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Objective:The diagnostic values of urine free and fractionated catecholamine metabolites (including metanephrine MN and normetanephrine NMN, usually known as MNs) were established and their clinical value was evaluated.Methods:Using high performance liquid chromatography tandem mass spectrometry(HPLC-MS/MS), urine free MNs (f-MN, f-NMN) and fractionated MNs(t-MN, t-NMN) from 180 cases of non-pheochromocytoma and 54 cases of pheochromocytoma (PCC)patients were detected respectively.Receiver operating characteristic curve (ROC) was used to establish clinical reference cut-off value for different forms of MNs, and diagnostic efficacy of free, fractionated and total MNs was evaluated.Results:(1) The cut-off values of f-MN, f-NMN, t-MN and t-NMN were 47.8 μg/24 h, 52.3 μg/24 h, 224.9 μg/24 h and 664 μg/24 h, respectively. The cut-off values of total f-MNs and total t-MNs were 126 μg/24 h and 1 070 μg/24 h, respectively. (2) The correlation between f-MN and t-MN ( r=0.976, P<0.001), f-NMN and t-NMN ( r=0.940, P<0.001) was good. The area under ROC curve(AUC)of f-MN was lower than that of t-MN(0.579 vs 0.730, P<0.001), the sensitivity was slightly lower than that of t-MN((37.01% vs 51.85%, P=0.036), and the specificity was similar (99.44% vs 96.67%, P>0.05). There was no significant difference in sensitivity (90.74% vs 92.59%, P>0.05), specificity (99.44% vs 96.67%, P>0.05) and AUC (0.944 vs 0.959, P>0.05) between f-NMN and t-NMN. The combined diagnostic value of MN and NMN (total MNs) was higher than MN (free type:0.932>0.579, fractionation type: 0.960>0.730), which was similar to NMN. Conclusions:The diagnostic performance of urine free NMN or total MNs for PCC is similar to that of fractionated typewhich can meet the clinical needs.With few influencing factors, free type MNs may be used as an alternative indicator for PCC screening in the future.
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Objective To study the relationship between sdLDL-C level and CHD.Methods Two hundred and thirty-one CHD patients were divided into carotid stenosis group (n=119) and carotid stenosis-free group (n=112).The relationship between serum sdLDL-C level and risk factors for CHD were analyzed by logistic stepwise regression analysis.Results The serum sdLDL-C level was significantly higher in carotid stenosis group than in carotid stenosis-free group (P＜0.05).The elevated rate of serum sdLDL-C level was significantly higher in carotid stenosis group than in carotid stenosis-free group when 1.39 mmol/L was set as its upper limit reference cutoff value (36.3％ vs 17.0％,P＜0.05).The serum levels of TC,LDL-C,apoB,D-dimer and Fib were significantly higher while those of HDL-C were significantly lower in carotid stenosis group than in carotid stenosis-free grou (P＜0.05).The serum levels of sdLDL-C were positively related with those of TC,LDL-C,apoB,D-dimer,Fib and negatively related with those of HDL-C (P＜0.01).Logistic stepwise regression analysis showed that TC,LDL-C,apoB,D-dimer,Fib and sdLDL-C were the independent risk factors for CHD (P＜0.05).Conclusion Serum sdLDL-C level is significantly higher in CHD patients and is thus an important risk factor for CHD.