Analisi della concordanza analitica e clinica tra due sistemi analitici nella determinazione di anticorpi anti toxoplasma, rosoliavirus e cytomegalovirus

Nino Di Pietro*, Corrado Romano, Cristiana Giovanetti, Roberta Carosella, Paolo Testa, Elisabetta Procida
*Laboratorio Analisi, Presidio Ospedaliero G.Bernabeo Ortona, ASL Chieti

Biochimica Clinica: 2006; 30(3): 175-179 [Article in italian]

ABSTRACT. Analysis of the analytical and clinical concordance between two different laboratory instuments in the determination of antibodies against toxoplasma gondii, rubella virus and citomegalovirus. The aim of our work was to compare two different analytical systems (EIA3000 and CHORUS) to measure serum levels of specific IgG antibodies: anti Toxoplasma Gondii, (TOXO), anti Rosoliavirus (RUB), and anti Citomegalovirus (CMV). We analysed sera from 185 women in the first 3 months of pregnancy. The analytical correlation between the two different methods was determined using the Spearman test. The Wilcoxon test permitted us to verify the analytical concordance. The clinical concordance was determined using the ROC curves, that produced an area under curve (AUC) of the 0,988 for the anti TOXO IgG, 0,999 for the anti RUB IgG, and 0,904 for the anti CMV IgG.

Studio dell'effetto delle condizioni pre-analitiche sulla misura dell'inibitore-1 dell'attivatore del plasminogeno (PAI-1) e dell'effetto del congelamento sulla misura del fattore di von Willebrand (vWF)

Andrea Bolner*, Walter Filippini, Alessandro M. Lomeo, Luca Lomeo
*Exacta Central Laboratory, Verona

Biochimica Clinica: 2006; 30(3): 180-184 [Article in italian]

ABSTRACT. Effects of pre-analytical conditions on the measurement of plasminogen activator (PAI-1) inhibitor-1, and of freezing on the von Willebrand factor (vWF) measurement. The collection, preparation and storage of plasma samples for the assay of plasminogen activator (PAI-1) inhibitor-1, and of the von Willebrand factor (vWF), are steps of the analytical process not well understood and sometimes underestimated: nevertheless, they may play an important role in analytical accuracy. We have studied the effects of centrifugation and of sample storage before testing, with special consideration to the risk of PAI-1 release from platelets to plasma. Further investigations concerned analytes stability in plasma samples during long-term storage in the frozen state. Centrifugation speed and temperature were found to have no effect on in-vitro platelets activation; however, even very short delay of samples centrifugation after blood drawing may lead to false increments of plasma PAI-1. This fact also occurs if samples are immediately refrigerated. Contrarily, immediate centrifugation of the sample, not necessarily refrigerated, allows the best prevention of platelets PAI-1 release. Both the analytes showed good stability following long-term storage of the frozen plasma at -20 °C.

Relationship between adipocytokines (leptin, adiponectin) and arterial blood pressure

Omayma El Kholy*, Fatma Eid, Ratiba Abdel Al, Murad Gorgi
Departments of Medical Biochemistry and Medicine, Faculty of Medicine, Cairo University

Biochimica Clinica: 2006; 30(3): 185-189 [Article in english]

ABSTRACT. Background: The relationship between adipose tissue hormones (adiponectin and leptin) and obese state is often reported; however their cardiovascular effects are not as well understood. We attempted to study the relation between circulating concentrations of the adipocytokines (leptin and adiponectin) and arterial blood pressure in order to determine whether the reported cardiovascular effects of the above-mentioned hormones are secondary to the obese state or not. Methods: The mean arterial blood pressure (MABP, as a measure of arterial blood pressure), body mass index (BMI, as a measure of obesity) and serum leptin and adiponectin concentrations were estimated in four groups of subjects: lean and obese normotensives and lean and obese hypertensives. Results: Serum leptin shows an increase in obese subjects compared to lean subjects; whether normo (22.0 ± 8.44 vs. 5.9 ± 2.9; P < 0.001) or hypertensives (26.4 ± 8.99 vs. 12.2 ± 5.43; P < 0.001). Lean hypertensive subject have higher values than lean normotensives. The same pattern was observed for leptin/ adiponectin ratio, with obese hypertensive subjects showing the highest concentration (3.0±1.41) and lean normotensives showing the lowest (0.5±0.29) An opposite pattern was observed for serum adiponectin, with obese hypertensive subjects showing the lowest concentration (9.36±1.71) and lean normotensives the highest (15.46±2.10). A positive and a negative correlation was observed between each of leptin and adiponectin respectively and mean arterial blood pressure (MABP). Serum adiponectin & serum leptin were inversely correlated in all groups (r = - 0.74; P < 0.01). Conclusion: The results suggest that obese subjects and subjects with essential hypertension (whether lean or obese) show higher serum leptin level and lower serum adiponectin than normotensives. Furthermore, the correlations between mean arterial blood pressure, and each of serum leptin and adiponectin could suggest that leptin and adiponectin play a contradictory role and/or could be involved in the pathophysiology or the regulation of essential hypertension regardless of the obese state. In addition, we suggest serum leptin to adiponectin ratio to be used as a potential index of hypertension and obesity.

Is chronic hepatitis c infection a risk factor for developing diabetes mellitus before and after interferon therapy

El-Kholy Omayma Saad Reda*, Hegazy Adalat and Eid Fatma
*Departments of Biochemistry Radiodiagnosis and Internal Medicine-Faculty of Medicine, Cairo University

Biochimica Clinica: 2006; 30(3): 190-197 [Article in english]

ABSTRACT. Viruses have been implicated as a possible agent in the development of diabetes mellitus (DM). The present work aimed to estimate the level of islet cell autoantibodies in the course of HCV infection; and to assess the relationship between those levels and liver pathology as detected by ultrasonography (US). In addition , we attempted to assess the effect of interferon therapy on the predisposition to diabetes and the severity of hepatitis and cirrhosis.The study was conducted on forty patients with chronic hepatitis C (HCV). Patients were divided into two groups: HCV-seropositive diabetics and HCV-seropositive non-diabetics. Twenty age-sex-matched normoglycemic healthy individuals served as a control group. Liver functions, abdominal US, and hepatitis B and C markers were assessed in all subjects. Predictive and diagnostic markers of insulin depedent diabetes mellitus (IDDM) viz: glutamic acid decarboxylase antibodies (GAD-Ab) and second islet cell autoantibodies (IA2-Ab) were estimated in the whole study population before interferon therapy and in HCV-seropositive non-diabetics after interferon (IFN) therapy. Abdominal US was also performed after IFN therapy. The results showed that HCV-positive diabetics had significantly higher values of ALT, AST and prothrombin time than HCV-positive non-diabetics (p<0.05) while results of liver biopsy showed no significant difference between the two groups regarding disease activity. In additon, HCV-positive diabetics had highly significant values of GAD-Ab and IA2-Ab when compared either to HCV-positive non-diabetics or controls (p<0.001). However, HCV-positive non-diabetics showed significantly higher levels of GAD-Ab and IA2-Ab when compared to controls (p<0.05). Levels of GAD-Ab and IA2-Ab were significantly higher in HCV-positive non-diabetics after IFN therapy compared to before IFN therapy (P<0.05). Statistically positive correlations were found between GAD and IA2 antibodies before and after interferon therapy (r=0.49 and r=0.58 respectively p<0.05). No significant correlations were detected between US findings and each of GAD-Ab and IA2-Ab in both HCV diabetics and non diabetics before and after IFN therapy. In conclusion, HCV may be a predisposing factor in development of diabetes mellitus, as detected by the increased levels of GAD and anti IA2 antibodies. HCV patients most probably become more prone to develop DM after interferon therapy. Thus, GAD and anti IA2 antibodies assessment is very important to detect patients at risk of developing DM before and after interferon therapy. In addition, it seems most probable that the severity of cirrhosis, as detected by US, is not associated with the predisposition to diabetes.

Il peptide natriuretico di tipo B (BNP) nella diagnosi di re-stenosi dopo angioplastica coronarica con impianto di stent

**Renato Lo Mauro, Francesco Enia, Francesco Arcoleo, Angela Lo Giudice, Antonina Picone, Enrico Cillari
**Unità operativa Cardiologia II, Azienda Ospedaliera Vincenzo Cervello, Palermo

Biochimica Clinica: 2006; 30(3): 198-202 [Article in italian]

ABSTRACT. B-type natriuretic peptide (BNP) in the diagnosis of re-stenosis after percutaneous transluminal coronary angioplasty with stent implantation. We determined the serum level of BNP before and after exercise testing in 26 subjects who recently underwent a percutaneous coronary implantation of paclitaxel-eluting stent. Six of them showed clearcut re-stenosis of treated vessel at control angiography 9 months after the initial procedure. BNP levels were significantly increased in all coronary patients compared with normals, but in patients with re-stenosis the resting BNP was significantly higher than in patients without re-stenosis. We found that BNP determination, along with conventional stress-related markers of ischaemia, improved re-stenosis detection in these subjects (positive likelihood ratio 10, negative likelihood ratio 0.047). It could be useful to incorporate BNP determination in the routine evaluation of such patients

Transferrina carboidrato carente: marcatore di abuso alcolico cronico

*Vincenza Bianchi, Annalisa Roveta
*Laboratorio Analisi Azienda Ospedaliera SS Antonio e Biagio e C Arrigo Alessandria, Scuola di Specializzazione di Patologia Clinica Università del Piemonte Orientale “A Avogadro” di Novara

Biochimica Clinica: 2006; 30(3): 203-209 [Article in italian]

ABSTRACT. Carbohydrate deficient transferrin: a marker of chronic alcohol abuse. Carbohydrate deficient transferrin (CDT) is a useful biomarker for monitoring the chronic use and abuse of alcohol . CDT is characterized by extreme micro-heterogeneity, and this characteristic makes it critical its measurement, more so in relation to legal environment where the measurement is often requested. There are different forms of transferrin, differing in their primary structure, iron load and sugar content. Even the definition of CDT should be reconsidered today with respect to that originally given by Stibler (1991), because of the more sophisticated technologies nowadays used for its identification and measurement. The quick availability of a standardized method, to serve as a reference basis for the harmonization of the commercial analytical systems (instruments and reagents), is also a high-priority need. In this review we discuss the biochemical, analytical and toxicological-legal problems linked to this marker of chronic alcohol abuse, in consideration of the increased number of determination-requests observed in the last years.

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