血清白蛋白检测方法对糖化白蛋白的影响
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摘要
随机抽取306份不同白蛋白(Alb)浓度的新鲜血清标本,分别用溴甲酚绿法(BCG)、改良溴甲酚紫法(m BCP)、免疫比浊法(ITA)检测Alb浓度,液态酶法检测糖化白蛋白(GA),并计算GA值[GA%(%)=GA/Alb×100%]。正常Alb浓度(Alb≥40 g/L)时,BCG与m BCP法、BCG与ITA法、m BCP与ITA法检测结果比较,临床差异不明显,而且GA%BCG与GA%m BCP比较,差异无统计学意义(P=0.537);低Alb浓度(Alb<40 g/L)时,BCG法分别与m BCP、ITA法比较差异有统计学意义(P<0.01),GA%BCG明显低于GA%m BCP(P<0.01)。故正常Alb浓度时,BCG、m BCP与ITA法三者结果差异无明显临床意义,各法用于GA%计算无明显差异;但低Alb浓度时,m BCP与ITA法二者一致性优于BCG与ITA法,若使用BCG法则GA%结果可能被低估。
A total of 306 fresh human serum samples were randomly selected. Alb concentrations were measured by bromcresol green( BCG) method,modified bromcresol purple( m BCP) method,and immunoturbidmetic assay( ITA),respectively. GA was measured by an enzymatic method. GA value was expressed as the percentage of GA in the total serum Alb [GA%( %) = GA / Alb * 100%]. When Alb ≥40 g / L,the clinical differences between BCG and m BCP,BCG and ITA,and m BCP and ITA were not significant,and there was no statistical difference between GA%BCGand GA%m BCP( P = 0. 537); when Alb < 40 g /L,BCG had statistical difference between m BCP and ITA( P < 0. 01),and GA%BCGwas significantly lower than GA%m BCP( P < 0. 01). No obvious clinical significance of Alb concentrations was observed measured by BCG,m BCP,and ITA when Alb≥40 g / L. There was no difference in different Alb methods for GA% calculation. When Alb < 40 g / L,the consistency of m BCP and ITA was better than that of BCG and ITA,which indicated that m BCP method may be more suitable for the assay of glycated albumin value( GA%),whereas the GA% may be underestimated if using BCG method for the determination of Alb.
A total of 306 fresh human serum samples were randomly selected. Alb concentrations were measured by bromcresol green( BCG) method,modified bromcresol purple( m BCP) method,and immunoturbidmetic assay( ITA),respectively. GA was measured by an enzymatic method. GA value was expressed as the percentage of GA in the total serum Alb [GA%( %) = GA / Alb * 100%]. When Alb ≥40 g / L,the clinical differences between BCG and m BCP,BCG and ITA,and m BCP and ITA were not significant,and there was no statistical difference between GA%BCGand GA%m BCP( P = 0. 537); when Alb < 40 g /L,BCG had statistical difference between m BCP and ITA( P < 0. 01),and GA%BCGwas significantly lower than GA%m BCP( P < 0. 01). No obvious clinical significance of Alb concentrations was observed measured by BCG,m BCP,and ITA when Alb≥40 g / L. There was no difference in different Alb methods for GA% calculation. When Alb < 40 g / L,the consistency of m BCP and ITA was better than that of BCG and ITA,which indicated that m BCP method may be more suitable for the assay of glycated albumin value( GA%),whereas the GA% may be underestimated if using BCG method for the determination of Alb.
引文
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[12]Koga M,Saito H,Mukai M,et al.Serum glycated albumin levels are influenced by smoking status,independent of plasma glucose levels[J].Acta Diabetol,2009,46(2):141-4.
[13]周健,李红,杨文英,等.糖化血清白蛋白正常参考值的多中心临床研究[J].中华内科杂志,2009,48(6):467-72.
[14]周翔海,纪立农,张秀英,等.我国正常糖耐量人群糖化白蛋白的参考范围[J].中国糖尿病杂志,2009,17(8):572-5.
[2]贾珂珂,李国权,张捷.酮胺氧化酶法测定糖化白蛋白的评价[J].中国实验诊断学,2010,14(10):1620-3.
[3]Paroni R,Ceriotti F,Galanello R,et al.Performance characteristics and clinical utility of an enzymatic method for the measurement of glycated albumin in plasma[J].Clin Biochem,2007,40(18):1398-405.
[4]Kouzuma T,Uemastu Y,Usami T,et al.Study of glycated amino acid elimination reaction for an improved enzymatic glycated albumin measurement method[J].Clin Chim Acta,2004,346(2):135-43.
[5]中华人民共和国卫生部.临床生物化学检验常规项目分析质量目标[S].中华人民共和国卫生行业标准WS/T 403-2012,2012.
[6]陈智平,秦雪,陈兴财,等.溴甲酚绿法与溴甲酚紫法检测血清清蛋白的结果比较[J].国际检验医学杂志,2009,30(10):940-4.
[7]Muramoto Y,Matsushita M,Irino T.Reduction of reaction differences between human mercaptalbumin and human nonmercaptalbumin measured by the bromcresol purple method[J].Clin Chem Acta,1999,289(1):69-78.
[8]杨静,孙林,孟志民,等.糖化白蛋白临床诊断切点的选择和评估[J].中华检验医学杂志,2013,36(12):1120-5.
[9]梁国威,贾玫,徐旭,等.糖化白蛋白在甲状腺功能紊乱患者中的水平变化及其影响因素[J].中国实验诊断学,2010,14(1):95-8.
[10]Kitamura T,Otsuki M,Tamada D,et al.Glycated albumin is set lower in relation to plasma glucose levels in patients with Cushing’s syndrome[J].Clin Chim Acta,2013,424:164-7.
[11]Wang F,Ma X,Hao Y,et al.Serum glycated albumin is inversely influenced by fat mass and visceral adipose tissue in Chinese with normal glucose tolerance[J].PLo S One,2012,7(11):e51098.
[12]Koga M,Saito H,Mukai M,et al.Serum glycated albumin levels are influenced by smoking status,independent of plasma glucose levels[J].Acta Diabetol,2009,46(2):141-4.
[13]周健,李红,杨文英,等.糖化血清白蛋白正常参考值的多中心临床研究[J].中华内科杂志,2009,48(6):467-72.
[14]周翔海,纪立农,张秀英,等.我国正常糖耐量人群糖化白蛋白的参考范围[J].中国糖尿病杂志,2009,17(8):572-5.