A retrospective in-depth analysis of continuous glucose monitoring datasets for patients with hepatic glycogen storage disease: Recommended outcome parameters for glucose management.

Continuous glucose monitoring (CGM) systems have great potential for real-time assessment of glycemic variation in patients with hepatic glycogen storage disease (GSD). However, detailed descriptions and in-depth analysis of CGM data from hepatic GSD patients during interventions are scarce. This is a retrospective in-depth analysis of CGM parameters, acquired in a continuous, real-time fashion describing glucose management in 15 individual GSD patients. CGM subsets are obtained both in-hospital and at home, upon nocturnal dietary intervention (n = 1), starch loads (n = 11) and treatment of GSD Ib patients with empagliflozin (n = 3). Descriptive CGM parameters, and parameters reflecting glycemic variation and glycemic control are considered useful CGM outcome parameters. Furthermore, the combination of first and second order derivatives, cumulative sum and Fourier analysis identified both subtle and sudden changes in glucose management; hence, aiding assessment of dietary and medical interventions. CGM data interpolation for nocturnal intervals reduced confounding by physical activity and diet. Based on these analyses, we conclude that in-depth CGM analysis can be a powerful tool to assess glucose management and optimize treatment in individual hepatic GSD patients.

The lipoxygenase sensor, a new approach in essential fatty acid determination in foods.

Both an enzyme electrode and enzyme column with immobilized lipoxygenase, respectively, were used for the determination of essential fatty acids. The former was applied in a batch system, the latter was part of a fully automated flow injection analysis (FIA)-system. The oxygen consumption due to the lipoxygenase catalysed oxygenation of essential fatty acids was monitored amperometrically. Both systems were compared with regard to linear ranges of the calibration plots, sensitivities, detection limits, apparent Michaelis-Menten constants and lifetimes. The enzyme electrode showed different sensitivities for linoleic and alpha-linolenic acids, the most common essential fatty acids. The reason for this was not a second oxygenation step by lipoxygenase in case of alpha-linolenic acid, but a different dialytic behaviour of the two substrates. Hence, only the FIA-system was used for the determination of these fatty acids in real matrices such as vegetable oils and margarines. In the presence of detergent the triglycerides of the hydrophobic food samples were converted into water soluble glycerol and free fatty acids by a 15 min incubation with a ready to use lipase/esterase-mix, thus avoiding the use of organic solvents for analysis. Results obtained by the enzymatic FIA-system were in excellent agreement with those obtained by standard gas chromatography.

An immunosensor based on disposable electrodes for rapid estimation of fatty acid-binding protein, an early marker of myocardial infarction.

An immunosensor was developed that allows the rapid estimation of fatty acid-binding protein (FABP) in neat plasma samples. FABP is released into the blood following myocardial infarction and elevated levels are found already 3 h after onset of symptoms. The sensor is based on screen-printed graphite working and Ag/AgCl reference electrodes and an immunosandwich procedure for the quantification of FABP. The capture antibodies are bound to the electrode surface by adsorption and will trap FABP from the plasma sample. The sandwich is then completed by a second monoclonal antibody conjugated with alkaline phosphatase. The enzyme converts p-aminophenylphosphate to p-aminophenol, which is detected amperometrically at +350 mV. The high binding capacity and very short response time of the working electrode allow within 20 min the quantification of FABP in the measuring range 10-350 ng/ml, covering the pathological range of FABP release into the circulation. Measurements of plasma samples from a patient with acute myocardial infarction show an excellent correlation of the results obtained with the biosensor and those obtained with the respective reference ELISA. Owing to the long stability of the electrodes with immobilized capture antibody (> 3 months) a quick application without the need of labour-intensive electrode preparation is possible.