+
Home The relationship between the Spine Deformity Index, biochemical parameters of bone metabolism and vascular calcifications: results from the Epidemiological VERtebral FRACtures iTalian Study (EVERFRACT) in dialysis patients
Article
Licensed
Unlicensed Requires Authentication

The relationship between the Spine Deformity Index, biochemical parameters of bone metabolism and vascular calcifications: results from the Epidemiological VERtebral FRACtures iTalian Study (EVERFRACT) in dialysis patients

  • Maria Fusaro EMAIL logo , Maurizio Gallieni , Marianna Noale , Giovanni Tripepi , Davide Miozzo , Mario Plebani , Martina Zaninotto , Giuseppe Guglielmi , Diego Miotto , Fabrizio Fabris , Antonio Piccoli , Maria Teresa Vilei , Stefania Sella , Paolo Morachiello , Fabrizio Stoppa , Maurizio Rossini and Sandro Giannini
Published/Copyright: June 4, 2014
Become an author with De Gruyter Brill
Submit Manuscript Author Information
Clinical Chemistry and Laboratory Medicine (CCLM)
From the journal Clinical Chemistry and Laboratory Medicine (CCLM) Volume 52 Issue 11

Abstract

Background: The Spine Deformity Index (SDI) is a measure of vertebral fractures (VFs), providing information on both their number and severity.

Methods: We evaluated the relationships between SDI and clinical, biochemical and arterial calcification parameters in 387 hemodialysis (HD) patients. VFs, assessed by quantitative vertebral morphometry, and vascular calcifications were identified in the same lateral spinal X-ray. To improve the detection of fracture severity, we created a corrected SDI (c-SDI), by dividing SDI for the number of VFs. We assessed routine biochemistry, bone-Gla-protein (BGP), undercaboxylated BGP (ucBGP), and matrix-Gla-protein (MGP).

Results: VFs prevalence was 55.3%. HD patients with a SDI >1 were more frequently males (p<0.05), and had lower BGP (p<0.01). Patients with a c-SDI >1 had higher LDL-cholesterol (p<0.05) and lower ucBGP (p<0.05) and MGP (p<0.05). Calcifications of the abdominal aorta (AAoC) were more frequent in patients with SDI >1 (p<0.05) and with c-SDI >1 (p<0.05). Multivariate logistic regression showed that male sex (OR 1.86, CI 1.20–2.91), age (OR 1.03, CI 1.01–1.05) and albumin ≥3.5 g/dL (OR 0.54, CI 0.31–0.93) were predictors of a SDI >1. Age (OR 1.05, CI 1.03–1.07), LDL-cholesterol (OR 1.74, CI 1.04–2.92) and ucBGP (OR 0.35, CI 0.18–0.70) were associated with c-SDI >1.

Conclusions: We conclude that the severity of VFs was associated with age, atherogenic factors and bone metabolism markers.

Keywords: arterial calcifications; hemodialysis; vertebral fractures
Corresponding author: Maria Fusaro, MD, PhD, CNR, Neuroscience Institute, Via Giustiniani, 2, 35128 Padua, Italy, Phone: +39 0498212173, Fax: +39 0498212151, E-mail:

Acknowledgments

We would like to acknowledge the contribution of Dr. S.A. Jamal, University of Toronto, Women’s College Hospital and Women’s College Research Institute of Toronto, Ontario, Canada, for her precious work in reviewing the manuscript.

Conflict of interest statement

Authors’ conflict of interest disclosure: The authors stated that there are no conflicts of interest regarding the publication of this article.

Research funding: None declared.

Employment or leadership: None declared.

Honorarium: None declared.

Appendix

Parathyroid hormone (PTH)

The method for quantitative determination of PTH in serum was the automated LIAISON® N-Tact® PTH Assay 310910 (DiaSorin Inc., Stillwater, MN, USA), which is a direct, two-site, sandwich type chemiluminescence immunoassay (CLIA) carried out on the LIAISON® (DiaSorin Inc.) instrument. During incubation, the solid phase, coated with specific antibodies against 39-84 region of PTH, binds the molecules in the samples and is subsequently bound by a second antibody for the 1-34 region conjugated to an isoluminol-derivative. The starter reagent is then added, leading to a chemiluminescent signal that is proportional to the concentration of PTH present in the samples. The analytical sensitivity is 1 pg/mL, and the intra- and inter-assay CV were 3.7%–6.3% and 3.5–5.3%, respectively.

25-OH vitamin D

For quantitative determination of total 25-OH vitamin D (both D2 and D3 form) in serum, we used the automated LIAISON® 25 OH Vitamin D TOTAL Assay 310600, which is a direct competitive CLIA executed on the LIAISON® (DiaSorin Inc.) instrument. During the first incubation, 25-OH vitamin D is dissociated from its binding protein and binds to the specific antibody on the solid phase. Then the tracer (vitamin D linked to isoluminol derivative) is added. After a second incubation and the wash cycle for unbound material, the starter reagents are added. The flashlight signal is inversely proportional to the concentration of 25-OH vitamin D present in the samples. The analytical sensitivity is <4 ng/mL, and the intra-assay coefficients of variation (CV) have been found to range between 2.9% and 5.5%, while the inter-assay CV is 6.3%–12.9%.

Osteocalcin (BGP)

The method for quantitative determination of total osteocalcin in serum was the automated LIAISON® Osteocalcin Assay 310950 (DiaSorin Inc.), which is a direct, two-site, sandwich type CLIA executed on the LIAISON® (DiaSorin Inc.) instrument. The osteocalcin in the samples binds the mouse antibody, coating the solid phase, and is subsequently bound by isoluminol conjugated antibody. After the incubation, the unbound material is removed by wash cycle, and then the starter reagents are added. The flashlight signal is proportional to the concentration of osteocalcin present in the samples. The analytical sensitivity is <0.3 mcg/L, and the intra-assay CV is 3%–8%, while the inter-assay CV is 4%–9%.

Undercarboxylated osteocalcin (ucBGP)

For quantitative determination of the undercarboxylated form, we used Glu-osteocalcin EIA Kit MK118 (Takara Bio Inc., Otsu, Shiga, Japan), a manual solid phase EIA based on a sandwich method that utilizes two mouse monoclonal anti-ucBGP antibodies to detect uc-BGP by a two-step procedure. One of the mouse monoclonal anti-undercarboxylated BGP is immobilized onto the microtiter plate and blocked against non-specific binding. Samples are added to each well and incubated. The second step is to wash the plate and to add the second anti-BGP labeled with peroxidase (POD). The reaction between POD and substrate (H2 O2 and 3,3ʹ, 5,5ʹ tetramethylbenzidine) results in color development with intensities proportional to the amount of uc-BGP present in the samples. The analytical sensitivity is 0.25 mcg/L, and the intra- and inter-assay CV are 4.4%–6.7% and 5.7%–9.9%, respectively.

Matrix-Gla-protein (MGP)

The quantitative determination of MGP was performed using the Human MGP-Matrix Gla ProteinKit (Biomedica Medizinprodukte GmbH & Co KG, Vienna, Austria). It is a manual competitive ELISA method designed to detect MGP in serum. During the first incubation, the MGP in the samples is bound by the specific antibody coated to the microtiter plate. Moreover, the tracer (biotinylated synthetic MGP) is added to each well. Then, after a wash cycle to remove the unbounded tracer, the conjugate [streptavidin-linked horseradish peroxidase (HRPO)] is added to each well. The reaction between HRPO and substrate TMB (3,3ʹ,5,5ʹ-tetramethylbenzidine) develops color with intensities inversely proportional to the MGP present in samples. The analytical sensitivity is 0.3 nmol/L, and the intra- and inter-assay CV are 5%–6% and 7%–9%, respectively.

References

1. Johnell O, Kanis JA. An estimate of the worldwide prevalence and disability associated with osteoporotic fractures. Osteoporos Int 2006;17:1726–33.10.1007/s00198-006-0172-4Search in Google Scholar PubMed

2. Waterloo S, Ahmed LA, Center JR, Eisman JA, Morseth B, Nguyen ND, et al. Prevalence of vertebral fractures in women and men in the population-based Tromso Study. BMC Musculoskel Disord 2012;13:3.10.1186/1471-2474-13-3Search in Google Scholar PubMed PubMed Central

3. El Maghraoui A, Mounach A, Gassim S, Ghazi M. Vertebral fracture assessment in healthy men: prevalence and risk factors. Bone 2008;43:544–8.10.1016/j.bone.2008.05.008Search in Google Scholar PubMed

4. El Maghraoui A, Morjane F, Nouijai A, Achemlal L, Bezza A, Ghozlani I. Vertebral fracture assessment in Moroccan women: prevalence and risk factors. Maturitas 2009;62: 171–5.10.1016/j.maturitas.2008.11.020Search in Google Scholar PubMed

5. Melton 3rd LJ, Lane AW, Cooper C, Eastell R, O’Fallon WM, Riggs BL. Prevalence and incidence of vertebral deformities, Osteoporos Int 1993;3:113–9.10.1007/BF01623271Search in Google Scholar PubMed

6. Ho-Pharm LT, Nguyen ND, Vu BQ, Pharm HN, Nguyen TV. Prevalence and risk factors of radiographic vertebral fracture in postmenopausal Vietnamese women. Bone 2009;45:213–7.10.1016/j.bone.2009.04.199Search in Google Scholar PubMed

7. Sadat-Ali M, Gullenpet AH, Al-Mulhim F, Al Turki H, Al-Shammary H, Al-Elq A, et al. Osteoporosis-related vertebral fractures in postmenopausal women: prevalence in a Saudi Arabian sample. East Mediterr Health J 2009;15:1420–5.Search in Google Scholar

8. Sanfélix-Genovés J, Reig-Molla B, Sanfélix-Gimeno G, Peiró S, Graells-Ferrer M, Vega-Martinez, et al. The population-based prevalence of osteoporotic vertebral fracture and densitometric osteoporosis in postmenopausal women over 50 in Valencia, Spain (the FRAVO study). Bone 2010;47:610–6.10.1016/j.bone.2010.06.015Search in Google Scholar PubMed

9. Lentle BC, Brown JP, Khan A, Leslie WD, Levesque J, Lyons DJ, et al. Recognizing and reporting vertebral fractures: reducing the risk of future osteoporotic fractures. Can Assoc Radiol J 2007;58:27–36.Search in Google Scholar

10. Delmas PD, van de Langerijt L, Watts NB, Eastell R, Genant H, Grauer A, et al. IMPACT study group. Underdiagnosis of vertebral fractures is a worldwide problem: the IMPACT study. J Bone Miner Res 2005;20:557–63.10.1359/JBMR.041214Search in Google Scholar PubMed

11. Gehlbach SH, Bigelow C, Heimisdottir M, May S, Walker M, Kirkwood JR. Recognition of vertebral fracture in a clinical setting. Osteoporos Int 2000;11:577–82.10.1007/s001980070078Search in Google Scholar PubMed

12. Christiansen BA, Bouxsein ML, Biomechanics of vertebral fractures and the vertebral fracture cascade. Curr Osteoporos Rep 2010;8:198–204.10.1007/s11914-010-0031-2Search in Google Scholar PubMed

13. Rodriguez-Garcia M, Gomez Alonso C, Navez Diaz M, Diaz Lopez JB, Megido J, Gago E, et al. Prevalence of vertebral fractures and aortic calcifications in hemodialysis patients: comparison with a population of the same age and sex. Nefrologia 2003;23:106–11.Search in Google Scholar

14. Kado DM, Browner WS, Palermo L, Nevitt MC, Genant HK, Cummings SR. Vertebral fractures and mortality in older women: a prospective study. Study of Osteoporotic Fractures Research Group. Arch Intern Med 1999;159:1215–20.10.1001/archinte.159.11.1215Search in Google Scholar

15. Cauley JA, Thompson DE, Ensrud KC, Scott JC, Black D. Risk of mortality following clinical fractures. Osteoporos Int 2000;11:556–61.10.1007/s001980070075Search in Google Scholar

16. Hasserius R, Karlsson MK, Jónsson B, Redlund-Johnell I, Johnell O. Long-term morbidity and mortality after a clinically diagnosed vertebral fracture in the elderly – a 12- and 22-year follow-up of 257 patients. Calcif Tissue Int 2005;76:235–42.10.1007/s00223-004-2222-2Search in Google Scholar

17. Bliuc D, Nguyen ND, Milch VE, Nguyen TV, Eisman JA, Center JR. Mortality risk associated with low-trauma osteoporotic fracture and subsequent fracture in men and women. J Am Med Assoc 2009;301:513–21.10.1001/jama.2009.50Search in Google Scholar

18. Lee YK, Jang S, Jang S, Lee HJ, Park C, Ha YC, et al. Mortality after vertebral fracture in Korea: analysis of the national Claim Registry. Osteoporos Int 2012;23:1859–65.10.1007/s00198-011-1833-5Search in Google Scholar

19. Delmas PD, Genant HK, Crans GG, Stock JL, Wong M, Siris E, et al. Severity of prevalent vertebral fractures and the risk of subsequent vertebral and nonvertebral fractures: results from the MORE trial. Bone 2003;33:522–32.10.1016/S8756-3282(03)00241-2Search in Google Scholar

20. Fusaro M, D’Angelo A, Scalzo G, Gallieni M, Giannini S, Guglielmi G. Vertebral fractures in dialysis: endocrinological disruption of the bone-kidney axis. J Endocrinol Invest 2010;33:347–52.10.1007/BF03346598Search in Google Scholar

21. Crans GG, Genant HK, Krege JH. Prognostic utility of a semiquantitative spinal deformity index. Bone 2005;37:175–9.10.1016/j.bone.2005.04.003Search in Google Scholar

22. Minne HW, Leidig G, Wüster C, Siromachkostov L, Baldauf G, Bickel R, et al. A newly developed spine deformity index (SDI) to quantitate vertebral crush fractures in patients with osteoporosis. Bone Miner 1988;3:335–49.10.1016/0378-5122(88)90041-2Search in Google Scholar

23. Sauer P, Leidig G, Minne HW, Duckeck G, Schwarz W, Siromachkostov L, et al. Spine Deformity Index (SDI) versus other objective procedures of vertebral fracture identification in patients with osteoporosis: a comparative study. J Bone Miner Res 1991;6:227–38.10.1002/jbmr.5650060304Search in Google Scholar PubMed

24. Genant HK, Wu CY, van Kuijk C, Nevitt MC. Vertebral fracture assessment using a semiquantitative technique. J Bone Miner Res 1993;8:1137–48.10.1002/jbmr.5650080915Search in Google Scholar

25. Guglielmi G, Palmieri F, Placentino MG, D’Errico F, Stoppino LP. Assessment of osteoporotic vertebral fractures using specialized workflow software for 6-point morphometry. Eur J Radiol 2009;70:142–8.10.1016/j.ejrad.2007.12.001Search in Google Scholar

26. Diacinti D, Guglielmi G, Tomei E, D’Erasmo E, Minisola S, Valentini C, et al. Vertebral morphometry: evaluation of osteoporosis-caused fractures. Radiol Med 2001;101:140–4.Search in Google Scholar

27. Diacinti D, Pisani D, Del Fiacco R, Francucci CM, Fiore CE, Frediani B, et al. Vertebral morphometry by X-ray absorptiometry: which reference data for vertebral heights? Bone 2011;49:526–36.10.1016/j.bone.2011.05.027Search in Google Scholar

28. Fusaro M, Tripepi G, Noale M, Vajente N, Plebani M, Zaninotto M, et al. High prevalence of vertebral fractures assessed by quantitative morphometry in hemodialysis patients, strongly associated with vascular calcifications. Calcif Tissue Int 2013;93:39–47.10.1007/s00223-013-9722-xSearch in Google Scholar

29. Witteman JC, Grobbee DE, Valkenburg HA, Van Hemert AM, Stijnen T, Burger H, et al. J-shaped relation between change in diastolic blood pressure and progression of aortic atherosclerosis. Lancet 1994;343:504–7.10.1016/S0140-6736(94)91459-1Search in Google Scholar

30. Giannini S, Sella S, Silva Netto F, Cattelan C, Dalle Carbonare L, Lazzarin R, et al. Persistent secondary hyperparathyroidism and vertebral fractures in kidney transplantation: role of calcium-sensing receptor polymorphisms and vitamin D deficiency. J Bone Miner Res 2010;25:841–8.Search in Google Scholar

31. Neve A, Corrado A, Cantatore FP. Osteocalcin: skeletal and extra-skeletal effects. J Cell Physiol 2013;228:1149–53.10.1002/jcp.24278Search in Google Scholar PubMed

32. Karsenty G, Oury F. Regulation of male fertility by the bone-derived hormone osteocalcin. Mol Cell Endocrinol 2014;382:521–6.10.1016/j.mce.2013.10.008Search in Google Scholar PubMed PubMed Central

33. Yilmaz MI1, Sonmez A, Qureshi AR, Saglam M, Stenvinkel P, Yaman H, et al. Endogenous testosterone, endothelial dysfunction, and cardiovascular events in men with nondialysis chronic kidney disease. Clin J Am Soc Nephrol 2011;6:1617–25.10.2215/CJN.10681210Search in Google Scholar PubMed

34. Stehman-Breen CO, Sherrad DJ, Alem AM, Gillen DL, Heckbert SR, Wong CS, et al. Risk factors for hip fracture among patients with end-stage renal disease. Kidney Int 2000;58:2200–5.10.1111/j.1523-1755.2000.00394.xSearch in Google Scholar PubMed

35. Fusaro M, Crepaldi G, Maggi S, Galli F, D’Angelo A, Calò L, et al. Vitamin K, bone fractures, and vascular calcifications in chronic kidney disease: an important but poorly studied relationship. J Endocrinol Invest 2011;34:317–23.10.1007/BF03347093Search in Google Scholar PubMed

36. Edwards BJ, Langman CB, Bunta AD, Vicuna M, Favus M. Secondary contributors to bone loss in osteoporosis related hip fractures. Osteoporos Int 2008;19:991–9.10.1007/s00198-007-0525-7Search in Google Scholar PubMed

37. Naves M, Rodríguez-García M, Díaz-López JB, Gómez-Alonso C, Cannata-Andía JB. Progression of vascular calcifications is associated with greater bone loss and increased bone fractures. Osteoporos Int 2008;19:1161–6.10.1007/s00198-007-0539-1Search in Google Scholar PubMed

38. Gundberg CM, Lian JB, Booth SL. Vitamin K-dependent carboxylation of osteocalcin: friend or foe? Adv Nutr 2012;3:149–57.10.3945/an.112.001834Search in Google Scholar PubMed PubMed Central

39. Sarkis KS, Martini LA, Szejnfeld VL, Pinheiro MM. Low fatness, reduced fat intake and adequate plasmatic concentrations of LDL-cholesterol are associated with high bone mineral density in women: a cross-sectional study with control group. Lipids Health Dis 2012;11:37.10.1186/1476-511X-11-37Search in Google Scholar PubMed PubMed Central

40. Kaji H, Hisa I, Inoue Y, Sugimoto T. Low density lipoprotein-cholesterol levels affect vertebral fracture risk in female patients with primary hyperparathyroidism. Exp Clin Endocrinol Diabetes 2010;118:371–6.10.1055/s-0029-1224152Search in Google Scholar PubMed

41. Confavreux CB, Szulc P, Casey R, Boutroy S, Varennes A, Vilayphiou N, et al. Higher serum osteocalcin is associated with lower abdominal aortic calcification progression and longer 10-year survival in elderly men of the MINOS cohort. J Clin Endocrinol Metab 2013;98:1084–92.10.1210/jc.2012-3426Search in Google Scholar PubMed

Received: 2014-2-21
Accepted: 2014-4-19
Published Online: 2014-6-4
Published in Print: 2014-11-19

©2014 by De Gruyter

Articles in the same Issue

  1. Frontmatter
  2. Editorial
  3. From symptoms to biomarkers: a change of paradigm
  4. Reviews
  5. Biochemical markers in early diagnosis and management of systemic amyloidoses
  6. The accuracy of the anti-mitochondrial antibody and the M2 subtype test for diagnosis of primary biliary cirrhosis: a meta-analysis
  7. Genetics and Molecular Diagnostics
  8. Selection of an optimal method for co-isolation of circulating DNA and miRNA from the plasma of pregnant women
  9. General Clinical Chemistry and Laboratory Medicine
  10. Harmonisation of seven common enzyme results through EQA
  11. Harmonization in hemolysis detection and prevention. A working group of the Catalonian Health Institute (ICS) experience
  12. Adopting European Network for Health Technology Assessments (EunetHTA) core model for diagnostic technologies for improving the accuracy and appropriateness of blood gas analyzers’ assessment
  13. Impact of assay design on test performance: lessons learned from 25-hydroxyvitamin D
  14. Anti-ruthenium antibodies mimic macro-TSH in electrochemiluminescent immunoassay
  15. The relationship between the Spine Deformity Index, biochemical parameters of bone metabolism and vascular calcifications: results from the Epidemiological VERtebral FRACtures iTalian Study (EVERFRACT) in dialysis patients
  16. Quantification of polyclonal free light chains in clinical samples using a single turbidimetric immunoassay
  17. Global coagulation tests: their applicability for measuring direct factor Xa- and thrombin inhibition and reversal of anticoagulation by prothrombin complex concentrate
  18. Reference Values and Biological Variations
  19. The importance of individual biology in the clinical use of serum biomarkers for ovarian cancer
  20. The quality of diagnostic testing may be impaired during shipment of lithium-heparin gel tubes
  21. Cancer Diagnostics
  22. Serum human epididymis protein 4 (HE4) as a tumor marker in men with lung cancer
  23. Intestinal permeability in patients with metastatic colon cancer treated with patupilone
  24. Cardiovascular Diseases
  25. European multicenter analytical evaluation of the Abbott ARCHITECT STAT high sensitive troponin I immunoassay
  26. Infectious Diseases
  27. Early indicators of severity and construction of a risk model for prognosis based upon laboratory parameters in patients with hemorrhagic fever with renal syndrome
  28. Corrigendum
  29. Automated indirect immunofluorescence antinuclear antibody analysis is a standardized alternative for visual microscope interpretation
  30. Letters to the Editor
  31. The future of the laboratory information system – what are the requirements for a powerful system for a laboratory data management?
  32. Hypernatraemia in disguise
  33. Interference of therapeutic monoclonal immunoglobulins in the investigation of M-proteins
  34. The impact of exercise on the variation of serum free light chains
  35. Response to Jacobs: N Latex FLC serum free light-chain assays in patients with renal impairment
  36. Reply to Berlanga et al. (DOI 10.1515/cclm-2014-0420)
  37. Mean platelet volume in patients with non-alcoholic fatty liver disease: is mean platelet volume ready as a surrogate marker?
  38. False-positive D-dimer result in a latex-enhanced immunoassay caused by interfering human anti-mouse antibodies
  39. D-Dimer in normal pregnancy: determination of reference values for three commercially available assays
  40. Paraoxonase 2 sequence variation (c.311 C>G) is associated with a modest decrease in circulating LDL size in children and adolescents
  41. The effect of volume of hydrochloric acid preservation on 24-hour urinary catecholamine test
  42. Congress Abstracts
  43. Congress of Clinical Chemistry and Laboratory Medicine
  44. The 3rd EFLM-UEMS Congress
  45. 46th National Congress of the Italian Society of Clinical Biochemistry and Clinical Molecular Biology (SIBioC – Laboratory Medicine)
DOI:  doi.org/10.1515/cclm-2014-0194
Keywords for this article
arterial calcifications&semi; hemodialysis&semi; vertebral fractures

Articles in the same Issue

  1. Frontmatter
  2. Editorial
  3. From symptoms to biomarkers: a change of paradigm
  4. Reviews
  5. Biochemical markers in early diagnosis and management of systemic amyloidoses
  6. The accuracy of the anti-mitochondrial antibody and the M2 subtype test for diagnosis of primary biliary cirrhosis: a meta-analysis
  7. Genetics and Molecular Diagnostics
  8. Selection of an optimal method for co-isolation of circulating DNA and miRNA from the plasma of pregnant women
  9. General Clinical Chemistry and Laboratory Medicine
  10. Harmonisation of seven common enzyme results through EQA
  11. Harmonization in hemolysis detection and prevention. A working group of the Catalonian Health Institute (ICS) experience
  12. Adopting European Network for Health Technology Assessments (EunetHTA) core model for diagnostic technologies for improving the accuracy and appropriateness of blood gas analyzers’ assessment
  13. Impact of assay design on test performance: lessons learned from 25-hydroxyvitamin D
  14. Anti-ruthenium antibodies mimic macro-TSH in electrochemiluminescent immunoassay
  15. The relationship between the Spine Deformity Index, biochemical parameters of bone metabolism and vascular calcifications: results from the Epidemiological VERtebral FRACtures iTalian Study (EVERFRACT) in dialysis patients
  16. Quantification of polyclonal free light chains in clinical samples using a single turbidimetric immunoassay
  17. Global coagulation tests: their applicability for measuring direct factor Xa- and thrombin inhibition and reversal of anticoagulation by prothrombin complex concentrate
  18. Reference Values and Biological Variations
  19. The importance of individual biology in the clinical use of serum biomarkers for ovarian cancer
  20. The quality of diagnostic testing may be impaired during shipment of lithium-heparin gel tubes
  21. Cancer Diagnostics
  22. Serum human epididymis protein 4 (HE4) as a tumor marker in men with lung cancer
  23. Intestinal permeability in patients with metastatic colon cancer treated with patupilone
  24. Cardiovascular Diseases
  25. European multicenter analytical evaluation of the Abbott ARCHITECT STAT high sensitive troponin I immunoassay
  26. Infectious Diseases
  27. Early indicators of severity and construction of a risk model for prognosis based upon laboratory parameters in patients with hemorrhagic fever with renal syndrome
  28. Corrigendum
  29. Automated indirect immunofluorescence antinuclear antibody analysis is a standardized alternative for visual microscope interpretation
  30. Letters to the Editor
  31. The future of the laboratory information system – what are the requirements for a powerful system for a laboratory data management?
  32. Hypernatraemia in disguise
  33. Interference of therapeutic monoclonal immunoglobulins in the investigation of M-proteins
  34. The impact of exercise on the variation of serum free light chains
  35. Response to Jacobs: N Latex FLC serum free light-chain assays in patients with renal impairment
  36. Reply to Berlanga et al. (DOI 10.1515/cclm-2014-0420)
  37. Mean platelet volume in patients with non-alcoholic fatty liver disease: is mean platelet volume ready as a surrogate marker?
  38. False-positive D-dimer result in a latex-enhanced immunoassay caused by interfering human anti-mouse antibodies
  39. D-Dimer in normal pregnancy: determination of reference values for three commercially available assays
  40. Paraoxonase 2 sequence variation (c.311 C>G) is associated with a modest decrease in circulating LDL size in children and adolescents
  41. The effect of volume of hydrochloric acid preservation on 24-hour urinary catecholamine test
  42. Congress Abstracts
  43. Congress of Clinical Chemistry and Laboratory Medicine
  44. The 3rd EFLM-UEMS Congress
  45. 46th National Congress of the Italian Society of Clinical Biochemistry and Clinical Molecular Biology (SIBioC – Laboratory Medicine)
Stay updated on our offers and services
Institutional Access
How does access work?
Have an idea on how to improve our website?
Please write us.
© 2025 De Gruyter Brill
Downloaded on 29.4.2025 from https://www.degruyterbrill.com/document/doi/10.1515/cclm-2014-0194/html
Scroll to top button
点击 这是indexloc提供的php浏览器服务，不要输入任何密码和下载