Abstract:
BACKGROUND:Since more than 90% of cortisol is bound to protein, serum free cortisol (SFC) may be a more appropriate marker of adrenal status than total cortisol. However, measurement of SFC is technically difficult and calculated SFC may offer a more practical alternative. METHODS:SFC, measured by equilibrium dialysis coupled with immunoassay, and calculated using Coolens' equation from total cortisol and corticosteroid binding globulin (CBG) concentrations, was compared in short Synacthen test (SST) serum from 42 patients, of whom 20 demonstrated a suppressed adrenal response. RESULTS:Considering the patient group as a whole, calculated SFC was found to be significantly lower than measured SFC, pre- and post-Synacthen (P < 0.05 and <0.001, respectively). Upon classifying the patients as pass or fail based on total cortisol response to Synacthen, the difference in calculated and measured SFC only reached statistical significance for post-Synacthen concentrations in the pass group (P < 0.01), suggesting a greater discrepancy at higher cortisol concentrations. There was no difference in CBG levels between the pass and fail groups and both measured and calculated SFC gave a diminished 30 min response in subjects deemed to have failed the SST. CONCLUSION:Coolens' equation was found to underestimate measured SFC in this cohort of outpatients, as has been previously demonstrated, particularly in patients with a pronounced acute phase response. Although calculated SFC gave a diminished response in individuals deemed to have failed the SST, the concentration-dependent nature of the discrepancy may limit the usefulness of this method for assessing adrenal status.
journal_name
Ann Clin Biochemjournal_title
Annals of clinical biochemistryauthors
Barlow NL,Holme J,Stockley RA,Clark PMdoi
10.1258/acb.2010.009246subject
Has Abstractpub_date
2010-05-01 00:00:00pages
200-4issue
Pt 3eissn
0004-5632issn
1758-1001pii
acb.2010.009246journal_volume
47pub_type
杂志文章abstract:BACKGROUND:Measurement of plasma-free metanephrine plus normetanephrine (PFM) is the best screening test for phaeochromocytoma. While clearly raised levels are diagnostic, borderline increases may be associated with factors such as stress and medications, and should prompt a repeat study after interfering factors are w...
journal_title:Annals of clinical biochemistry
pub_type: 杂志文章
doi:10.1258/acb.2010.010131
更新日期:2010-11-01 00:00:00
abstract::The mechanisms of hypercalcaemia were assessed in 20 hypercalcaemic patients with breast cancer. Abnormalities suggestive of a PTH-related peptide (PTHrP) mechanism were observed in up to 60% of cases; urinary cyclic adenosine monophosphate (UcAMP) was elevated in nine patients (45%), renal tubular reabsorption of cal...
journal_title:Annals of clinical biochemistry
pub_type: 杂志文章
doi:10.1177/000456329002700605
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abstract::A recently introduced turbidimetric immunoassay using shell/core particles for determination of myoglobin (Turbiquant Myoglobin, Behringwerke, Marburg, Germany) was evaluated on the Behring Turbitimer analyzer. Intra-assay CV varied between 1.0% and 3.2%; interassay CV was between 2.0% and 3.6%. Linear results were ob...
journal_title:Annals of clinical biochemistry
pub_type: 杂志文章
doi:10.1177/000456329102800509
更新日期:1991-09-01 00:00:00
abstract:PURPOSE:We assessed erythrocyte sedimentation rate and high-sensitivity C-reactive protein concentration in knee osteoarthritis and non-knee osteoarthritis. In addition, we investigated potential relationship between the levels of erythrocyte sedimentation rate and high-sensitivity C-reactive protein with clinical find...
journal_title:Annals of clinical biochemistry
pub_type: 杂志文章
doi:10.1177/0004563215610142
更新日期:2016-09-01 00:00:00
abstract::The hypoglycaemia caused by non-islet cell tumours is often associated with an increase in plasma insulin-like activity. In many cases there is a relative if not always absolute increase in plasma insulin-like growth factor II (IGF-II). Growth hormone (GH) secretion is almost invariably depressed as is the plasma insu...
journal_title:Annals of clinical biochemistry
pub_type: 杂志文章
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更新日期:1992-05-01 00:00:00
abstract:BACKGROUND:Patient-based real-time quality control (PBRTQC) techniques have been described in clinical chemistry for over 50 years. PBRTQC has a number of advantages over traditional quality control including commutability, cost and the opportunity for real-time monitoring. However, there are few systematic investigati...
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abstract::Serum osteocalcin did not show any response to the onset of osteosarcoma in Paget's disease of bone whereas serum alkaline phosphatase increased rapidly. This suggests that osteocalcin is not useful in the diagnosis and management of Paget's osteosarcoma and does not reflect the same osteoblastic processes in bone as ...
journal_title:Annals of clinical biochemistry
pub_type: 杂志文章
doi:10.1177/000456329102800216
更新日期:1991-03-01 00:00:00
abstract:BACKGROUND:Interpretative commenting constitutes an important aspect of the post-analytical phase in chemical pathology, but has only recently been the subject of quality assessment. The Royal College of Pathologists of Australasia (RCPA)-Australasian Association of Clinical Biochemists (AACB) Chemical Pathology Patien...
journal_title:Annals of clinical biochemistry
pub_type: 杂志文章
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更新日期:2002-05-01 00:00:00
abstract::Background The clinical utility of serum thyroglobulin in the follow-up of patients with differentiated thyroid carcinoma may be compromised by the presence of endogenous antithyroglobulin antibodies. To prevent interference by antithyroglobulin antibodies several groups have developed real-time PCR-based assays for q...
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journal_title:Annals of clinical biochemistry
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abstract::We investigated the effect of a fatty meal on plasma concentrations of lipids, apolipoproteins, and the cholesterol component of lipoproteins. Sixteen nonobese, healthy, asymptomatic males, 22-34 years of age, served as subjects for this study. None smoked, consumed more than two alcoholic drinks per day, or took any ...
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abstract:BACKGROUNDS:Diabetic patients with end-stage renal disease who are not on haemodialysis show low concentrations of HbA1c and glycated albumin due to renal anaemia and proteinuria, respectively. In the present study, we examined whether serum albumin-adjusted glycated albumin could accurately reflect glycaemic control i...
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abstract:BACKGROUND:The analysis of steroids in biological matrices is challenging. One can apply immunoassay as well as gas and liquid chromatography with various types of detection, depending on the available equipment and the experience of the analyst. The question is how the methods are interchangeable between themselves. D...
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pub_type: 杂志文章
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abstract::A rapid gas liquid chromatography method has been developed which is suitable for emergency estimations of paracetamol in overdose. The method is compared with a standard ultraviolet method. ...
journal_title:Annals of clinical biochemistry
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doi:10.1177/000456327501200102
更新日期:1975-01-01 00:00:00
abstract::The magnitude of the inflammatory response to surgery depends on the degree of injury during surgical procedures. Laparoscopic techniques are generally associated with less postoperative pain and shorter hospital stay compared with open procedures, presumably due to less tissue injury and reduced inflammatory response...
journal_title:Annals of clinical biochemistry
pub_type: 临床试验,杂志文章
doi:10.1177/000456329703400509
更新日期:1997-09-01 00:00:00
abstract::We developed a binary gradient high-performance liquid chromatography (HPLC) method for measuring HbA2 in whole blood samples using a Pharmacia Mono Q column (1 mL) and measurement at 415 nm. The assay requires a simple lysis and centrifugation step before injection onto the column. We found good agreement of results ...
journal_title:Annals of clinical biochemistry
pub_type: 杂志文章
doi:10.1177/000456329603300313
更新日期:1996-05-01 00:00:00
abstract::Experience in the use of an in-house urinary free catecholamine assay for the investigation of possible neural crest tumours in a District General Hospital laboratory is described. Elevated excretion of catecholamines and vanillylmandelic acid was found in a number of cases including phaeochromocytoma and neuroblastom...
journal_title:Annals of clinical biochemistry
pub_type: 杂志文章
doi:10.1177/000456328702400512
更新日期:1987-09-01 00:00:00
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journal_title:Annals of clinical biochemistry
pub_type: 杂志文章
doi:10.1258/0004563041731583
更新日期:2004-09-01 00:00:00
abstract:BACKGROUND:There are few data on oxidative stresses during and after pregnancy, although aggravation of autoimmune disease is implicated in oxidative stress and occurs frequently in the postpartum period. Thioredoxin (TRX) is a stress-inducible protein, and is used as a good biomarker for oxidative stress. To clarify t...
journal_title:Annals of clinical biochemistry
pub_type: 杂志文章
doi:10.1258/acb.2009.009120
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abstract:BACKGROUND:Current guidelines define acute myocardial infarction (AMI) by the rise and/or fall of cardiac troponin with ≥1 value above the 99th percentile. Past troponin assays have been unreliable at the lower end of the range. Highly sensitive assays have therefore been developed to increase the clinical sensitivity ...
journal_title:Annals of clinical biochemistry
pub_type: 杂志文章
doi:10.1258/acb.2010.010219
更新日期:2011-05-01 00:00:00
abstract::Background The aim of the present study is to evaluate the utility of extraction versus non-extraction-based commercial melatonin ELISA kits for determining the melatonin concentration in amniotic fluid obtained in early and late pregnancy. Methods Pregnancy duration less than 28 weeks was defined as early and from 28...
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doi:10.1177/0004563216645123
更新日期:2017-01-01 00:00:00
abstract::Auto-antibodies to oxidized low-density lipoprotein (ox-LDL) are thought to play a pivotal role in the pathogenesis of atherosclerosis. This study investigates the value of auto-antibodies to ox-LDL as a predictive marker of atherosclerosis in patients with both homozygous and heterozygous familial hypercholesterolaem...
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pub_type: 杂志文章
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更新日期:2000-03-01 00:00:00
abstract:BACKGROUND:Phlebotomy is a potential cause of preanalytical errors. We have observed phlebotomy in routine practice in a busy Emergency Department, to see how current practice compares with optimal blood sampling. METHODS:Phlebotomy episodes were audited and compared with standard procedures. A computer-based search o...
journal_title:Annals of clinical biochemistry
pub_type: 杂志文章
doi:10.1258/acb.2011.011099
更新日期:2011-11-01 00:00:00
abstract::Despite sonographic detection of foetal goitre, uncertainty persists in the initial diagnosis of thyrotoxicosis and hypothyroidism. The aim of this study was to establish foetal and neonatal iodothyronine and thyrotrophin reference values for the ACS-180SE analyser. From 22 to 36 weeks of gestation, median foetal seru...
journal_title:Annals of clinical biochemistry
pub_type: 杂志文章
doi:10.1177/000456320103800509
更新日期:2001-09-01 00:00:00
abstract:BACKGROUND:The relationship between plasma angiopoietin-like protein 3 (ANGPTL3), and lipoprotein lipase (LPL) activity and hepatic triglyceride lipase (HTGL) activity has not been investigated in the metabolism of remnant lipoproteins (RLPs) and high-density lipoprotein (HDL) in human plasma. METHODS:ANGPTL3, LPL act...
journal_title:Annals of clinical biochemistry
pub_type: 杂志文章
doi:10.1258/acb.2010.009307
更新日期:2010-09-01 00:00:00
abstract::Erythrocyte and fasting plasma magnesium were assayed by a dyebinding colorimetric method using the metallochromic dye, Calmagite, in 51 diabetic Nigerians and 25 controls. Erythrocyte magnesium concentrations were similar in the diabetics and the controls. Fasting plasma magnesium concentrations were significantly lo...
journal_title:Annals of clinical biochemistry
pub_type: 杂志文章
doi:10.1177/000456328902600111
更新日期:1989-01-01 00:00:00
abstract::Homocysteine, a sulphur amino acid, is a branch-point intermediate of methionine metabolism. It can be degraded in the transsulphuration pathway to cystathionine, or remethylated to methionine via the remethylation pathway. In both pathways, major genetic defects that cause enzyme deficiencies are associated with very...
journal_title:Annals of clinical biochemistry
pub_type: 杂志文章,评审
doi:10.1258/000456303321016169
更新日期:2003-01-01 00:00:00
abstract::591 patients with a history of coronary heart disease had one or more biochemical markers of tobacco smoking measured. 26% were self reported smokers and a further 4% were apparent 'smoking deceivers'. The urinary nicotine metabolite concentration is an excellent marker for tobacco smoking; breath CO would be a suitab...
journal_title:Annals of clinical biochemistry
pub_type: 杂志文章
doi:10.1177/000456329503200213
更新日期:1995-03-01 00:00:00
abstract::A comparison has been made between three methods for measuring capillary blood glucose collected on filter paper, including a new method using a Beckman glucose analyser 2. The methods are suitable for use with capillary blood spots collected onto filter paper for monitoring the control of diabetic patients. Their acc...
journal_title:Annals of clinical biochemistry
pub_type: 杂志文章
doi:10.1177/000456328201900105
更新日期:1982-01-01 00:00:00
abstract::We investigated the contributions made by the entero-insular axis, proinsulin and the fractional hepatic extraction of insulin to the hyperinsulinaemia characteristic of polycystic ovarian syndrome (PCOS). We measured plasma glucose, gastric inhibitory polypeptide (GIP), glucagon-like peptide-1 (7-36 amide) (GLP-1(7-3...
journal_title:Annals of clinical biochemistry
pub_type: 杂志文章
doi:10.1177/000456329603300303
更新日期:1996-05-01 00:00:00