gas analyser. Neonatal-specific parameters such as hematocrit and total serum bilirubin levels may not have an effect.ConclusionsThe Glutest Mint II device can measure blood glucose levels with very high accuracy in the range used in the neonatal setting, comparable to the blood gas analyser.","PeriodicalId":8005,"journal":{"name":"Annals of Clinical Biochemistry","volume":" ","pages":"45632251326460"},"PeriodicalIF":2.1,"publicationDate":"2025-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143531188","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"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

Determination of the biological variation and reference change value of lipoprotein (a).

IF 2.1 4区医学

Annals of Clinical Biochemistry Pub Date : 2025-02-25 DOI: 10.1177/00045632251324063

Kofi Antwi, Paul Downie, Wycliffe Mbagaya

{"title":"Determination of the biological variation and reference change value of lipoprotein (a).","authors":"Kofi Antwi, Paul Downie, Wycliffe Mbagaya","doi":"10.1177/00045632251324063","DOIUrl":"10.1177/00045632251324063","url":null,"abstract":"Background: Understanding lipoprotein (a) [Lp(a)] measurement variability is essential in establishing its coronary heart disease (CHD) association, and optimizing assessment and management of atherosclerotic cardiovascular disease (ASCVD) risk. We established the components of biological variation (BV) and reference change value (RCV) of Lp(a) in a UK cohort.Method: 22 healthy individuals were recruited to the study. Blood samples were collected for six consecutive weeks and analysed in duplicate using the Lp(a) assay by Sentinel Diagnostics on the Beckman Coulter AU5800. Outlier, heterogeneity, normality, and trend analysis were performed, followed by CV-ANOVA to determine estimates of BV, adhering to the 14 BIVAC quality items. RCV was calculated based on estimated CVA and CVI.Results: Four participants were excluded from the analysis as their mean Lp(a) levels fell below the functional sensitivity of the assay. Mean Lp(a) concentration ranged from 14 to 241 nmol/L. The overall estimate of CVI for all participants was 10.9% (95% CI of 9.1 - 13.0%). The RCV for Lp(a) was +31.6%/-24.0%.Conclusion: Our study obtained a CVI estimate for Lp(a) that aligned consistently with recent studies adhering to the quality specifications outlined in the BIVAC checklist. The CVI estimate was significantly lower than Lp(a) estimates reported in studies up to 2003. The CVI estimate highlights the limitations of relying solely on a single Lp(a) measurement for prognosticating ASCVD risk and identifying candidates for novel Lp(a) therapies, particularly when the measured value is near clinical decision thresholds.","PeriodicalId":8005,"journal":{"name":"Annals of Clinical Biochemistry","volume":" ","pages":"45632251324063"},"PeriodicalIF":2.1,"publicationDate":"2025-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143413051","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"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

Metronidazole is a chromatographic interference on a routine HPLC-UV assay for thiopurine metabolites.

IF 2.1 4区医学

Annals of Clinical Biochemistry Pub Date : 2025-02-21 DOI: 10.1177/00045632251319917

Andrew A Wood, Sophie Rothwell Mason, Anna F Robson

{"title":"Metronidazole is a chromatographic interference on a routine HPLC-UV assay for thiopurine metabolites.","authors":"Andrew A Wood, Sophie Rothwell Mason, Anna F Robson","doi":"10.1177/00045632251319917","DOIUrl":"10.1177/00045632251319917","url":null,"abstract":"Background: Thiopurine metabolites, 6-thioguanine (6TG) and 6-methylmercaptopurine (6MMP), are monitored to aid therapeutic management of thiopurine drugs. At Manchester University NHS Foundation Trust (MFT), thiopurine metabolites are measured by high performance liquid chromatography with ultraviolet detection (HPLC-UV). Whole blood samples are lysed and subjected to hydrolysis with derivatisation of 6MMP before HPLC-UV detection at 304 nm for the 6MMP-derivative and 342 nm for 6TG. For some samples, 6MMP cannot be reported due to a chromatographic interference at 304 nm co-eluting with the 6MMP peak. An investigation was performed to identify the interfering compound.Methods: Patient medication histories were examined to identify candidate compounds for the interference. Candidate compounds were spiked into blood at supraphysiological concentrations and tested on the assay.Results: Metronidazole was identified as being prescribed to all patients whose samples demonstrated the interference. Metronidazole and its metabolite, hydroxymetronidazole, were spiked into blood. HPLC-UV analysis of spiked blood demonstrated similar UV absorbance patterns to those seen in patient samples with the interference. Hydroxymetronidazole co-eluted with 6MMP causing interference in the measurement.Conclusion: Metronidazole and its major metabolite can interfere with 6MMP measurement by HPLC-UV analysis at 304 nm.","PeriodicalId":8005,"journal":{"name":"Annals of Clinical Biochemistry","volume":" ","pages":"45632251319917"},"PeriodicalIF":2.1,"publicationDate":"2025-02-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143057759","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"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

Falsely elevated type IV collagen caused in part by heterophilic antibodies: A case report.

IF 2.1 4区医学

Annals of Clinical Biochemistry Pub Date : 2025-02-20 DOI: 10.1177/00045632251322316

Xian-Min Lv, Long Xiao, Hong-Lei Yu, Lu-Wei Yan

{"title":"Falsely elevated type IV collagen caused in part by heterophilic antibodies: A case report.","authors":"Xian-Min Lv, Long Xiao, Hong-Lei Yu, Lu-Wei Yan","doi":"10.1177/00045632251322316","DOIUrl":"https://doi.org/10.1177/00045632251322316","url":null,"abstract":"Immunoassays, which are used ubiquitously in clinical practice, are inherently vulnerable to distortions arising from endogenous immunoglobulins, particularly heterophilic antibodies. While many studies have explored interference in substances measured using chemiluminescence or electrochemiluminescence methods based on the double-antibody sandwich principle, there are limited data on interference in immunoturbidimetric assays, particularly for type IV collagen. This article presents the first report of a noteworthy increase in serum type IV collagen levels stemming from heterophilic antibody interference detected through an immunoturbidimetric assay. The present study investigated the mechanisms of this interference and the differences introduced by heterophilic antibodies between the two methodologies. Additionally, it outlines strategies for identifying and mitigating such interference, and discusses the principles, limitations, and considerations of each corrective approach. The objective is to raise awareness among clinical laboratory professionals concerning the potential interference of heterophilic antibodies in immunoturbidimetric assays. Increased awareness will aid in the prompt detection and correction of this issue, ensuring the provision of accurate and reliable laboratory data for informed clinical decision-making and the prevention of adverse medical outcomes.","PeriodicalId":8005,"journal":{"name":"Annals of Clinical Biochemistry","volume":" ","pages":"45632251322316"},"PeriodicalIF":2.1,"publicationDate":"2025-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143456743","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"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 United Kingdom-wide audit of the laboratory investigation of primary aldosteronism.

IF 2.1 4区医学

Annals of Clinical Biochemistry Pub Date : 2025-02-13 DOI: 10.1177/00045632251319984

Sarah L Davies, Daniel J Cuthbertson, Louise J Ward, Wassif S Wassif, Mark Gurnell, Andrew S Davison

{"title":"A United Kingdom-wide audit of the laboratory investigation of primary aldosteronism.","authors":"Sarah L Davies, Daniel J Cuthbertson, Louise J Ward, Wassif S Wassif, Mark Gurnell, Andrew S Davison","doi":"10.1177/00045632251319984","DOIUrl":"10.1177/00045632251319984","url":null,"abstract":"Objectives: Primary aldosteronism (PA) is a common but under-recognised cause of secondary hypertension. Early diagnosis with targeted medical and/or surgical intervention is important to prevent irreversible end-organ damage. An Endocrine Society Clinical Practice Guideline was used to define audit standards against which to assess current United Kingdom (UK) laboratory practice.Methods: A survey comprising 22 questions, which captured information on screening, confirmatory testing and adrenal vein sampling (AVS), was distributed to all UK Clinical Biochemistry laboratories by the Association for Laboratory Medicine. Consultation with clinical colleagues was encouraged.Results: 50 of 147 laboratories (34.0%) responded, 17 of which provided an analytical service for plasma aldosterone concentration (PAC) and renin, measured as plasma renin activity (PRA) or direct renin concentration (DRC). PRA/DRC, PAC and aldosterone:renin ratios were used to screen for PA. Saline infusion testing was the most common confirmatory test. AVS was used to aid lateralisation. Chemiluminescence immunoassay and liquid chromatography tandem mass spectrometry were the preferred analytical methods for PAC and PRA/DRC. However, there was considerable variation across centres in respect of reference intervals and cutoffs, which were not fully accounted for by differences in analytical platforms. Although diagnostic algorithms, with pre- and post-analytical support, were in evidence in some centres, these were not universal or always embedded in a multidisciplinary team setting.Conclusions: We observed significant heterogeneity in the laboratory investigation of PA across the United Kingdom. Therefore, this work serves as a stimulus for greater collaboration to permit national harmonisation/standardisation of analytical and clinical aspects of UK PA practice.","PeriodicalId":8005,"journal":{"name":"Annals of Clinical Biochemistry","volume":" ","pages":"45632251319984"},"PeriodicalIF":2.1,"publicationDate":"2025-02-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143057758","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"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

Standardising lipid testing and reporting in the United Kingdom; a joint statement by HEART UK and The Association for Laboratory Medicine. 英国血脂检测和报告标准化；英国心脏协会和检验医学协会的联合声明。

IF 2.1 4区医学

Annals of Clinical Biochemistry Pub Date : 2025-01-31 DOI: 10.1177/00045632251315303

Julia S Kenkre, Tina Mazaheri, R Dermot G Neely, Handrean Soran, Dev Datta, Peter Penson, Paul Downie, Alexandra M Yates, Katharine Hayden, Mayur Patel, Jaimini Cegla

{"title":"Standardising lipid testing and reporting in the United Kingdom; a joint statement by HEART UK and The Association for Laboratory Medicine.","authors":"Julia S Kenkre, Tina Mazaheri, R Dermot G Neely, Handrean Soran, Dev Datta, Peter Penson, Paul Downie, Alexandra M Yates, Katharine Hayden, Mayur Patel, Jaimini Cegla","doi":"10.1177/00045632251315303","DOIUrl":"10.1177/00045632251315303","url":null,"abstract":"Atherosclerotic cardiovascular disease remains a major cause of premature death in the United Kingdom. Lipid testing is a key tool used to assess cardiovascular risk and guide clinical management decisions. There are currently no national guidelines to provide evidence-based recommendations on lipid testing and reporting for UK laboratories and clinicians. Here we present consensus guidance, following a review of published evidence by a multidisciplinary group of UK experts across a range of laboratory and clinical services. Recommendations include the composition of a standard lipid profile; indications for, and composition of, an enhanced lipid profile including apolipoprotein B and lipoprotein (a); use of the Sampson-NIH calculation for LDL-c estimation and guidance on when to flag abnormal results. This consensus guidance on lipid testing and reporting in the United Kingdom has been endorsed by HEART UK and The Association for Laboratory Medicine.","PeriodicalId":8005,"journal":{"name":"Annals of Clinical Biochemistry","volume":" ","pages":"45632251315303"},"PeriodicalIF":2.1,"publicationDate":"2025-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142943256","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"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

Biochemical osteomalacia in adults undergoing vitamin D testing in the North-East of Scotland.

IF 2.1 4区医学

Annals of Clinical Biochemistry Pub Date : 2025-01-25 DOI: 10.1177/00045632251315671

Angus D Macleod, Mark J Bolland, Andrew Balfour, Andrew Grey, Josh Newmark, Alison Avenell

{"title":"Biochemical osteomalacia in adults undergoing vitamin D testing in the North-East of Scotland.","authors":"Angus D Macleod, Mark J Bolland, Andrew Balfour, Andrew Grey, Josh Newmark, Alison Avenell","doi":"10.1177/00045632251315671","DOIUrl":"https://doi.org/10.1177/00045632251315671","url":null,"abstract":"Background: International guidelines give greatly varying definitions of 25-hydroxyvitamin D (25OHD) insufficiency and deficiency. Vitamin D testing is increasing despite 2016 UK guidance for adults advising routine vitamin D supplementation October-March and year-round for high risk groups. A service evaluation of vitamin D testing and biochemical osteomalacia in the North-East of Scotland (57-58°N) could inform definitions and testing guidance.Methods: We identified adult 25OHD requests 8/7/2008-29/2/2020 and albumin-adjusted serum calcium (aCa), parathyroid hormone (PTH) and alkaline phosphatase (ALP) within 6 months of 25OHD testing. After excluding renal impairment and liver disease, we defined biochemical osteomalacia as ALP >130 IU/L and aCa <2.0 mmol/L and elevated PTH >9.2 or >6.8 pmol/L, depending on the assay. Possible biochemical osteomalacia was defined as 2 of these abnormalities in the absence of the third measurement. From these cases anonymised clinical data were then examined to confirm the diagnosis of osteomalacia.Results: 25,379 eligible patients had 25OHD measured: 25% were <25 nmol/L (6,258/25,379) and 18% <20 nmol/L (4,536/25,379). 0.5% (126/25,379) of eligible patients had biochemical or possible biochemical osteomalacia. After reviewing clinical records, only 0.1% (29/25,379) had clinically confirmed osteomalacia, equivalent to 2-3 cases/y for a population of 0.5 million, none of the untreated cases of clinically confirmed osteomalacia had 25OHD >25 nmol/L. For the entire tested population, when 25OHD was <25 nmol/L untreated osteomalacia confirmed by clinical records was rare (0.4%).Conclusions: Osteomalacia is rare in North-East Scotland. Our data call into question designating 25OHD 25-50 nmol/L 'insufficiency'. The risk of osteomalacia even when 25OHD is <25 nmol/L is very low.","PeriodicalId":8005,"journal":{"name":"Annals of Clinical Biochemistry","volume":" ","pages":"45632251315671"},"PeriodicalIF":2.1,"publicationDate":"2025-01-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143035770","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"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