健康受试者血液中不同临床实验室分析物生物学变异的评估。
Evaluation of Biological Variation of Different Clinical Laboratory Analytes in the Blood of Healthy Subjects.
作者信息
Ali Md Akshad, Hossain Md Sabir, Juliana Farha Matin, Reza Md Selim
机构信息
Pathology Laboratory, United Hospital Limited, Dhaka, BGD.
Biochemistry and Molecular Biology, Jahangirnagar University, Dhaka, BGD.
出版信息
Cureus. 2023 Mar 16;15(3):e36242. doi: 10.7759/cureus.36242. eCollection 2023 Mar.
Background Biological variation (BV) as a prognostic marker implies that each individual has a "subject mean" or central tendency, control level, or "set point" concentration for maintaining homeostasis regulation, which is influenced by factors such as genes, diet, exercise, and age. Uses for information on BV include determining the value of population-based reference intervals, assessing the importance of variation in serial findings, and establishing criteria for judging correct analysis. Aims We focused on the assessment of BV parameters for these elements as within-subject BV (CV), between subject BV (CV), the index of individuality (II), and the reference change value (RCV) of important biochemical analytes in the Bangladeshi adult population. Methodology This is a cross-sectional analytical study of a representative sample in the population of Bangladesh to determine BV in clinical laboratory analytes. For the study, 758 people were requested to take part; among those 730 (ages 18-65) apparently, healthy adults were blood donors, hospital staff, laboratory personnel, or any individuals who presented themselves for health screening at a tertiary hospital in Dhaka, Bangladesh. Results The CV for blood sugar, creatinine, urea, uric acid, sodium, potassium, chloride, calcium, magnesium, and phosphate were calculated as 5.10 %, 4.64%, 10.72%, 5.71%, 0.69%, 4.35%, 0.75%, 3.69%, 4.57%, and 4.72%, respectively. The CV for blood sugar, creatinine, urea, uric acid, sodium, potassium, chloride, calcium, magnesium, and phosphate was 10.70%, 21.46%, 31.47%, 23.52%, 1.95%, 9.74%, 2.56%, 4.64%, 9.96 %, and 17.45%, respectively. The index of individuality (II) for blood sugar, creatinine, urea, uric acid, sodium, potassium, chloride, calcium, magnesium, and phosphate were 0.48, 0.22, 0.34, 0.24, 0.35, 0.45, 0.29, 0.79, 0.46, and 0.27, respectively. The RCV for blood sugar, creatinine, urea, uric acid, sodium, potassium, chloride, calcium, magnesium, and phosphate was 14.75%, 14.10%, 30.58%, 16.13%, 2.82%, 12.58%, 3.54%, 10.62%, 13.62 %, and 15.80%, respectively. Conclusions Nine serum biochemistry analytes (blood sugar, creatinine, urea, uric acid, sodium, potassium, chloride, magnesium, and phosphate) had low individuality, indicating that subject-based reference intervals are appropriate, only one analyte (calcium) had high individuality and, therefore, population-based reference intervals are more appropriate.
背景 生物变异（BV）作为一种预后标志物意味着每个个体都有一个“个体均值”或中心趋势、控制水平或“设定点”浓度，用于维持体内稳态调节，这受到基因、饮食、运动和年龄等因素的影响。BV信息的用途包括确定基于人群的参考区间的值、评估系列检查结果中变异的重要性以及建立判断正确分析的标准。目的 我们专注于评估孟加拉国成年人群中重要生化分析物的这些元素的BV参数，即个体内BV（CV）、个体间BV（CV）、个体性指数（II）和参考变化值（RCV）。方法 这是一项对孟加拉国人群中具有代表性样本的横断面分析研究，以确定临床实验室分析物中的BV。对于该研究，邀请了758人参与；其中730名（年龄在18 - 65岁之间）明显健康的成年人是献血者、医院工作人员、实验室人员或在孟加拉国达卡一家三级医院进行健康筛查的任何个体。结果 血糖、肌酐、尿素、尿酸、钠、钾、氯、钙、镁和磷酸盐的CV分别计算为5.10%、4.64%、10.72%、5.71%、0.69%、4.35%、0.75%、3.69%、4.57%和4.72%。血糖、肌酐、尿素、尿酸、钠、钾、氯、钙、镁和磷酸盐的CV分别为10.70%、21.46%、31.47%、23.52%、1.95%、9.74%、2.56%、4.64%、9.96%和17.45%。血糖、肌酐、尿素、尿酸、钠、钾、氯、钙、镁和磷酸盐的个体性指数（II）分别为0.48、0.22、0.34、0.24、0.35、0.45、0.29、0.79、0.46和0.27。血糖、肌酐、尿素、尿酸、钠、钾、氯、钙、镁和磷酸盐的RCV分别为14.75%、14.10%、30.58%、16.13%、2.82%、12.58%、3.54%、10.62%、13.62%和15.80%。结论 九种血清生化分析物（血糖、肌酐、尿素、尿酸、钠、钾、氯、镁和磷酸盐）个体性较低，表明基于个体的参考区间是合适的，只有一种分析物（钙）个体性较高，因此基于人群的参考区间更合适。
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