Dimension Clinical Chemistry System Research Articles

Vitamin D levels in type 2 diabetics on insulin sensitizers vis a vis in newly diagnosed diabetics

Objective: Vitamin D mediates a pivotal role and major risk factor in the development of type 2 diabetes mellitus mediated by alteration in the insulin sensitivity or b -cell physiological function, or both. The present study was carried out to analyze the serum levels of vitamin D3 in type 2 diabetics on insulin sensitizers and in newly diagnosed diabetics. Materials and Methods: In this 100 subjects were enrolled and they are divided in two groups, newly diagnosed type 2 diabetics and type 2 diabetics on insulin sensitizers. Serum vitamin D3 was measured by chemiluminescence microparticle immunoassay. Fasting plasma glucose level was measured by hexokinase method using the Dimension clinical chemistry system. Results: In this study, the mean serum vitamin D3 level was significantly (p type 2 diabetes mellitus subjects as compared to the type 2 diabetics on insulin sensitizers (10.332.56 vs 20.89 3.24 ng/ml)s. Further, in patients who were on treatment with insulin sensitizers showed normal level of Vitamin D3 and Fasting blood glucose. Conclusion: Thus, vitamin D3 deficiency is the hallmark status in diabetes mellitus and maintenance of type 2 DM with insulin sensitizers may ameliorate the vitamin D deficiency. Keywords: Type 2 Diabetes, Blood glucose level, Vitamin D.

Variation in common serum lipid parameters in patients with malaria: A 1-year cross-sectional study

Background: Variations in serum lipid parameters are commonly and ubiquitously reported in patients with malaria. Different host cell lipid-dependent processes have been observed in the life cycle of the malarial parasite Plasmodium. Aim: The present study was undertaken to assess the serum lipid profile in patients with malaria. Materials and Methods: This 1-year cross-sectional study was conducted from January 2013 to December 2013 at the Department of Medicine. A total of 50 adult patients with positive-smear and quantitative buffy coat test for malaria, as well as with clinical features of malarial infection, were investigated for serum lipid profile changes. Patients on lipid-lowering drugs were excluded from the study. Fasting lipid profile estimation was performed using fully-automated Siemens Dimension Clinical Chemistry System for total cholesterol, low-density lipoprotein (LDL), high-density lipoprotein (HDL), and triglycerides. Data were analyzed using the independent sample t-test and one-way ANOVA. Results: Majority (86%) of the patients were positive for Plasmodium vivax. Thrombocytopenia was observed in 64% of the patients. Serum lipid profile estimation in these patients revealed that 60% of the patients had low total cholesterol levels (100–150 mg/dL), 56% of patients had low-LDL levels ( 150 mg/dL). Interestingly, patients with low-LDL cholesterol level had low-platelet count (51.25 ± 29.67;P = 0.035). Conclusion: Patients with malaria infections may have lipid parameters alteration in terms of hypocholesterolemia, low-HDL and -LDL levels, and hypertriglyceridemia.

Association of serum vitamin D3 with newly diagnosed type 2 diabetes mellitus

Vitamin D has an important role and supposed to be a risk factor in the development of pathogenesis of type 2 diabetes mellitus by affecting either insulin sensitivity or β-cell function, or both. The present study was conducted to evaluate the relation of serum vitamin D3 and type 2 diabetes mellitus. Total 80 individuals were enrolled in this study. Forty newly diagnosed type 2 diabetic individual were enrolled as cases and 40 healthy glucose tolerant subjects were enrolled as controls. Serum vitamin D3 was measured by chemiluminescence microparticle immunoassay. Fasting and 2 hours plasma glucose level were measured by hexokinase method using the Dimension clinical chemistry system. The mean serum vitamin D3 level was significantly low in type 2 diabetes mellitus than in controls (p= 0,007). The individual with vitamin D3 deficiency showed 3.4 times higher chances to develop type 2 diabetes mellitus compare to the individual with normal vitamin D status. Correlation test showed significant (r= -0.351) negative correlation (p=0.026) between serum vitamin D3 and type 2 diabetes mellitus. It can be concluded that vitamin D3 deficiency is related to type 2 diabetes mellitus.

Comparative Assessment of Levels of Total Proteins in Saliva on Control and Diabetic Patients

Abstract Diabetic Patients frequently report for Dental prob-lems; however assessment of their diabetic status thou-gh empirical is quiet challenging. Either patients do not know about their diabetic status or are not willing to get it done due to financial constraints or chances of cross infection. Some of them get it checked but do not report at proper time. Though serum analysis has alwa-ys been a gold standard for diagnosis of various dise-ases, but serum assessment at dental clinic is not pos-sible because of non-existence of such culture. In the recent past assessment of other body fluids such as Saliva as diagnostic tool has gained importance. Aim of this study was thus to assess level of Total Proteins in saliva of control and diabetics and correlate between Total Protein levels and incidence of caries and gin-gival health. Study was conducted on 90 subjects; 30 control and 60 diabetics. Sample was selected on the basis of history, HbA1c levels, serum sugar levels and salivary sugar levels. Un-stimulated whole saliva from diabetics and control group was then collected, stored and freezed at -20°C. Saliva samples were then defros-ted centrifuged and its supernatant portion was analy-zed by Dimension Clinical Chemistry System for Total Proteins. SPSS 17.0 was used for statistical analysis. Results showed that salivary Total protein levels were higher for the diseased group when compared with control group and were correlated statistically signifi-cantly with caries and poor gingival health. Key Words: Serum Glucose Level, Salivary Total Protein Level, Diabetes Mellitus, Caries, Gingival Health.

OC195: Evaluation of perinatal condition in newborns with elevated concentration of cord cardiac troponin I

To assess the results of fetal examination and neonatal condition in cases with elevated cord cardiac troponin I concentration. Cardiac troponin I (cTnI) is a specific marker of myocardial injury in adults and children. Perinatal asphyxia can cause cardiac dysfunction. Some 161 samples among fetuses from pathological pregnancies were collected. Twenty-two had an elevated level of cTnI (above 0.1 ng/mL). Disorders in pregnancy, date of gestation, Doppler flow velocimetry in the ductus venosus (DV) and umbilical artery (AU) and vein (DV), mode of delivery, Apgar score and respiratory status after birth were evaluated. cTnI was determined on a dimension clinical chemistry system. There were 22 newborns with a raised level of TnI: seven (31.8%) with SGA, five (22.2%) with fetal cardiac problems (arrhythmia, structural and functional abnormalities), nine (40.9%) with abnormal biophysical test results (abnormal Doppler velocimetry, computerized cardiotocography, biophysical profile score) and six (27.2%) whose mothers who had disorders (diabetes mellitus, hypertension). Results are shown in the table. Median gestational age at delivery was 36.6 (range, 27–43) weeks. Seventeen (77.2%) patients had a Cesarean section. The range of TnI blood concentration was 0.11–6.66 ng/mL in this group. Five (22.7%) had umbilical pH below 7.25. A high level of cTnI was associated with several disorders that could have led to fetal asphyxia. More detailed fetal heart examination is necessary to prove that fetal asphyxia had an impact on heart function.

OC196: The contribution of CNTI‐SonoVue in the classification of adnexal masses as benign or malignant: a multicenter study

I concentration. Cardiac troponin I (cTnI) is a specific marker of myocardial injury in adults and children. Perinatal asphyxia can cause cardiac dysfunction. Methods: Some 161 samples among fetuses from pathological pregnancies were collected. Twenty-two had an elevated level of cTnI (above 0.1 ng/mL). Disorders in pregnancy, date of gestation, Doppler flow velocimetry in the ductus venosus (DV) and umbilical artery (AU) and vein (DV), mode of delivery, Apgar score and respiratory status after birth were evaluated. cTnI was determined on a dimension clinical chemistry system. Results: There were 22 newborns with a raised level of TnI: seven (31.8%) with SGA, five (22.2%) with fetal cardiac problems (arrhythmia, structural and functional abnormalities), nine (40.9%) with abnormal biophysical test results (abnormal Doppler velocimetry, computerized cardiotocography, biophysical profile score) and six (27.2%) whose mothers who had disorders (diabetes mellitus, hypertension). Results are shown in the table. Median gestational age at delivery was 36.6 (range, 27–43) weeks. Seventeen (77.2%) patients had a Cesarean section. The range of TnI blood concentration was 0.11–6.66 ng/mL in this group. Five (22.7%) had umbilical pH below 7.25. Conclusions: A high level of cTnI was associated with several disorders that could have led to fetal asphyxia. More detailed fetal heart examination is necessary to prove that fetal asphyxia had an impact on heart function.

P07.23: Cardiac troponin I in pregnancy complicated by IUGR, fetal distress and cardiac problems

Troponin I (TnI) is a highly specific marker of myocardial injury. The aim of the study was to evaluate the prognostic value of cord blood TnI in SGA newborns, cardiac problems (arrhythmia, structural defects) or abnormal results of prenatal biophysical tests (abnormal Doppler flow velocimetry, computerized cardiotocography, biophysical profile score). 64 neonates: 26 (40%) with cardiac problems, 18 (28%) with abnormal results of prenatal biophysical tests, 14 with IUGR (22%) and 5 (8%) infants whose mothers presented other complications of pregnancy were in the study group. 22 healthy neonates were in the control group. Samples for TnI were taken from umbilical cord during delivery. TnI was determined on dimension clinical chemistry system. The normal range for TnI was 0–0.1 ng/ml. The median cord blood concentration of TnI was 0,01 ± 0.02 ng/ml in healthy controls (range 0–0.05). The incidence of increased concentration of cTnI was significantly higher in infants with abnormal results of prenatal biophysical tests (27.7 vs. 0%, p < 0.05). The corresponding results were very close to significancy in neonates with a history of IUGR (21.4 vs. 0%, p = 0.05). IUGR and fetal distress contrary to cardiac problems (arrhythmia, structural defects) influences umbilical cord TnI concentration. Further investigation is needed to explain whether the course of pregnancy or delivery has essential impact on TnI changes.

HDL Cholesterol

PURPOSE To compare the contributions of physical activity volume (vPA) and intensity (iPA) to HDL levels in middle-aged women. METHODS A cross-sectional design was used. Subjects were 273 women, mean age 40.1 years, who were nonsmokers and non-obese (BMI <30). HDL was measured by a certified hospital laboratory using the Dimension clinical chemistry system. vPA and iPA were assessed using MTI (formerly CSA) accelerometers worn over the left hip for 7 consecutive days. Each day was divided into 10-minute segments (epochs) for a total of 144 epochs each day and 1008 epochs over the 7 days. The sum of all activity counts over the 1008 epochs was used to index vPA. Subjects were divided into quartiles based on their vPA and the middle-two quartiles were collapsed producing 3 categories of vPA. iPA was calculated by categorizing the activity counts of every epoch as Low Intensity, if the activity counts for that epoch were <30,000 (sedentary to slow walking), Moderate Intensity, 30,000–50,000 counts (slow to fast walking), or High Intensity, >50,000 counts (fast walking to running and beyond). A total of 9 epochs (90 min of activity) over the week had to be accumulated in the High Intensity category for the woman to be classified into that iPA category. If she did not have 90 min of High Intensity activity, the 9 epoch cut-point was used to check for Moderate Intensity. If there was not 90 min of activity within the High or Moderate Intensity categories, then she was classified into the Low Intensity category. RESULTS Mean (± SD) vPA over the week was 2.7 ± 0.8 million activity counts. A total of 145 (53.1%) women were classified in the Low Intensity category, 70 (25.6%) in the Moderate Intensity category, and 58 (21.2%) in the High Intensity category. With age controlled, HDL levels differed across the three vPA categories F=4.1, p=0.044), but not without (F=3.5, p=0.063). On the other hand, HDL levels differed across the iPA categories with age controlled (F=6.9, p=0.009), and with no adjustment for differences in age (F=6.2, 0.014). Specifically, after controlling for age, mean HDL levels were 56.2, 52.2, and 52.1 across the High, Moderate, and Low Intensity categories, respectively, with the High Intensity subjects showing significantly higher levels of HDL than the other two categories of women. After controlling for age and iPA, the association between vPA and HDL was eliminated (F=1.1, p=0.30). However, after adjusting for age and vPA, the relationship between iPA and HDL remained significant (F=4.0, p=0.047). CONCLUSION When weekly duration of activity is at least 90 minutes, intensity of physical activity seems to contribute more to HDL levels in women than total volume of activity.

Serum iron, ferritin, transferrin, total iron binding capacity, hs-CRP, LDL cholesterol and magnesium in children; new reference intervals using the Dade Dimension Clinical Chemistry System

Background: We studied serum/Plasma iron, ferritin, transferrin concentrations, and total iron binding capacity (TIBC) in addition to highly sensitive C-reactive protein (hs-CRP), low-density lipoprotein (LDL) cholesterol and magnesium concentrations in a population of 800 in- and outpatients and defined new 95% reference intervals for pediatrics using the Dade Behring RxL Dimension Clinical Chemistry System. Methods: Plasma/serum concentrations of the above analytes were determined on patient samples accrued from January to June 2003 and the data were analyzed employing a computer adapted Hoffmann approach. Results and conclusions: New pediatric reference intervals on the Dade RxL Dimension were obtained for serum iron, ferritin, transferrin, TIBC, hs-CRP, LDL-cholesterol and magnesium. This work represents the first hs-CRP data for children <3 years old. The values for all the analytes were established on new data ( n=800). These values are new for hs-CRP and LDL cholesterol, while for iron, ferritin and magnesium these intervals are more reliable than those previously published by our group which had used regression equations on samples measured by the old (Vitros/Immuno1) methods for which intervals were available.

Modification of Fully Automated Total Iron-binding Capacity (TIBC) Assay in Serum and Comparison with Dimension TIBC Method

We previously reported the development of a fully automated assay for total iron-binding capacity (TIBC) in serum, using a multipurpose automated analyzer. However, this method requires four different reagents and is thus useful only with a limited number of available analyzers. We simplified our original assay and compared the analytical performance of the modified method with that of a commercial, fully automated TIBC assay (Dimension TIBC assay). We simplified our original method to require only three reagents. Calibration was also altered and was performed with human transferrin standard solutions. An advantage of this method is that it does not require separation of excess unbound iron after the first step of transferrin saturation. Unbound iron is eliminated by formation of a complex with the chromogenic reagent ferrozine in the second step. Iron dissociated from transferrin by acidic pH reacts with ferrozine to form a colored complex in the final step, and the increase in absorbance at 570/660 nm is directly proportional to the TIBC measured. TIBC values were determined for 49 healthy individuals and 148 patients with this modified TIBC assay and with a commercial, fully automated TIBC method (Dimension clinical chemistry system), and calculation of TIBC based on the sum of the serum iron and unsaturated iron-binding capacity was performed for 97 patients. The within-run CVs for the modified TIBC assay and the Dimension TIBC assay were <4.8% and <2.4%, and the between-run CVs were 1.2% and 1.7%, respectively. The dilution curves were linear for TIBC values up to at least 180 micromol/L with both methods. TIBC values obtained by our method were linearly correlated with serum transferrin concentrations (r = 0.984; S(y/x) = 3.18 micromol/L; P <0.001). The correlation between the values obtained with the present method (y) and those obtained with the Dimension TIBC method (x) was y = 1.04x + 1.19 micromol/L (r = 0.985; S(y/x) = 2.47 micromol/L), and with the calculation method (x) was y = 1.18x + 2.62 micromol/L (r = 0.976; S(y/x) = 3.27 micromol/L). Our modified, fully automated TIBC assay performed similarly to the Dimension TIBC assay and is adaptable for use with many multipurpose automated analyzers.

Automated Homogeneous Immunoassay for Gentamicin on the Dimension Clinical Chemistry System

Monitoring of the concentration of gentamicin in serum and plasma during therapy is widely recommended and practiced in hospitals. Our aim was to develop a homogeneous immunoassay based on particle-enhanced turbidimetric inhibition immunoassay technology to quantify gentamicin on the Dimension clinical chemistry system. Assay performance was assessed on each of the Dimension models in a 15-instrument interlaboratory comparison study. A split-sample comparison (n = 1171) was also performed between the gentamicin methods on the Dimension system and the Abbott TDx analyzer, using multiple reagent and calibrator lots on multiple instruments. The Dimension method was linear to 25.1 micromol/L (12.0 microg/mL) with a detection limit of 0.63 micromol/L (0.3 microg/mL). Calibration was stable for 30 days. The within-run imprecision (CV) was <1.3%, and total imprecision ranged from 1.8% to 3.2% between 4.2 micromol/L (2.0 microg/mL) and 16.7 micromol/L (8.0 microg/mL) gentamicin. Linear regression analysis of the results on the Dimension method (DM) vs the Abbott TDx yielded the following equation: DM = 0.98TDx - 0.42; r = 0.987. Minimal interference was observed from structurally related compounds such as sagamicin, netilmicin, and sisomicin. The monoclonal antibody used in this method has similar reactivities toward the individual gentamicin subspecies C1, C1a, and C2, thus providing analytical recovery not significantly dependent on relative subspecies concentrations.

Development and analytical performance of an automated screening method for cannabinoids on the Dimension clinical chemistry system

A fully automated, random access method for the determination of cannabinoids (UTHC) was developed for the Dimension AR and XL clinical chemistry systems. The method utilizes Abuscreen ONLINE reagents and a multianalyte liquid calibrator containing 11-nor-Δ9-THC-9-carboxylic acid. Within-run and total reproducibility, determined using NCCLS protocol EP5- T2, was less than 0.6% and 1.6% CV, respectively, at all concentrations. Calibration stability was retained for at least 30 days. An extensive evaluation of non-structurally related drugs and various physiological substances indicated lack of interference in the method. No sample carry-over was observed following a specimen containing 1886 ng/ml 11-nor-Δ9-THC-9-carboxylic acid. A 99.1% agreement (N = 445 samples) was found between an EMIT based method on the aca discrete clinical analyser and the Dimension UTHC method. Dimension clinical chemistry system and aca discrete clinical analyser are registered trademarks of Dade International.

Laboratory evaluation of the Du Pont "Dimension Clinical Chemistry System".

We evaluated the analytical performance of the Du Pont Dimension Clinical Chemistry System to assess its suitability as a replacement for the Du Pont aca III, currently routinely used for analysis of pediatric, high-risk, and emergency specimens. Twenty-six analyses were studied. These generally fulfilled pre-set analytical goals for precision based on biological variation or "state of the art." Significant economies were achieved and we found the Dimension to be reliable, easy to operate, and simple to maintain. It also fulfilled safety requirements for analysis of specimens of high risk to laboratory staff.