{"title":"Establishment of reference intervals for estimated glomerular filtration rate in apparently healthy adults based on the full age spectrum equation: A single-centre study.","authors":"Qian Liu, Huan Hang, Tongdao Xu, Yidi Zhang, Fang Yang, Xizhen Wang, Yali Ren, Fumeng Yang","doi":"10.1177/00045632241306060","DOIUrl":"https://doi.org/10.1177/00045632241306060","url":null,"abstract":"<p><strong>Background: </strong>Identifying gender and age-related eGFR trends is crucial for precise renal function assessment. This study aims to analyse eGFR distribution with the full age spectrum (FAS) equation and establish reference intervals based on gender and age in a single-centre cohort.</p><p><strong>Methods: </strong>Following the inclusion and exclusion criteria outlined in this study, a total of 24,024 reference individuals were ultimately selected. Using the approach recommended by the CLSI C28-A3 guidelines, we assessed the distribution of eGFR across different gender and age groups. The two-sided nonparametric method (P<sub>2.5</sub>-P<sub>97.5</sub>) was applied to establish the eGFR reference intervals for a healthy Chinese population.</p><p><strong>Results: </strong>The eGFR levels in healthy adults exhibited a non-normally distributed pattern. Notably, there were significant differences in eGFR levels between males and females, with females showing a notably higher eGFR level than males. Additionally, eGFR levels demonstrated significant variations across different age groups within both male and female cohorts. As age increased, eGFR showed a significant decline, except in individuals aged 20-29 and 30-39 years. Therefore, reference intervals for eGFR were created based on both gender and age.</p><p><strong>Conclusions: </strong>We established the reference interval for eGFR using the FAS equation, drawing from a large sample population at a single centre. This establishes a potential framework for evaluating renal function in healthy individuals and for diagnosing and treating kidney-related diseases.</p>","PeriodicalId":8005,"journal":{"name":"Annals of Clinical Biochemistry","volume":" ","pages":"45632241306060"},"PeriodicalIF":2.1,"publicationDate":"2024-12-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142778926","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}
{"title":"The effects of controlled acute psychological stress on serum cortisol and plasma metanephrine concentrations in healthy subjects.","authors":"Aaron Vage, Gerard Gormley, Paul K Hamilton","doi":"10.1177/00045632241301618","DOIUrl":"https://doi.org/10.1177/00045632241301618","url":null,"abstract":"<p><strong>Background: </strong>As cortisol and metanephrine are involved in the stress response, it is often recommended that individuals are relaxed at the time of venepuncture, however, evidence behind these recommendations is lacking. We investigated the effects of acute psychological stress on serum cortisol and plasma metanephrine concentrations in healthy individuals exposed to varying levels of psychological stress and compared these results to self-reported measures of stress.</p><p><strong>Methods: </strong>Ten medical students completed two medical in-person simulations (one low-complexity, one high-complexity) in a random order. At four times, participants completed the State-Trait Anxiety Inventory (STAI) and serum cortisol and plasma metanephrine/normetanephrine were tested.</p><p><strong>Results: </strong>Median (interquartile range) STAI prior to the low-complexity simulation was 44 (18) versus 33 (13) afterwards (<i>P</i> = 0.050). STAI prior to the high-complexity simulation was 33 (10) versus 48 (17) afterwards (<i>P</i> = 0.007). Cortisol prior to the low-complexity simulation was 272 nmol/L (115) versus 247 (115) afterwards (<i>P</i> = 0.333). Prior to the high-complexity simulation, cortisol was 246 (70) versus 261 (137) afterwards (<i>P</i> = 0.859). Metanephrine prior to the low-complexity simulation was 242 pmol/L (79) versus 247 (93) afterwards (<i>P</i> = 0.515). Metanephrine prior to the high-complexity simulation was 220 (81) versus 251 pmol/L (120) afterwards (<i>P</i> = 0.074). Normetanephrine prior to the low-complexity simulation was 593 pmol/L (247) versus 682 (281) afterwards (<i>P</i> = 0.047 for the difference). Normetanephrine prior to the high-complexity simulation was 696 (123) versus 705 pmol/L (224) afterwards (<i>P</i> = 0.169).</p><p><strong>Conclusions: </strong>The trend in cortisol levels largely reflected changes in STAI. We outline some implications of these findings for current practice and future research.</p>","PeriodicalId":8005,"journal":{"name":"Annals of Clinical Biochemistry","volume":" ","pages":"45632241301618"},"PeriodicalIF":2.1,"publicationDate":"2024-11-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142646799","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}
Han Ma, Wei Wang, Na Dong, Jiali Liu, Shuai Yuan, Chuanbao Zhang, Chao Zhang, Jie Zeng, Ying Yan, Zhiguo Wang
{"title":"Coefficients of variation analyses of internal quality control status for blood lead in China from 2015 to 2023.","authors":"Han Ma, Wei Wang, Na Dong, Jiali Liu, Shuai Yuan, Chuanbao Zhang, Chao Zhang, Jie Zeng, Ying Yan, Zhiguo Wang","doi":"10.1177/00045632241297885","DOIUrl":"10.1177/00045632241297885","url":null,"abstract":"<p><strong>Background: </strong>Blood lead test is widely conducted in Chinese laboratories, while the imprecision of blood lead measurement based on internal quality control (IQC) across China has not been comprehensively evaluated nowadays.</p><p><strong>Methods: </strong>Using the IQC data of blood lead collected through a web-based external quality assessment (EQA) reporting system, we analysed current coefficients of variation (CVs) of blood lead from 2015 to 2023 among Chinese laboratories. Two allowable total error (TEa) imprecision levels from EQA were applied to calculate the pass rates, namely percentages of laboratories meeting precision quality specifications. Besides, CV values and pass rates by different subgroups were further performed to assess potential differences.</p><p><strong>Results: </strong>Generally, median CV values significantly declined year by year from 6.8% in February 2015 to 5.9% in March 2023. The pass rates based on 1/3 TEa showed upward trends increasing from 15.3% in February 2015 to 20.0% in March 2023, but these percentages were non-ideal with less than 25%. No significant differences in CVs were found between tertiary hospitals and non-tertiary hospitals and between accredited and non-accredited laboratories. Significant time trends were observed in tertiary hospitals and non-accredited laboratories. As for manufacturers, Bohui and self-made QC sample were most widely used with obvious interannual declining trends of CVs.</p><p><strong>Conclusions: </strong>The CVs of blood lead demonstrated continuous overall improvements in the past twenty years. However, relatively lower pass rates indicated the non-ideal imprecision performance, and more proper performance specifications are warranted. Thus, imprecision improvement and ongoing investigation for blood lead IQC are still needed.</p>","PeriodicalId":8005,"journal":{"name":"Annals of Clinical Biochemistry","volume":" ","pages":"45632241297885"},"PeriodicalIF":2.1,"publicationDate":"2024-11-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142493404","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}
Bauke A de Boer, Tatum T van Laar, Firmin Candido, Karlijn J van Stralen, Anne Margreet de Jong
{"title":"Automated tools for identifying the causes of anaemia in general practices are particularly advantageous for patients who do not fit the typical profile.","authors":"Bauke A de Boer, Tatum T van Laar, Firmin Candido, Karlijn J van Stralen, Anne Margreet de Jong","doi":"10.1177/00045632241268252","DOIUrl":"10.1177/00045632241268252","url":null,"abstract":"<p><strong>Background: </strong>The Dutch guideline algorithm for the analysis of anaemia in patients of general practitioners (GPs) was programmed in a Clinical Decision Support system (CDS-anaemia) to support the process of diagnosing the cause of anaemia in the laboratory. This research aims to assess the supplementary benefit provided by the automated algorithm in various demographic categories, including different sexes, age groups and severities of anaemia, in comparison to the manual diagnostic approach employed by GPs.</p><p><strong>Methods: </strong>This was a retrospective cohort study of 5399 primary care patients where the cause of anaemia was diagnosed by GPs with or without the aid of CDS-anaemia within the age groups 18-44, 45-64, 65-79 and 80 and older. Anaemia was defined according to the Dutch College of General Practitioners (DCGP) guideline. Causes of anaemia were based on the DCGP guidelines with the corresponding blood tests. By calculation of rate ratios and percentage differences of the determined cause of anaemia we evaluated the effect of the diagnostic algorithm.</p><p><strong>Results and conclusion: </strong>The percentage patients in which an underlying cause of anaemia was found increased 34 and 46 percentage points in females and males, respectively, when GPs were supported by CDS-anaemia compared to GPs who were not supported by CDS-anaemia. The highest increase in percentage points when CDS-anaemia was used, was found in younger- and middle-aged males and mild or moderate anaemia.</p>","PeriodicalId":8005,"journal":{"name":"Annals of Clinical Biochemistry","volume":" ","pages":"480-483"},"PeriodicalIF":2.1,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141756764","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}
Saniye Başak Oktay, Şeyma Sehlikoğlu, Sevler Yildiz, Behice Han Almiş, İsmail Gürkan Çikim
{"title":"The effect of lithium variation coefficient on the risk of attack in patients with bipolar disorder: A pilot study.","authors":"Saniye Başak Oktay, Şeyma Sehlikoğlu, Sevler Yildiz, Behice Han Almiş, İsmail Gürkan Çikim","doi":"10.1177/00045632241262873","DOIUrl":"10.1177/00045632241262873","url":null,"abstract":"<p><strong>Background: </strong>This study examines the association between the coefficient of variation (%CV) of lithium levels and episode risk and frequency in bipolar patients maintaining serum lithium levels within the therapeutic range.</p><p><strong>Methods: </strong>We retrospectively reviewed patients with bipolar disorder under care from 2018 to 2022. Inclusion criteria were at least 2 years of follow-up, a minimum of three annual lithium level measurements within the therapeutic range. Patients were categorized based on seizure status. We calculated mean lithium levels, standard deviation (SD), and %CV.</p><p><strong>Results: </strong>The study included 75 patients (patients with-without episodes, 39-36). Demographic data revealed no significant differences. While mean lithium levels showed no significant disparity between groups, SD and %CV were notably higher in patients with episodes (<i>P</i> < .05). ROC analysis demonstrated AUC values of 0.722 (95% CI: 0.607-0.836 <i>P</i> = .001) for %CV and 0.709 (95% CI: 0.593-0.826; <i>P</i> = .002) for SD. The optimal %CV cutoff was 17.39, with 67% sensitivity and 69% specificity. A weak correlation was found between %CV and the number of episodes (<i>P</i> = .001, r = 0.376). The post-hoc power analysis for this study was 0.78.</p><p><strong>Conclusions: </strong>Despite acceptable lithium levels, patients with recent episodes exhibited significant lithium level fluctuations. Integrating %CV with real-time lithium measurements during bipolar disorder follow-up may enhance clinical monitoring and seizure prediction.</p>","PeriodicalId":8005,"journal":{"name":"Annals of Clinical Biochemistry","volume":" ","pages":"446-450"},"PeriodicalIF":2.1,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141260681","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}
Joel D Smith, Vasiliki Karlaftis, Stephen Hearps, Chantal Attard, Helen Savoia, Janine Campbell, Paul Monagle
{"title":"Continuous reference intervals for holotranscobalamin, homocysteine and folate in a healthy paediatric cohort.","authors":"Joel D Smith, Vasiliki Karlaftis, Stephen Hearps, Chantal Attard, Helen Savoia, Janine Campbell, Paul Monagle","doi":"10.1177/00045632241280344","DOIUrl":"10.1177/00045632241280344","url":null,"abstract":"<p><strong>Background: </strong>The detection of deficiencies in B<sub>12</sub> and folate children is important. However, despite the availability of various markers to assess B<sub>12</sub> and folate metabolism, there are limited studies describing the reference intervals (RIs) and changes during growth and development for these markers in healthy children.</p><p><strong>Methods: </strong>Using samples collected from 378 children aged 30 days-< 18 years, we derived continuous RIs for holotranscobalamin, homocysteine and red cell folate.</p><p><strong>Results: </strong>The lower RI for holotranscobalamin was lowest at birth, rising during early childhood and then declining following ages 4-6 years whereas red cell folate was highest early in life and then declined steadily towards adulthood. Total homocysteine, reflective of both B<sub>12</sub> and folate status was elevated early in life, reaching a nadir at age 2 and then increasing towards adulthood.</p><p><strong>Conclusions: </strong>Continuous central 95<sup>th</sup> percentile RI for holotranscobalamin, homocysteine and red cell folate for children ages 30 days to <18 years were established. Each marker shows dynamic changes throughout childhood and adolescence which will assist clinicians in more appropriately assessing B<sub>12</sub> and folate status in this population.</p>","PeriodicalId":8005,"journal":{"name":"Annals of Clinical Biochemistry","volume":" ","pages":"469-473"},"PeriodicalIF":2.1,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142008175","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}
Divya N Mallikarjun, Shubham Jain, Palash Kumar Malo, Bratati Kahali, Jonas S Sundarakumar, Latha Diwakar, Vijayalakshmi Ravindranath
{"title":"Distribution of biochemical and haematological parameters in an aging population from southern India: A cross-sectional analysis.","authors":"Divya N Mallikarjun, Shubham Jain, Palash Kumar Malo, Bratati Kahali, Jonas S Sundarakumar, Latha Diwakar, Vijayalakshmi Ravindranath","doi":"10.1177/00045632241267905","DOIUrl":"10.1177/00045632241267905","url":null,"abstract":"<p><strong>Background: </strong>Examining the distribution of biochemical and haematological tests in different age groups of rural population is necessary to ensure that health care facilities are equipped to address the prevalent health conditions and manage age-related illness effectively. Hence, this study is aimed at seeing the distributions of blood biochemical and haematological parameters in rural population.</p><p><strong>Methods: </strong>This cross-sectional study investigated the distribution of 26 different haematological and biochemical parameters in longitudinal cohort study (Srinivaspura Aging, NeuoSenescence and COGnition - SANSCOG), from the villages of Srinivaspura, Kolar district, India. A total of 2592 participants (1240 males and 1352 females), aged ≥45 years who are cognitively healthy were included for the analysis. Mean, 2.5<sup>th</sup>, 5<sup>th</sup>, 25<sup>th</sup>, 50<sup>th</sup>, 75<sup>th</sup>, 95<sup>th</sup> and 97.5<sup>th</sup> percentiles were calculated for the entire sample. Additionally, median and percentiles were determined for both gender and age categories (45-54, 55-64, 65-74, and ≥75 years).</p><p><strong>Results: </strong>We observed the distinct distributions of various haematological and biochemical parameters, with elevated levels of glycaemic, lipid, liver, and thyroid parameters.</p><p><strong>Conclusion: </strong>Findings revealed the notable variations from the established reference ranges, indicating the potential undiagnosed cases and highlighting the gaps in health awareness and health seeking behaviour.</p>","PeriodicalId":8005,"journal":{"name":"Annals of Clinical Biochemistry","volume":" ","pages":"451-458"},"PeriodicalIF":2.1,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141756765","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}
Angela D Burns, Christina Kanonidou, Jane McNeilly
{"title":"Misleading thyroid function tests in congenital dysfibrinogenemia.","authors":"Angela D Burns, Christina Kanonidou, Jane McNeilly","doi":"10.1177/00045632241263494","DOIUrl":"10.1177/00045632241263494","url":null,"abstract":"<p><p>The presence of latent fibrin clots is a recognised pre-analytical factor that causes inaccurate immunoassay results. This report details a case of a patient with Graves' disease and congenital dysfibrinogenemia (CD) that had serum thyroid function test results (TFTs) that were not in keeping with clinical signs or symptoms. Analysis of plasma samples taken from the patient was shown to provide more accurate results than those obtained using serum samples. Further cases of patients with CD, all sharing the same genetic mutation of fibrinogen, and discordant TFTs are described, where TFTs measurement in serum samples proved to be unreliable. Despite evidence of fibrin effecting immunoassays, this is the first report of its kind linking CD to erroneous immunoassay results. The mechanism is postulated to be related to atypical forms of fibrinogen resulting in latent fibrin in serum samples blocking the antigen binding site and leading to incorrect results. Congenital dysfibrinogenemia is asymptomatic in most patients and therefore abnormal, albeit inaccurate, TFTs may be the first finding. Recognition of CD as a cause of discordant results is important when interpreting TFTs to avoid unnecessary investigations and inappropriate clinical interventions to those with the disorder and potentially identify undiagnosed cases.</p>","PeriodicalId":8005,"journal":{"name":"Annals of Clinical Biochemistry","volume":" ","pages":"474-479"},"PeriodicalIF":2.1,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141282802","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}
Esmond Urwin, Joanne Martin, Neil Sebire, Andy Harris, Jenny Johnson, Erum Masood, Gordon Milligan, Lucy Mairs, Antony Chuter, Michael Ferguson, Philip Quinlan, Emily Jefferson
{"title":"A SARS-CoV-2 minimum data standard to support national serology reporting.","authors":"Esmond Urwin, Joanne Martin, Neil Sebire, Andy Harris, Jenny Johnson, Erum Masood, Gordon Milligan, Lucy Mairs, Antony Chuter, Michael Ferguson, Philip Quinlan, Emily Jefferson","doi":"10.1177/00045632241261274","DOIUrl":"10.1177/00045632241261274","url":null,"abstract":"<p><strong>Background: </strong>Healthcare laboratory systems produce and capture a vast array of information, yet do not always report all of this to the national infrastructure within the United Kingdom. The global COVID-19 pandemic brought about a much greater need for detailed healthcare data, one such instance being laboratory testing data. The reporting of qualitative laboratory test results (e.g. positive, negative or indeterminate) provides a basic understanding of levels of seropositivity. However, to better understand and interpret seropositivity, how it is determined and other factors that affect its calculation (i.e. levels of antibodies), quantitative laboratory test data are needed.</p><p><strong>Method: </strong>36 data attributes were collected from 3 NHS laboratories and 29 CO-CONNECT project partner organisations. These were assessed against the need for a minimum dataset to determine data attribute importance. An NHS laboratory feasibility study was undertaken to assess the minimum data standard, together with a literature review of national and international data standards and healthcare reports.</p><p><strong>Results: </strong>A COVID serology minimum data standard (CSMDS) comprising 12 data attributes was created and verified by 3 NHS laboratories to allow national granular reporting of COVID serology results. To support this, a standardised set of vocabulary terms was developed to represent laboratory analyser systems and laboratory information management systems.</p><p><strong>Conclusions: </strong>This paper puts forward a minimum viable standard for COVID-19 serology data attributes to enhance its granularity and augment the national reporting of COVID-19 serology laboratory results, with implications for future pandemics.</p>","PeriodicalId":8005,"journal":{"name":"Annals of Clinical Biochemistry","volume":" ","pages":"418-445"},"PeriodicalIF":2.1,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11528979/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141160438","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Impact of Hub & Spoke organization on the measurement of plasma ammonia.","authors":"Davide Camerlengo, Valentina Moioli, Claudia Arrigo, Silvio Contorno, Felicia Stefania Falvella, Alberto Dolci","doi":"10.1177/00045632241266169","DOIUrl":"10.1177/00045632241266169","url":null,"abstract":"","PeriodicalId":8005,"journal":{"name":"Annals of Clinical Biochemistry","volume":" ","pages":"490-491"},"PeriodicalIF":2.1,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141733440","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}