Clinical performance of automated chemiluminescent methods for anticardiolipin and anti-ß2-glycoprotein I antibodies detection in a large cohort of Chinese patients with antiphospholipid syndrome.

INTRODUCTION: To assess the clinical performance and correlations of automated chemiluminescence assay (CIA) and enzyme-linked immunosorbent assay (ELISA) for detecting antiphospholipid (aPL) antibodies in the diagnosis of antiphospholipid syndrome (APS). METHODS: The study recruited 505 subjects, including 192 with APS, 193 with connective tissue diseases other than APS, and 120 healthy donors. We measured anticardiolipin (aCL) and anti-ß2-glycoprotein I (anti-ß2GPI) antibodies IgG, IgM, and IgA in all the samples using both CIA and ELISA. RESULTS: Total agreement between the two methods ranged from 83.50% for anti-ß2GPI IgG antibodies to 92.76% for anti-ß2GPI IgM antibodies in all the groups. Anti-ß2GPI and aCL IgG assays showed the highest Spearman's rho coefficients (anti-ß2GPI IgG = 0.742, aCL IgG = 0.715). Anti-ß2GPI IgG CIA showed the highest sensitivity for diagnosis of APS at 80.21%, which was significantly higher than the sensitivity of anti-ß2GPI IgG ELISA (52.08%). For diagnosis of APS, anti-ß2GPI IgG CIA had the best discrimination power with the area under the curves (AUC) of 0.922, followed by aCL IgG CIA (AUC of 0.905). While the CIA AUC was slightly higher in all cases, the difference was not statistically significant. CONCLUSION: CIA measurements had a good agreement and correlation with comparative ELISA assays. The CIA anti-ß2GPI IgG however was significantly more sensitive for APS diagnosis. The two assay methodologies showed comparable predictive powers and support the value of the CIA method for improved diagnosis and management of patients with APS.

[Expression of peroxisome proliferator-activated receptor alpha and beta in peripheral blood mononuclear cells of non-vavular hypertensive atrial fibrillation patients].

OBJECTIVE: To determine the mRNA expressions of PPARalpha and PPARbeta in peripheral blood mononuclear cells of non-vavular hypertensive atrial fibrillation (AF) patients and elucidate its possible role in the pathogenesis of AF. METHODS: Peripheral blood samples were collected from 103 patients with hypertensive AF (persistent AF: 55, paroxysmal AF: 48) and 50 age-adjusted hypertension patients without AF. The mRNA expressions of PPARalpha, PPARbeta, interleukin-6 (IL-6), and tumor necrosis factor-alpha (TNF-alpha) in monocytes were detected by using a Real time polymerase chain reaction. The concentrations of high sensitive C-reactive protein (CRP) and interleukin-1 (IL-1) were measured by immunoenzymetric method. RESULTS: The PPARalpha mRNA expression level was persistently decreased in hypertensive non-AF group, paroxysmal AF group, and persistent AF group (1.34 +/- 0.17, 1.09 +/- 0.23, 0.85 +/- 0.22), while the difference was statistically significant (P < 0.001; respectively). TNF-alpha mRNA, IL-6 mRNA,CRP and IL-1 persistently increased in hypertensive non-AF group, paroxysmal AF group, persistent AF group, also the difference was statistically significant (P < 0. 001; respectively). The difference of PPARbeta mRNA was not statistically significant between non-AF group, paroxysmal AF group and persistent AF group. Left atrial diameter (LAD) was in positive correlation with CRP, IL-1, IL-6 mRNA and TNF-alpha mRNA (P < 0.05). PPARalpha mRNA level was in negative correlation with CRP, IL-1, IL-6 mRNA and TNF-alpha mRNA, the correlation coefficient was -0.519, -0.532, -0.491 and -0.528, respectively (P < 0.05). CONCLUSION: In hypertensive patients with AF, increased inflammatory cytokines were associated with atrial remodeling and lead to the development of atrial fibrillation; PPARalpha was negatively correlated with these inflammatory cytokines and may play a vital role in the process of atrial fibrillation development.

[Variation of serum thyroid transcription factor-1 protein and its value in the diagnosis of lung carcinoma].

OBJECTIVE: To investigate the variation of serum thyroid transcription factor-1 (TTF-1) in different patients and explore its significance in the diagnosis of lung carcinoma. METHODS: Dot-enzyme linked immunosorbent assay (dot-ELISA) and Leica Q500 MC image analysis system were used to quantitatively detect TTF-1 protein in the serum samples from normal healthy adults and from patients with benign lung disease, lung cancer, thyroid carcinoma and non-thyroid carcinoma. RESULTS: The sensitivity, specificity, standardized positive predicative value, standardized negative predicative value, standardized accuracy and standardized wrong diagnostic rate of the method were 90.91%, 82.22%, 83.64%, 90.04%, 86.57% and 13.43%, respectively. The cutoff value of serum TTF-1 in healthy normal adults was 36.39, with a ROC value of 0.95. Serum TTF-1 PU was significantly higher in patients with lung adenocarcinoma, squamous cell lung carcinoma and thyroid carcinoma than in healthy adults and patients with benign lung diseases and non-thyroid carcinoma (P=0.000). Serum TTF-1 PU was similar in lung adenocarcinoma, squamous cell lung carcinoma, small cell lung carcinoma, large cell lung carcinoma and thyroid carcinoma (P=0.744, 0.677, and 0.333, respectively). Serum TTF-1 PU was greater than the PU in the corresponding homogenate of lung adenocarcinoma, squamous cell lung carcinoma, small cell lung carcinoma, large cell lung carcinoma and thyroid carcinoma (P=0.000). Serum and homogenate TTF-1 PU was correlated to TNM stage of lung cancer patients (P=0.000) but not to gender, tumor types, differentiation or lymph node metastasis. CONCLUSIONS: Lung adenocarcinoma, squamous cell lung carcinoma and thyroid carcinoma are suspected when serum TTF-1 PU is higher than 36.39. Serum TTF-1 is not helpful in differentiating the types of lung carcinomas and thyroid carcinoma. After exclusion of thyroid carcinoma, detection of serum TTF-1 can be helpful in the diagnosis of lung cancer. In different lung carcinomas and thyroid carcinomas, the serum TTF-1 is higher than the corresponding homogenate TTF-1 level. Serum TTF-1 increases with the progression of TNM stage of lung carcinoma.

[Predictive value of serum uric acid on type 2 diabetes mellitus].

OBJECTIVE: To evaluate the predictive value of uric acid (UA) on type 2 diabetes mellitus (DM). METHODS: 711 subjects aged 45 - 60 years old with normal fasting blood glucose (FBG) were studied in 1992. The subjects were divided into 2 groups according to their 1992 UA data in the normal UA group and in the hyperuricemia (HUA) group. We analyzed the prevalence of DM-2 in 2007 according to data on UA in 1992. Relative risk (RR) of the cohort was calculated under χ(2) test and logistic regression analysis. RESULTS: FBG and the prevalence rate of DM in 2007 in the HUA group were statistically higher than those in the normal group. The relative risk (RR) of HUA to DM was 3.749 (P = 0.000), with 95% Confidence interval (CI) as 2.387 - 5.890. Data from the logistic regression analysis, after adjusting for other risk factors, the RR of UA to DM was 1.426 (P = 0.003), with 95%CI as 1.173 - 1.705. CONCLUSION: The abnormal UA was closely related to glucose metabolism disorder while hyperuricemia appeared to be associated with increased risk of type 2 DM.

[Changes of prevalence of hypertension and blood pressure levels in 1061 adults in Chengdu from 1992 to 2007].

OBJECTIVE: To investigate the changes of blood pressure (BP) levels of a general population in Chengdu, China from 1992 to 2007. METHODS: A baseline survey on CVD risk factors was carried out in a general population of Chengdu in 1992. A total of 1365 adults aged 35-64 years were recruited randomly. In 2007, 1061 of the participants completed a follow up survey. RESULTS: 1) The systolic blood pressure (SBP) levels increased with age in both men and women, and larger increase was found in older people. The diastolic blood pressure (DBP) levels also increased with age, however, the smallest increase was found in the age group of 45 to 54 years. 2) People of 50-64 years old in 2007 had higher SBP than those of the same age in 1992. Similar changes were also found for DBP in men, but not in women. 3) From 1992 to 2007, the prevalence of hypertension increased in all of the age groups. The greater increase occurred in the younger population. 4) During the 15 years, the prevalence of hypertension increased from 13.2% to 51.2% in men, and from 14.0% to 45.1% in women. People of 50-64 years old had higher prevalence of hypertension in 2007 than those of the same age in 1992. CONCLUSION: SBP and DBP increase with age, and younger people have larger increase than older people. The prevalence of hypertension increases with age, and the greater increase also occurred in younger people. In people with the same age of 50-64 years, the prevalence of hypertension and SBP and DBP levels are higher in 2007 than in 1992, except for DBP in women.

[Association of PPARgamma2 Pro12Ala polymorphism and cognitive dysfunction in hypertension patients].

OBJECTIVE: To study the relationship between PPARgamma2 Pro12Ala polymorphism and cognitive function in patients with primary hypertension. METHODS: This study enrolled 502 hypertensive patients of Chinese Han population from Jan 2008 to Feb 2009 in West China Hospital of Sichuan University. We collected the general data and applied the mini mental state examination (MMSE) to test the cognitive function and computed score. Total cholesterol (TC), triglyeride (TG), fasting plasma glucose (FPG) and postprandial blood sugar (PPBS), fasting insulin (FINS) and postprandial plasma insulin (PINS) were measured. PCR-RELP method was used to analysis the PPARgamma2 Pro12Ala gene polymorphism. RESULTS: Pro12Pro genotype was present in 88.6% of the patients and Prol2Ala genotype was present in 11.4% of the population. Allele frequencies were 94.3% for Pro allele and 5.7% for Ala allele. In cognitive normal group, the frequencies of PP and PA genotype were 328 (87.2%) and 48 (12.8%), while the frequencies of PP and PA genotypes in the cognitive dysfunction group were 126 (92.9%), 9 (7.1%) respectively. Analyzed by chi2 test, both the genotype frequency and the allele frequency of PPARy2 Pro12Ala polymorphism did not display statistical variability between the cognitive normal group and the cognitive dysfunction group, even eliminating the influence of age and sexuality. CONCLUSION: Pro12Ala polymorphism in PPARgamma2 with primary hypertension may not associate with cognitive impairment.