Serum phosphate: Does it more closely reflect the true state of acromegaly?

血清磷酸盐: 它是否更密切地反映了肢端肥大症的真实状态?

  • 影响因子:1.63
  • DOI:10.1016/j.jocn.2019.11.012
  • 作者列表:"Xie T","Tian P","Wu S","Zhang X","Liu T","Gu Y","Sun C","Hu F
  • 发表时间:2020-01-01

:An increased serum phosphate (P) level is common in acromegaly patients, however, the relationships among P, growth hormone (GH), insulin-like growth factor 1 (IGF-1) and disease status remain unknown. To reveal these relationships, we examined the association of P with comprehensive clinical data. We measured the serum P, calcium, GH, oral glucose tolerance test-GH (OGTT-GH), IGF-1, and insulin-like growth factor binding protein-3 (IGBP-3) levels in 103 acromegaly patients. SAGIT® was used to assess the disease status comprehensively. Spearman's rank correlation coefficient was obtained to evaluate the associations among the above parameters. Stepwise multiple linear regression analysis was performed to investigate factors independently associated factors with the SAGIT scores. The area under the receiver operating characteristic curve (AUCROC) was used to evaluate the efficacy of the percentage change in the serum phosphate level in predicting remission in patients with postoperatively discordant GH and IGF-1 levels. Hyperphosphatemia was found in 68.9% of patients at baseline. The serum P level was higher in the non-remission group, but no correlation was found between hyperphosphatemia and remission. We revealed a significant correlation between the P level and SAGIT® score in patients both preoperatively (r = 0.659, p = 0.000) and 1-year postoperatively without remission patients (r = 0.534, p = 0.027). All biochemical levels decreased significantly postoperatively, and the GH and OGTT-GH levels achieved early stability (1 month); however, the P, IGF-1 and IGBP-3 levels showed a gradual decline. A percentage change in P of -8.12% is recommended as a cut-off value for predicting remission in patients with postoperatively discordant GH and IGF-1 levels. As a metabolic product which affected by the GH/IGF-1 axis, serum P appears to more closely reflect the comprehensive disease status in acromegaly. When the GH and IGF-1 levels are discordant during follow-up, perioperative change in the P level may be a potential predictor of remission.


: 肢端肥大症患者血清磷酸盐 (P) 水平升高是常见的,然而,P、生长激素 (GH) 、胰岛素样生长因子1 (IGF-1) 和疾病状态之间的关系仍然未知。为了揭示这些关系,我们检查了P与综合临床数据的相关性。我们测量了103例肢端肥大症患者的血清P、钙、GH、口服葡萄糖耐量试验-GH (OGTT-GH) 、IGF-1和胰岛素样生长因子结合蛋白-3 (IGBP-3) 水平。SAGIT®用于综合评估疾病状态。获得Spearman等级相关系数以评估上述参数之间的关联。进行逐步多元线性回归分析以研究与SAGIT评分相关的独立因素。受试者工作特征曲线下面积 (AUCROC) 用于评估血清磷酸盐水平的百分比变化在预测术后GH和IGF-1水平不一致的患者的缓解中的功效。在基线时,在68.9% 的患者中发现高磷酸盐血症。非缓解组血清P水平较高,但高磷血症与缓解无相关性。我们揭示了P水平和SAGIT之间的显著相关性。®术前 (r = 0.659,p = 0.000) 和术后1年无缓解患者 (r = 0.534,p = 0.027) 的评分。术后所有生化水平显著下降,GH和OGTT-GH水平达到早期稳定 (1个月); 然而,P、IGF-1和IGBP-3水平呈逐渐下降。建议将P的百分比变化-8.12% 作为预测术后GH和IGF-1水平不一致的患者缓解的临界值。作为受GH/IGF-1轴影响的代谢产物,血清P似乎更密切地反映了肢端肥大症的综合疾病状态。当随访期间GH和IGF-1水平不一致时,围手术期P水平的变化可能是缓解的潜在预测因子。



作者列表:["Strawn M","Xu KT","Brodeur M","Youngblood G","Richman P"]

METHODS:BACKGROUND:There is a commonly held belief that overweight women are more likely to offer contaminated urine samples (UAs) in the emergency department (ED) than women with normal body mass index (BMI). However, there is a paucity of research evaluating this potential concern. OBJECTIVE:We hypothesized that patients with higher BMI would be more likely to provide contaminated urine samples than women with low BMI. METHODS:This was a prospective, observational, cohort study evaluating consenting, adult, women that provided a clean catch, mid-stream sample at an inner-city ED. UAs were ordered at the discretion of the caring physician, cultures based on standardized parameters. The primary outcome parameter was the presence of UA contamination as defined by our microbiology lab. Demographic/historical data and BMI were recorded on a structured data sheet. Categorical data were analyzed by chi-square; continuous data by t-tests. Multivariable logistic regression was performed to control for confounding. RESULTS:There were 350 patients in the study group; 22% overweight, 35% obese, 17% morbidly obese, mean BMI 31. 5, and 60% provided contaminated specimens. The mean BMIs of the subjects with contaminated vs. uncontaminated UAs were significantly different (32.7 ± 10.2 vs 29.7 ± 8.8, p < 0.01). Within our multiple variable logistic regression model, obese and morbidly obese patients were more likely to provide contaminated UAs, while there were no significant associations for contamination with other variables except for hypertension (OR = 1.85, p = 0.02). CONCLUSION:Obesity was significantly associated with contamination of clean catch mid-stream samples in our population.

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来源期刊:Laboratory medicine
作者列表:["Tang J","Jiang Y","Ge Z","Wu H","Chen H","Dai J","Gu Y","Mao X","Lu J"]

METHODS:OBJECTIVE:To determine whether the performance of a new quantum dots-based point-of-care test (POCT) devices is qualified for procalcitonin testing. METHODS:Finger-prick and venous blood specimens from 153 patients were measured with a quantum dots-based POCT device; the results were compared with those from the reference method. RESULTS:The quantum dots-based POCT device correlated well with the reference method in measuring plasma, venous whole blood, and finger-prick blood. No significant bias was observed (-0.08 ng/mL). At 0.5 ng per mL cutoff value, the concordances were 96.6%, 94.6%, and 90.5% for plasma, venous whole blood, and finger-prick blood, respectively. And at 2 ng per mL cutoff value, the concordances were 98.0%, 96.6%, and 95.3%, respectively. CONCLUSIONS:The quantum dots-based POCT device measured procalcitonin with multiple specimen types, high sensitivity, wide detection range, and short turnaround time. It would allow a more widespread use of procalcitonin and help lessen the burden of overcrowding in healthcare facilities in China.

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作者列表:["Barkan GA","Tabatabai ZL","Kurtycz DFI","Padmanabhan V","Souers RJ","Nayar R","Sturgis CD"]

METHODS:CONTEXT.—:The Paris System for Reporting Urinary Cytology has been disseminated since its inception in 2013; however, the daily practice patterns of urinary tract cytopathology are not well known. OBJECTIVE.—:To assess urinary tract cytopathology practice patterns across a variety of pathology laboratories to aid in the implementation and future update of the Paris System for Reporting Urinary Cytology. DESIGN.—:A questionnaire was designed to gather information about urinary tract cytopathology practices and mailed in July 2014 to 2116 laboratories participating in the College of American Pathologists interlaboratory comparison program. The participating laboratories' answers were summarized. RESULTS.—:Of the 879 of 2116 laboratories (41%) that participated, 745 (84.8%) reported processing urinary tract specimens in house. The laboratories reported processing various specimen types: voided urine, 735 of 738 (99.6%); bladder washing/barbotage, 639 of 738 (86.6%); and catheterized urine specimens, 653 of 738 (88.5%). Some laboratories used multiple preparation methods, but the most commonly used preparation techniques for urinary tract specimens were ThinPrep (57.4%) and Cytospin (45.5%). Eighty-eight of 197 laboratories (44.7%) reported preparing a cell block, but with a low frequency. Adequacy criteria were used by 295 of 707 laboratories (41.7%) for voided urine, and 244 of 707 (34.5%) assessed adequacy for bladder washing/barbotage. More than 95% of the laboratories reported the use of general categories: negative, atypical, suspicious, and positive. Polyomavirus was classified as negative in 408 of 642 laboratories (63.6%) and atypical in 189 of 642 (29.4%). One hundred twenty-eight of 708 laboratories (18.1%) performed ancillary testing, and of these, 102 of 122 (83.6%) reported performing UroVysion. CONCLUSIONS.—:Most laboratories use the ThinPrep method followed by the Cytospin technique; therefore, the criteria published in The Paris System for Reporting Urinary Cytology, based mostly on ThinPrep and SurePath, should be validated for Cytospin, and relevant information should be included in the revised edition of The Paris System for Reporting Urinary Cytology.

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