Serum regucalcin is a useful indicator of liver injury severity in patients with hepatitis B virus-related liver diseases

Regucalcin is a soluble protein that is principally expressed in hepatocytes. Studies of regucalcin have mainly been conducted in animals due to a lack of commercially available kits. We aimed to develop an enzyme-linked immunosorbent assay (ELISA) to quantify serum regucalcin in patients with hepatitis B virus (HBV)-related disease. High-titer monoclonal antibodies and a polyclonal antibody to regucalcin were produced, a double-antibody sandwich ELISA method was established, and serum regucalcin was determined in 47 chronic hepatitis B (CHB) patients, 91 HBV-related acute-on-chronic liver failure (HBV-ACLF) patients, and 33 healthy controls. The ELISA demonstrated an appropriate linear range, and high levels of reproducibility, sensitivity, specificity, accuracy, and stability. The median serum regucalcin concentrations in HBV-ACLF and CHB patients were 5.46 and 3.76 ng/mL, respectively (P<0.01), which were much higher than in healthy controls (1.72 ng/mL, both P<0.01). For the differentiation of CHB patients and healthy controls, the area under curve (AUC) was 0.86 with a cut-off of 2.42 ng/mL, 85.7% sensitivity, and 78.8% specificity. In contrast, the AUC of alanine aminotransferase (ALT) was lower (AUC=0.80, P=0.01). To differentiate ACLF from CHB, the AUC was 0.72 with a cut-off of 4.26 ng/mL, 77.0% sensitivity, and 61.2% specificity while the AUC of ALT was 0.41 (P=0.07). Thus, we have developed an ELISA that is suitable for measuring serum regucalcin and have shown that serum regucalcin increased with the severity of liver injury due to HBV-related diseases, such that it appears to be more useful than ALT as a marker of liver injury.

Prevalence and environmental impact factors of somatization tendencies in eastern Chinese adolescents: a multicenter observational study / Prevalência e fatores ambientais de tendências de somatização em adolescentes do leste chinês: um estudo observacional multicêntrico / Prevalencia y factores de impacto ambientales en las tendencias somatización con adolescentes de la China oriental: un estudio observacional multicéntrico

The aim of this study is at examining the prevalence and impact factors of adolescent somatization tendencies (ST) across three eastern Chinese provinces. A multicenter school-based cross-sectional study was conducted in these provinces from 2015 to 2016. The sample included 11,153 middle-school students aged 13-18 years, who were randomly selected using a multi-phase stratified cluster sampling technique. We also designed a multicenter school-based case-control study to evaluate the potential environmental impact of ST factors on this population. The overall positive rate of ST among the eastern Chinese adolescents was 12.1%. Somatic symptoms score (SSS) and positive ST rate were higher in females than males. Additionally, the SSS and positive ST rate for the 18-year-old group were significantly higher than in other age groups. In comparison to those in urban areas, adolescents in rural areas had significantly higher SSS and positive ST rate. Multiple conditional regression analyses revealed that family medical history, anxiety and depression scores; superstitious beliefs; left-behind adolescents; teacher-student support; family conflict; and family independence and achievement orientation were significantly linked to ST in adolescents. The models also indicated family medical history was the strongest impact factor to adolescent ST, even though ST were prevalent in the three studied eastern Chinese provinces. Gender, age, and dwelling differences were very significant in the SSS and positive ST rate in adolescents. This study concludes that adolescent ST are influenced by multiple environments.

O objetivo deste estudo é examinar a prevalência e fatores de impacto de tendências de somatização (TS) em adolescentes em três províncias do leste da China. Um estudo transversal multicêntrico baseado em escolas foi realizado nessas províncias de 2015 a 2016. A amostra incluiu 11.153 estudantes entre 13 e 18 anos que foram selecionados aleatoriamente usando uma técnica de amostragem estratificada por clusters multi-fase. Também elaboramos um estudo caso-controle multicêntrico baseado em escolas para avaliar o impacto ambiental potencial de fatores de TS nessa população. A taxa positiva geral de TS entre adolescentes do leste chinês foi de 12,1%. O escore de sintomas somáticos (SSS) e taxa positiva de TS foram mais altos entre mulheres do que homens. Adicionalmente, o SSS e taxa positiva de TS para o grupo de 18 anos foram significativamente mais altos do que em outros grupos etários. Em comparação com os habitantes de áreas urbanas, adolescentes de áreas rurais tiveram SSS e taxa positiva de ST significativamente mais altos. Análises de regressão múltipla condicional revelaram que o histórico de saúde da família; scores de ansiedade e depressão; crenças supersticiosas; adolescentes deixados para trás; apoio de professores a estudantes; conflito familiar; e independência familiar e orientação para sucesso estavam significativamente relacionadas a TS em adolescentes. O modelo também indicou que o histórico de saúde da família era o fator de impacto mais forte para TS em adolescentes, ainda que TS sejam prevalentes nas três províncias do leste da China estudadas. Gênero, idade e diferenças residenciais foram muito significativos para o SSS e taxa positiva de TS entre adolescentes. Este estudo conclui que TS entre adolescentes são influenciadas por múltiplos ambientes.

El objetivo de este estudio fue examinar la prevalencia y factores de impacto de las tendencias de somatización adolescentes (TS) en tres provincias orientales chinas. Se realizó un estudio trasversal multicéntrico, basado en escolares de estas provincias de 2015 a 2016. La muestra incluyó a 11.153 estudiantes de secundaria, con edades comprendidas entre los 13-18 años, que fueron seleccionados aleatoriamente, usando a técnicas de muestreo multifase estratificado por conglomerados. También se diseñó un estudio multicéntrico escolar de caso-control para evaluar el potencial impacto ambiental de factores TS en esta población. La tasa positiva general de TS entre adolescentes chinos orientales fue un 12,1%. El marcador de síntomas somáticos (SSS, por sus siglas en inglés) y tasa positiva de TS fueron más altos en mujeres que en hombres. Asimismo, las tasas SSS y TS positiva para el grupo de 18 años de edad fueron significativamente más altas que en otros grupos de edad. En comparación con quienes vivían en áreas urbanas, los adolescentes en áreas rurales contaban con tasas significativamente más altas de SSS y TS positivas. Los análisis de regresión múltiple condicional revelaron que el historial médico familiar, los marcadores de ansiedad y depresión; creencias supersticiosas; adolescentes a la zaga respecto al resto del grupo; el apoyo profesor-estudiante; conflictos familiares; e independencia familiar, así como la orientación de logros estuvieron vinculados a las TS en adolescentes. Los modelos también indicaron que el historial médico familiar fue el impacto más fuerte para las TS en adolescentes, a pesar de que las TS fueron prevalentes en las tres provincias chinas estudiadas. El género, edad, y las diferencias de vivienda fueron muy significativas en la tasas de SSS y TS positivas en adolescentes. Este estudio llega a la conclusión de que las TS adolescentes estaban influenciadas por múltiples entornos.