Evaluation of the diagnostic utility of carbohydrate-deficient transferrin in chronic alcoholism: Results from Southwest China.

ABSTRACT: Although recent gathered evidence indicates that obtaining the diagnostic value of serum carbohydrate-deficient transferrin might be more useful for identifying alcohol abuse than other widely available biochemical tests; however, its precise value as an indicator of chronic alcoholism is unclear. The main objective is to investigate the diagnostic significance of carbohydrate-deficient transferrin in chronic alcoholism in the Chinese population.In this study, we enrolled (1) 52 physically healthy subjects, (2) 20 patients with nonalcoholic liver disease, and (3) 70 alcoholics. Patients with liver injuries and a history of liver surgery were excluded. Serum gamma-glutamyltransferase, aspartate aminotransferase, alanine aminotransferase, and mean corpuscular volume were determined by standard biochemical assays, and serum carbohydrate-deficient transferrin was estimated in each group using capillary electrophoresis. Subsequently, the diagnostic value of carbohydrate-deficient transferrin (CDT) in chronic alcoholism was determined based on differences between each indicator among the three groups.The CDT level in the alcoholic group was significantly higher than that of the non-alcoholic liver disease and healthy control groups (P < .05). The area under the curve for alcoholism diagnosis was the highest for CDT, at 0.922, whereas those for gamma-glutamyltransferase, aspartate aminotransferase, alanine aminotransferase, and mean corpuscular volume were 0.860, 0.744, 0.615, and 0.754, respectively. When the cutoff value of CDT was set at 1.25%, the sensitivity and specificity were 85.5% and 89.6%, respectively. However, the correlation between CDT and daily alcohol consumption was weak (r = 0.175; P = .16).Compared with the other parameters evaluated, CDT was a better indicator of alcoholism. It should, therefore, be actively promoted in clinical practice. However, the correlation between CDT and daily alcohol consumption needs further evaluation.

[The Influence of Transferrin Gene Polymorphism on Measuring Carbohydrate Deficient Transferrin by Capillary Electrophoresis].

OBJECTIVE: To determine the influence of isoforms of transferrin (Tf) on the detection of serum carbohydrate-deficient transferrin (CDT) by capillary electrophoresis (CE). METHODS: A total of 51,17,and 65 serum samples were collected from the healthy participants,the patients with non-alcoholic liver diseases,and the patients with alcoholic liver diseases,respectively. Serum CDT was measured by CE. The genotype ofTf of the samples without a good separation was further analyzed using high resolution melting (HRM) methods. Those with suspected mutation were confirmed by sequencing. RESULTS: Six samples showed incomplete separation (2 from the healthy participants,3 from the patients with non-alcoholic liver diseases,1 from the patient with alcoholic liver diseases). Of the 133 serum samples,2.3% (3/133) were detected withTf-Dchi heterozygote. But noTf-D1 andTf-B2 heterozygote were identified. CONCLUSION: Tf-Dchi variant influences the measurement of carbohydrate deficientTf by CE,leading to unreliable results.

[Clinical Significance of Urinary Microalbumin to Creatinine Ratio in Physical Examinations].

OBJECTIVE: To-determine the association between urinary microalbumin to creatinine ratio (mALB/Cr) and metabolic indicators in people undergoing physical examinations. METHODS: A total of 4 184 people who took physical examinations in West China Hospital, Sichuan University from November 2013 to October 2014 participated in this study. We measured their body mass index (BMI), systolic blood pressure (SBP), diastolic blood pressure (DBP), waistline, hipline, Waist-to-hip ratio (WHR), urinary mALB/Cr, serum glucose (GLU), total cholesterol (TC), triglyceride (TG) , high density lipoprotein cholesterol (HDL-C), low density lipoprotein cholesterol (LDL-C), blood urea nitrogen (BUN), serum creatinine (SCr) , uric acid (UA), cystatin C (Cys-C), glomerular filtration rate (eGFR) and homocysteine (Hcy). RESULTS: (1) The participants had a median (interquartile range) mALB/Cr of 5.7 (3.1-11.8) mg/g: 5.4 (3.0-11.3) mg/g for males and 6.3 (3.6-13.2) mg/g for females (P < 0.05). (2) About 10.95% participants (10.96% for males and 10.90% for females) had a mALB/Cr ≥ 30 mg/g. (3) mALB/Cr increased with age. (4) BMI, SBP, DBP, waistline, WHR, GLU, HDL-C, TG, SCr, BUN, UA, eGFR and Cys-C were associated the distribution of participants (P < 0.05) across the three groups of mALB/Cr: normal (< 30 mg/g), microalbuminuria (30-300 mg/g) , and proteinuria (> 300 mg/g). (5) Logistic regression demonstrated that age, SBP, WHR, GLU, TG and eGFR were significant predictors of albuminuria. CONCLUSION: A high level of abnormal/positive mALB/Cr was found in people undergoing physical examinations. Increased age, SBP, WHR, GLU, TG and decreased eGFR are major risk factors of abnormal mALB/Cr. mALB/Cr should be monitored, especially in the elderly and those with high-metabolic-syndrome.

[The levels of serum cystatin C in patients with tumors and healthy controls].

OBJECTIVE: To determine the association between serum cystatin C and tumors. METHODS: Serum samples were obtained from 273 patients with tumors and 185 healthy volunteers. Serum cystatin C was determined by particle-enhanced turbidimetric immunoassay (PETIA). Student t-test, covariance analysis and multiple linear regressions were performed to examine the differences in the levels of cystatin C between the two groups. RESULTS: The student t-test did not show significant statistical differences in the serum cystatin C levels between the two groups (P = 0.075). However, such differences became statistically significant (P < 0.01) after adjustment of age. The multiple liner regression demonstrated that healthy volunteers and men had higher levels of cystatin C than those with tumors and women. Cystatin C also increased with age and decreases with estimating glomerular filtration rate. CONCLUSION: Cystatin C may be associated with the genesis and development of tumors.

Reference intervals and factors contributing to serum cystatin C levels in a Chinese population.

BACKGROUND: Serum cystatin C (Cys-C), an inhibitor of cysteine proteases, has been suggested as an ideal biomarker of glomerular filtration rate (GFR). OBJECTIVES: The objective of this study was to describe the reference intervals of serum Cys-C and identify factors associated with serum Cys-C or its variability, including age, gender, creatinine (Crea), blood urea nitrogen (BUN), and uric acid (UA). DESIGN AND METHODS: Serum Cys-C, Crea, BUN, and UA were measured in 4,517 healthy participants aged 8-89 years attending our hospital. Serum Cys-C was analyzed using a latex-enhanced immunoturbidimetric method. Crea were tested by picric acid jaffe method, BUN, and UA by kinetic UV assays. RESULTS: The predominant characteristic of Cys-C distribution was that Cys-C concentration in age ≥60 years group was the highest (P < 0.05). The differences of Cys-C concentration between males and females existed for subjects aged from 30 to 59 years (P < 0.05). In a multiple model adjusted only for gender and age, gender (ß = 0.007) has stronger effect on Cys-C levels, compared with age (ß = 0.003). The clinical variables, comprised of age, gender, Crea, BUN, and UA, involved in the fully adjusted equation accounted for 37.6% of variation of Cys-C. CONCLUSIONS: Ninety-five percent reference intervals for healthy population were partitioned into three categories only by age, 0.59-1.07 mg/L for subjects aged 19-59 years; 0.74-1.14 mg/L for the older aged ≥60 years; and 0.63-1.11 mg/L for children aged ≤18 years. Serum Cys-C is significantly related to gender, age, UA, Crea, and BUN. Besides, there are still other factors contributing to variation of Cys-C levels.

[Association of sex, age, renal function, metabolic index and types of diseases with serum cystatin-C in patients].

OBJECTIVE: To identify the determinants of serum cystatin-C (Cys C) in patients. METHODS: The medical records of 31235 patients admitted to West China hospital from September to October, 2009 and their first laboratorial test results were examined. Liner regression analyses were performed to determine the association of sex, age, renal function, and metabolic index serum Cys C. One-way ANOVA and LSD tests were performed to determine the association between different diseases and serum Cys C. RESULTS: The multiple linear regression equation was obtained: Cys C = 0.331 + 0. 686Crea + 0. 174Urea + 0.119Age + 0. 068Uric - 0. 057HDL-C -0.041Sex + 0.038eGFR -0.031LDL-C -0. 026Glu, with a correlation coefficient of 0. 859 and a coefficient of determination of 0. 738. The level of serum Cys C varied with different diseases, with urinary diseases showing the highest level followed by vascular and respiratory diseases. CONCLUSION: Serum Cys C is associated with renal function, but not with metabolic index. Cys C tends to rise in patients renal function injury.

[Combined myocardial injury markers for diagnosis of acute myocardial infarction].

OBJECTIVE: To compare the diagnostic accuracy of different myocardial injury markers and their combinations in diagnosing acute myocardial infarction (AMI). METHODS: The myocardial injury markers: AST, CK, CK-MB, LDH, HBDH, cTnI, CK-MB mass were detected in patients with acute chest pain-onset who were hospitalized in Sichuan University West China Hospital from July 2005 to October 2006. The accuracy of those markers in diagnosing AMI were evaluated by their sensitivity, specificity, positive predictive value, negative predictive value, positive likelihood ratio, and negative likelihood ratio. Student t-test and one-way ANOVA were performed to compare the diagnostic accuracy of the markers. RESULTS: cTnI had the highest diagnostic accuracy, with 85% of sensitivity and 92.5% of specificity (P < 0.05). cTnI in parallel with myocardial enzymes produced the highest combined diagnostic accuracy, with 100% of sensitivity and 37.29% of specificity (P < 0.05). Myocardial enzymes in sequence with cTnI produced the highest sequential diagnostic accuracy, with 50% of sensitivity and 100% of specificity (P < 0.05). CONCLUSION: cTnI is the best indicator for diagnosis and differential diagnosis of AMI. Myocardiozymogram is poor in sensitivity and specificity, which should be used only in combination with cTnI or CK-MB mass. Parallel testing can increase sensitivity, while sequential testing can improve specificity.