Objective:To investigate the hook effect in the detection of beta2-microglobulin(β2-MG)with different reagents as well as on two fully automated biochemical analyzers and their solutions.Methods:Using immunoturbidime...Objective:To investigate the hook effect in the detection of beta2-microglobulin(β2-MG)with different reagents as well as on two fully automated biochemical analyzers and their solutions.Methods:Using immunoturbidimetric assay forβ2-MG as the research object,β2-MG levels were detected by different concentration gradients ofβ2-microglobulin samples in Liedemann,Mack,and Myriad reagents of three manufacturers on two automatic biochemical analyzers,and the difference of the hook effect was comparatively analyzed.Results:Leadman reagent showed the hook effect on the Beckman AU5800 automated biochemistry analyzer,while both Maccura and Mindray reagents did not show the hook effect.After the experiments,we found the limit value of the pre-zone check of Leadman reagent,and changed the parameters of the instrument,when the limit value of the pre-zone check was reached,the instrument automatically diluted the specimen five times and then detected it again.After changing the parameters of the instrument,the correlation between the three methods of detecting samples of different concentrations was r>0.99.Conclusion:Before selecting the application of immunoturbidimetric reagents,we have to carry out the risk assessment of the hook effect and selectively set the parameters of the pre-zone check based on the highest concentration that may occur in the clinic;for the items that may have the hook effect,we have to selectively set the parameters of the pre-zone check when the ratio of average reaction rate and the immediate reaction rate is at the limit value,and the phenomenon of antigen excess may occur,the instrument will carry out automatic dilution before detection,so as to avoid the issuance of erroneous results of high-value samples due to the hook effect.展开更多
目的分析2型糖尿病患者25-羟维生素D[25(OH)D]水平,初步了解血清25(OH)D水平与2型糖尿病患者糖化血红蛋白(HbA1c)、胰岛功能等代谢指标的相关性。方法选择新乡市第一人民医院内分泌科2020年1月至2020年12月收治的459例2型糖尿病患者为...目的分析2型糖尿病患者25-羟维生素D[25(OH)D]水平,初步了解血清25(OH)D水平与2型糖尿病患者糖化血红蛋白(HbA1c)、胰岛功能等代谢指标的相关性。方法选择新乡市第一人民医院内分泌科2020年1月至2020年12月收治的459例2型糖尿病患者为研究对象。收集患者的临床资料,包括性别、年龄、血清25(OH)D、空腹胰岛素、C肽、HbA1c、空腹血糖、餐后血糖、尿微量白蛋白、尿白蛋白肌酐比值、血钙、血尿酸(UA)、三酰甘油(TG)、总胆固醇(TCH)、低密度脂蛋白(LDL)、高密度脂蛋白(HDL)等。根据血清25(OH)D水平将患者分为充足组[n=20,25(OH)D≥30μg·L^(-1)]、不足组[n=95,20μg·L^(-1)≤25(OH)D<30μg·L^(-1)]、缺乏组[n=231,10μg·L^(-1)≤25(OH)D<20μg·L^(-1)]、严重缺乏组[n=113,25(OH)D<10μg·L^(-1)]。比较4组患者各代谢指标的差异,采用Pearson相关分析25(OH)D与各代谢指标的相关性。结果2型糖尿病患者血清25(OH)D水平为3.00~46.59(15.75±0.35)μg·L^(-1),男性患者的血清25(OH)D水平显著高于女性患者(P<0.05)。2型糖尿病患者25(OH)D缺乏的患病率为74.9%(344/459),25(OH)D缺乏主要发生在1、2、3、4、11、12月份。不足组、缺乏组和严重缺乏组患者HbA1c显著高于充足组(P<0.05),缺乏组和严重缺乏组患者HbA1c显著高于不足组(P<0.05);缺乏组和严重缺乏组患者HbA1c比较差异无统计学意义(P>0.05)。充足组与不足组、缺乏组与严重缺乏组患者空腹血糖比较差异无统计学意义(P>0.05);缺乏组和严重缺乏组患者空腹血糖显著高于充足组、不足组(P<0.05)。充足组、不足组、缺乏组患者空腹胰岛素、尿微量白蛋白、日尿白蛋白总量、尿白蛋白肌酐比值比较差异无统计学意义(P>0.05);严重缺乏组患者空腹胰岛素显著低于充足组、不足组和缺乏组,尿微量白蛋白、日尿白蛋白总量、尿白蛋白肌酐比值显著高于充足组、不足组和缺乏组(P<0.05)。4组患者的稳态模型评估的胰岛素抵抗指数(HOMA-IR)、血清白蛋白、血肌酐、餐后1 h血糖、餐后2 h血糖、餐后3 h血糖、空腹C肽、餐后1 h C肽、餐后2 h C肽、餐后3 h C肽、TG、TCH、LDL、HDL、血UA、血钙比较差异均无统计学意义(P>0.05)。Pearson相关性分析结果显示,2型糖尿病患者血清25(OH)D水平与HbA1c、尿微量白蛋白、尿白蛋白肌酐比值呈负相关(r=-0.093、-0.166、-0.157,P<0.05),与空腹胰岛素呈正相关(r=0.089,P<0.05)。2型糖尿病患者血清25(OH)D水平与空腹血糖、HOMA-IR、血清白蛋白、血肌酐、餐后1 h血糖、餐后2 h血糖、餐后3 h血糖、空腹C肽、餐后1 h C肽、餐后2 h C肽、餐后3 h C肽、TG、TCH、LDL、HDL、血UA、血钙等无相关性(P>0.05)。结论2型糖尿病患者25(OH)D缺乏与不足普遍存在,女性患者缺乏更明显。2型糖尿病患者25(OH)D水平与空腹胰岛素呈正相关,与HbA1c、尿微量白蛋白、尿白蛋白肌酐比值呈负相关,25(OH)D缺乏的2型糖尿病患者主要分布在1、2、3、4、11、12月份。展开更多
BACKGROUND Retinopathy is the most common microvascular disease of type 2 diabetes,and seriously threatens the life,health and quality of life of patients.It is worth noting that the development of diabetic retinopath...BACKGROUND Retinopathy is the most common microvascular disease of type 2 diabetes,and seriously threatens the life,health and quality of life of patients.It is worth noting that the development of diabetic retinopathy(DR)can be hidden,with few symptoms.Therefore,the preliminary screening of diabetic patients should identify DR as soon as possible,delay disease progression,and play a vital role in its diagnosis and treatment.AIM To investigate the correlation between glycated hemoglobin A1c(HbA1c),urinary microalbumin(U-mALB),urinary creatinine(U-CR),mALB/U-CR ratio,β2 microglobulin(β2MG),retinol binding protein(RBP)and DR.METHODS A total of 180 patients with type 2 diabetes mellitus attending the Second People’s Hospital of Hefei from January 2022 to August 2022 were retrospectively enrolled by ophthalmologists.Based on whether they had combined retinopathy and its degree,68 patients with diabetes mellitus without retinopathy(NDR)were assigned to the NDR group,54 patients with non-proliferative DR(NPDR)to the NPDR group,and 58 patients with proliferative DR to the PDR group.General data,and HbA1c,mALB,β2MG,RBP,mALB/U-CR and U-CR results were collected from the patients and compared among the groups.Pearson's correlation method was used to analyze the correlation between HbA1c,mALB,β2MG,RBP,mALB/U-CR and U-CR indices,and multiple linear regression was applied to identify the risk factors for DR.Receiver operator characteristic(ROC)curves were also drawn.RESULTS The differences in age,gender,systolic and diastolic blood pressure between the groups were not statistically significantly(P>0.05),but the difference in disease duration was statistically significant(P<0.05).The differences in fasting blood glucose,high-density lipoprotein cholesterol,low-density lipoprotein cholesterol,total cholesterol,and triglyceride between the groups were not statistically significant(P>0.05).HbA1c in the PDR group was higher than that in the NPDR and NDR groups(P<0.05).The levels of mALB,β2MG,RBP,mALB/U-CR and UCR in the PDR group were higher than those in the NPDR and NDR groups(P<0.05).Multiple linear regression analysis showed that disease duration,HbA1c,mALB,β2MG,RBP,mALB/U-CR and U-CR were risk factors for the development of DR.The ROC curve showed that the area under the curve(AUC)for the combination of indices(HbA1c+mALB+mALB/U-CR+U-CR+β2MG+RBP)was 0.958,with a sensitivity of 94.83%and specificity of 96.72%,which was higher than the AUC for single index prediction(P<0.05).CONCLUSION HbA1c,mALB,mALB/U-CR,U-CR,β2MG and RBP can reflect the development of DR and are risk factors affecting PDR,and the combination of these six indices has predictive value for PDR.展开更多
目的以24 h尿钠排泄水平(24 h UNa)作为钠摄入量评估指标,评估不同钠盐的摄入水平与血清炎症因子对2型糖尿病(T2DM)患者尿白蛋白(UA)发生风险的影响。方法纳入T2DM患者130例,依据尿白蛋白/肌酐比值(UACR)水平分为UA阳性组60例和UA阴性...目的以24 h尿钠排泄水平(24 h UNa)作为钠摄入量评估指标,评估不同钠盐的摄入水平与血清炎症因子对2型糖尿病(T2DM)患者尿白蛋白(UA)发生风险的影响。方法纳入T2DM患者130例,依据尿白蛋白/肌酐比值(UACR)水平分为UA阳性组60例和UA阴性组70例。收集患者的临床资料,检测炎性因子及24 h尿液相关指标。采用Spearman相关分析T2DM患者临床指标与UACR的相关性;二元Logistic回归分析T2DM患者临床指标对UA的影响;二分类回归法分析24 h UNa和IL-18关联对UA的影响。结果24 h UNa水平(OR=1.019,95%CI 1.003~1.035,P=0.017)与IL-18(OR=1.204,95%CI 1.060~1.368,P=0.004)是T2DM患者UA阳性的独立危险因素。联合分析提示,与低钠低IL-18组比较,高钠高IL-18组UA阳性风险显著增加(OR=10.774,95%CI 2.105~55.155,P=0.004)。结论24 h UNa、IL-18水平升高是T2DM患者UA发生的危险因素。展开更多
目的研究糖化血红蛋白变异指数(HGI)、尿微量白蛋白(u-ALB)及血清腱生蛋白C(TNC)与2型糖尿病视网膜病变(T2DR)的相关性。方法回顾性选择2021年4月至2023年5月于首都医科大学大兴教学医院接受治疗的2型糖尿病(T2DM)患者1390例的临床资料...目的研究糖化血红蛋白变异指数(HGI)、尿微量白蛋白(u-ALB)及血清腱生蛋白C(TNC)与2型糖尿病视网膜病变(T2DR)的相关性。方法回顾性选择2021年4月至2023年5月于首都医科大学大兴教学医院接受治疗的2型糖尿病(T2DM)患者1390例的临床资料,根据T2DR发生情况将其分为T2DR组(n=378)和非T2DR组(n=1012)。依据糖尿病视网膜病变早期治疗研究分类系统对T2DR患者进行分期,分为非增殖期T2DR组(n=275)和增殖期T2DR(n=103)。观察两组基线资料(性别、年龄、T2DM病程)、血糖[空腹血糖(FBG)、餐后2 h血糖(2 h PBG)]、血脂[高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)、总胆固醇、甘油三酯]、HGI、u-ALB及血清TNC水平;观察不同T2DR病变分期患者基线资料、血糖、血脂、HGI、u-ALB、血清TNC水平。采用Pearson相关分析对T2DM患者HGI、u-ALB、血清TNC与T2DR的相关性进行分析。采用多因素Logistic回归分析对影响T2DR发生的独立危险因素进行分析。结果T2DR组与非T2DR组的性别构成比、年龄比较,差异均无统计学意义(P>0.05);T2DR组T2DM病程、FPG、2 h PBG、HbA1c、HDL-C、LDL-C、总胆固醇、甘油三酯、HGI、u-ALB、TNC水平均大于非T2DR组,差异均有统计学意义(P<0.05)。增殖期T2DR组与非增殖期T2DR组的性别构成比、年龄比较,差异均无统计学意义(P>0.05);增殖期T2DR组的T2DM病程、FPG、2 h PBG、HbA1c、HDL-C、LDL-C、总胆固醇、甘油三酯、HGI、u-ALB、TNC水平均大于非增殖期T2DR组,差异均有统计学意义(P<0.05)。Pearson相关分析结果显示,HGI、u-ALB、TNC与T2DM患者发生T2DR呈正相关(P<0.05)。多因素Logistic回归分析结果显示,HbA1c、HGI、u-ALB及TNC为影响T2DM患者发生T2DR的独立危险因素。结论HGI、u-ALB、TNC的异常升高可促进T2DM患者T2DR的发生及进展,HbA1c、HGI、u-ALB及TNC为影响T2DM患者发生T2DR的独立危险因素。展开更多
基金Baoding Science and Technology Bureau(2141ZF313)。
文摘Objective:To investigate the hook effect in the detection of beta2-microglobulin(β2-MG)with different reagents as well as on two fully automated biochemical analyzers and their solutions.Methods:Using immunoturbidimetric assay forβ2-MG as the research object,β2-MG levels were detected by different concentration gradients ofβ2-microglobulin samples in Liedemann,Mack,and Myriad reagents of three manufacturers on two automatic biochemical analyzers,and the difference of the hook effect was comparatively analyzed.Results:Leadman reagent showed the hook effect on the Beckman AU5800 automated biochemistry analyzer,while both Maccura and Mindray reagents did not show the hook effect.After the experiments,we found the limit value of the pre-zone check of Leadman reagent,and changed the parameters of the instrument,when the limit value of the pre-zone check was reached,the instrument automatically diluted the specimen five times and then detected it again.After changing the parameters of the instrument,the correlation between the three methods of detecting samples of different concentrations was r>0.99.Conclusion:Before selecting the application of immunoturbidimetric reagents,we have to carry out the risk assessment of the hook effect and selectively set the parameters of the pre-zone check based on the highest concentration that may occur in the clinic;for the items that may have the hook effect,we have to selectively set the parameters of the pre-zone check when the ratio of average reaction rate and the immediate reaction rate is at the limit value,and the phenomenon of antigen excess may occur,the instrument will carry out automatic dilution before detection,so as to avoid the issuance of erroneous results of high-value samples due to the hook effect.
文摘目的分析2型糖尿病患者25-羟维生素D[25(OH)D]水平,初步了解血清25(OH)D水平与2型糖尿病患者糖化血红蛋白(HbA1c)、胰岛功能等代谢指标的相关性。方法选择新乡市第一人民医院内分泌科2020年1月至2020年12月收治的459例2型糖尿病患者为研究对象。收集患者的临床资料,包括性别、年龄、血清25(OH)D、空腹胰岛素、C肽、HbA1c、空腹血糖、餐后血糖、尿微量白蛋白、尿白蛋白肌酐比值、血钙、血尿酸(UA)、三酰甘油(TG)、总胆固醇(TCH)、低密度脂蛋白(LDL)、高密度脂蛋白(HDL)等。根据血清25(OH)D水平将患者分为充足组[n=20,25(OH)D≥30μg·L^(-1)]、不足组[n=95,20μg·L^(-1)≤25(OH)D<30μg·L^(-1)]、缺乏组[n=231,10μg·L^(-1)≤25(OH)D<20μg·L^(-1)]、严重缺乏组[n=113,25(OH)D<10μg·L^(-1)]。比较4组患者各代谢指标的差异,采用Pearson相关分析25(OH)D与各代谢指标的相关性。结果2型糖尿病患者血清25(OH)D水平为3.00~46.59(15.75±0.35)μg·L^(-1),男性患者的血清25(OH)D水平显著高于女性患者(P<0.05)。2型糖尿病患者25(OH)D缺乏的患病率为74.9%(344/459),25(OH)D缺乏主要发生在1、2、3、4、11、12月份。不足组、缺乏组和严重缺乏组患者HbA1c显著高于充足组(P<0.05),缺乏组和严重缺乏组患者HbA1c显著高于不足组(P<0.05);缺乏组和严重缺乏组患者HbA1c比较差异无统计学意义(P>0.05)。充足组与不足组、缺乏组与严重缺乏组患者空腹血糖比较差异无统计学意义(P>0.05);缺乏组和严重缺乏组患者空腹血糖显著高于充足组、不足组(P<0.05)。充足组、不足组、缺乏组患者空腹胰岛素、尿微量白蛋白、日尿白蛋白总量、尿白蛋白肌酐比值比较差异无统计学意义(P>0.05);严重缺乏组患者空腹胰岛素显著低于充足组、不足组和缺乏组,尿微量白蛋白、日尿白蛋白总量、尿白蛋白肌酐比值显著高于充足组、不足组和缺乏组(P<0.05)。4组患者的稳态模型评估的胰岛素抵抗指数(HOMA-IR)、血清白蛋白、血肌酐、餐后1 h血糖、餐后2 h血糖、餐后3 h血糖、空腹C肽、餐后1 h C肽、餐后2 h C肽、餐后3 h C肽、TG、TCH、LDL、HDL、血UA、血钙比较差异均无统计学意义(P>0.05)。Pearson相关性分析结果显示,2型糖尿病患者血清25(OH)D水平与HbA1c、尿微量白蛋白、尿白蛋白肌酐比值呈负相关(r=-0.093、-0.166、-0.157,P<0.05),与空腹胰岛素呈正相关(r=0.089,P<0.05)。2型糖尿病患者血清25(OH)D水平与空腹血糖、HOMA-IR、血清白蛋白、血肌酐、餐后1 h血糖、餐后2 h血糖、餐后3 h血糖、空腹C肽、餐后1 h C肽、餐后2 h C肽、餐后3 h C肽、TG、TCH、LDL、HDL、血UA、血钙等无相关性(P>0.05)。结论2型糖尿病患者25(OH)D缺乏与不足普遍存在,女性患者缺乏更明显。2型糖尿病患者25(OH)D水平与空腹胰岛素呈正相关,与HbA1c、尿微量白蛋白、尿白蛋白肌酐比值呈负相关,25(OH)D缺乏的2型糖尿病患者主要分布在1、2、3、4、11、12月份。
文摘BACKGROUND Retinopathy is the most common microvascular disease of type 2 diabetes,and seriously threatens the life,health and quality of life of patients.It is worth noting that the development of diabetic retinopathy(DR)can be hidden,with few symptoms.Therefore,the preliminary screening of diabetic patients should identify DR as soon as possible,delay disease progression,and play a vital role in its diagnosis and treatment.AIM To investigate the correlation between glycated hemoglobin A1c(HbA1c),urinary microalbumin(U-mALB),urinary creatinine(U-CR),mALB/U-CR ratio,β2 microglobulin(β2MG),retinol binding protein(RBP)and DR.METHODS A total of 180 patients with type 2 diabetes mellitus attending the Second People’s Hospital of Hefei from January 2022 to August 2022 were retrospectively enrolled by ophthalmologists.Based on whether they had combined retinopathy and its degree,68 patients with diabetes mellitus without retinopathy(NDR)were assigned to the NDR group,54 patients with non-proliferative DR(NPDR)to the NPDR group,and 58 patients with proliferative DR to the PDR group.General data,and HbA1c,mALB,β2MG,RBP,mALB/U-CR and U-CR results were collected from the patients and compared among the groups.Pearson's correlation method was used to analyze the correlation between HbA1c,mALB,β2MG,RBP,mALB/U-CR and U-CR indices,and multiple linear regression was applied to identify the risk factors for DR.Receiver operator characteristic(ROC)curves were also drawn.RESULTS The differences in age,gender,systolic and diastolic blood pressure between the groups were not statistically significantly(P>0.05),but the difference in disease duration was statistically significant(P<0.05).The differences in fasting blood glucose,high-density lipoprotein cholesterol,low-density lipoprotein cholesterol,total cholesterol,and triglyceride between the groups were not statistically significant(P>0.05).HbA1c in the PDR group was higher than that in the NPDR and NDR groups(P<0.05).The levels of mALB,β2MG,RBP,mALB/U-CR and UCR in the PDR group were higher than those in the NPDR and NDR groups(P<0.05).Multiple linear regression analysis showed that disease duration,HbA1c,mALB,β2MG,RBP,mALB/U-CR and U-CR were risk factors for the development of DR.The ROC curve showed that the area under the curve(AUC)for the combination of indices(HbA1c+mALB+mALB/U-CR+U-CR+β2MG+RBP)was 0.958,with a sensitivity of 94.83%and specificity of 96.72%,which was higher than the AUC for single index prediction(P<0.05).CONCLUSION HbA1c,mALB,mALB/U-CR,U-CR,β2MG and RBP can reflect the development of DR and are risk factors affecting PDR,and the combination of these six indices has predictive value for PDR.
文摘目的以24 h尿钠排泄水平(24 h UNa)作为钠摄入量评估指标,评估不同钠盐的摄入水平与血清炎症因子对2型糖尿病(T2DM)患者尿白蛋白(UA)发生风险的影响。方法纳入T2DM患者130例,依据尿白蛋白/肌酐比值(UACR)水平分为UA阳性组60例和UA阴性组70例。收集患者的临床资料,检测炎性因子及24 h尿液相关指标。采用Spearman相关分析T2DM患者临床指标与UACR的相关性;二元Logistic回归分析T2DM患者临床指标对UA的影响;二分类回归法分析24 h UNa和IL-18关联对UA的影响。结果24 h UNa水平(OR=1.019,95%CI 1.003~1.035,P=0.017)与IL-18(OR=1.204,95%CI 1.060~1.368,P=0.004)是T2DM患者UA阳性的独立危险因素。联合分析提示,与低钠低IL-18组比较,高钠高IL-18组UA阳性风险显著增加(OR=10.774,95%CI 2.105~55.155,P=0.004)。结论24 h UNa、IL-18水平升高是T2DM患者UA发生的危险因素。
文摘目的研究糖化血红蛋白变异指数(HGI)、尿微量白蛋白(u-ALB)及血清腱生蛋白C(TNC)与2型糖尿病视网膜病变(T2DR)的相关性。方法回顾性选择2021年4月至2023年5月于首都医科大学大兴教学医院接受治疗的2型糖尿病(T2DM)患者1390例的临床资料,根据T2DR发生情况将其分为T2DR组(n=378)和非T2DR组(n=1012)。依据糖尿病视网膜病变早期治疗研究分类系统对T2DR患者进行分期,分为非增殖期T2DR组(n=275)和增殖期T2DR(n=103)。观察两组基线资料(性别、年龄、T2DM病程)、血糖[空腹血糖(FBG)、餐后2 h血糖(2 h PBG)]、血脂[高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)、总胆固醇、甘油三酯]、HGI、u-ALB及血清TNC水平;观察不同T2DR病变分期患者基线资料、血糖、血脂、HGI、u-ALB、血清TNC水平。采用Pearson相关分析对T2DM患者HGI、u-ALB、血清TNC与T2DR的相关性进行分析。采用多因素Logistic回归分析对影响T2DR发生的独立危险因素进行分析。结果T2DR组与非T2DR组的性别构成比、年龄比较,差异均无统计学意义(P>0.05);T2DR组T2DM病程、FPG、2 h PBG、HbA1c、HDL-C、LDL-C、总胆固醇、甘油三酯、HGI、u-ALB、TNC水平均大于非T2DR组,差异均有统计学意义(P<0.05)。增殖期T2DR组与非增殖期T2DR组的性别构成比、年龄比较,差异均无统计学意义(P>0.05);增殖期T2DR组的T2DM病程、FPG、2 h PBG、HbA1c、HDL-C、LDL-C、总胆固醇、甘油三酯、HGI、u-ALB、TNC水平均大于非增殖期T2DR组,差异均有统计学意义(P<0.05)。Pearson相关分析结果显示,HGI、u-ALB、TNC与T2DM患者发生T2DR呈正相关(P<0.05)。多因素Logistic回归分析结果显示,HbA1c、HGI、u-ALB及TNC为影响T2DM患者发生T2DR的独立危险因素。结论HGI、u-ALB、TNC的异常升高可促进T2DM患者T2DR的发生及进展,HbA1c、HGI、u-ALB及TNC为影响T2DM患者发生T2DR的独立危险因素。
