Howey J E, Browning M C, Fraser C G
Department of Biochemical Medicine, Ninewells Hospital and Medical School, Dundee, Scotland.
Am J Kidney Dis. 1989 Jan;13(1):35-7. doi: 10.1016/s0272-6386(89)80112-x.
Studies on the analytic and biologic variability of albumin concentration, albumin/creatinine ratio, and albumin excretion rate in first morning, random, and 24-hour urine specimens from healthy subjects suggest that (1) first morning specimens are preferred, (2) results should be expressed as albumin concentration, (3) assay of creatinine confers little advantage, (4) an analytical precision of coefficient of variation (CV) less than 18% is satisfactory, and (5) semiquantitative or qualitative analyses are suitable for screening programs. The intraindividual variation of albumin concentration in first morning specimens from diabetics is such that no threshold value gives the desired 100% nosological sensitivity. However, a threshold value of 30 mg/L confers 100% specificity, and a single abnormal result therefore requires initiation of therapy. Patients with negative results should continue to be monitored regularly.
对健康受试者首次晨尿、随机尿和24小时尿标本中白蛋白浓度、白蛋白/肌酐比值及白蛋白排泄率的分析和生物学变异性研究表明：（1）首选首次晨尿标本；（2）结果应以白蛋白浓度表示；（3）肌酐检测优势不大；（4）变异系数（CV）小于18%的分析精密度令人满意；（5）半定量或定性分析适用于筛查项目。糖尿病患者首次晨尿标本中白蛋白浓度的个体内变异情况是，没有阈值能达到理想的100%疾病诊断敏感性。然而，30mg/L的阈值具有100%的特异性，因此单次异常结果就需要开始治疗。结果为阴性的患者应继续定期监测。
