Alterations in the enzyme profile in intensive care patients undergoing total parenteral nutrition.

Total parenteral nutrition (TPN) has been demonstrated to be an effective therapeutic means in improving the clinical course of the critically ill patients. Various metabolic complications are described; the cause of some of these remain unclear. The changes in some plasma enzyme indices (GOT, GPT, GIDH, LDH, HBDH, CPK, ChE, AP, gamma-GT) in two groups of critically ill patients undergoing TPN (group with more marked enzyme alterations and group with less marked alteration) were examined. Two types of alterations were found: (1) early increase of some enzymes (GOT, GPT, GIDH); (2) constant increase of plasma enzyme level during TPN (AP, gamma GT). These two evolutionary patterns were more evident in the complicated group and the enzyme changes were statistically significant for GOT and GPT (P = 0.05) and not significant for initial values of G1DH, ap and gamma-GT. Both groups presented constant elevated plasma values of LDH, HBDH, CPK and depressed constant ChE value during treatment; the difference was not significant in both groups for the same enzymes. The data were interpreted from a functional point of view; that is they were related to both the metabolic post-aggressive state and TPN. A relationship between the rate of protein catabolism and the inductive increase of some enzymes (GOT, GPT, G1DH) was found. Whereas a final induction in the energy metabolism is suggested for other enzymes (LDH, HBDH), the alteration of CPK, AP, gamma-GT and ChE was interpreted as dependent on: (1) direct muscular trauma (CPK); (2) functional increase in relation to the duration of TPN (AP and gamma-GT); (3) possible depressed malnutritive synthesis (ChE). The improvement of the enzymatic patterns with the early use of TPN and with the improvement of clinical and nutritional conditions was emphasized.     

Age and gender dependent alterations in the activities of glutathione related enzymes in healthy subjects

Objectives: Oxidative stress as a result of increased free radical production is implicated in the pathogenesis of several diseases. Specific antioxidant enzymes have a crucial role in the prevention of these deleterious effects. Since the activities of these enzymes differ significantly in different populations and seem to be affected by various environmental factors, in this study we aimed to determine the reference values of glutathione related antioxidant enzyme activities in the erythrocytes of healthy subjects and to investigate the possible variations as a function of age and gender in a healthy Turkish Mediterranean population.

Design and methods: 130 healthy subjects (12–90 yr, 82 females, 48 males) were divided into six different age groups. Erythrocyte glutathione peroxidase (GSH-PX), glutathione reductase (GR) and glutathione-s-transferase (GST) activities were measured on a Hitachi 704 autoanalyser by the modification of previously described manual UV spectrophotometric methods.

Results: No significant differences were observed in erythrocyte GSH-PX, GR and GST activities between different age groups. Overall, GST activities were significantly higher in females compared with males (8.08 ± 1.39, 6.88 ± 1.51 U/g Hb respectively, mean ± SD, p < 0.001). A significant positive correlation between GSH-PX and GR activities was observed (r = 0.49, p < 0.001).

Conclusion: The results of this study suggested that the activities of GSH-PX, GR and GST did not depend. GST activities overall were higher in females. The reference values that we obtained were different than the previous reports. This situation implies that each population should determine its own reference values and should investigate the influence of environmental factors and life style habits on the activities of these enzymes that constitute a major part of the antioxidant defense system in the human organism.     

Alcohol and changes in the hematopoietic system; an epidemiological contribution to the problem of alcoholic anemia

In the course of the "Vienna Health Study 1979" 1261 males and 1548 females divided into 3 age categories (25, 40 and 60 years), were investigated for serum iron level, RBC, leucocytes, haemoglobin, haematocrit, MCH, MVC, MCHC, GOT, GPT and AP. These parameters were evaluated in correlation to the drinking habits of each proband. Significant correlations were found between alcohol consumption and serum iron (elevation in most cases), RBC (decrease), MCV (elevation) and GOT (elevation).     

Method for establishing serum ferritin reference values depending on sex and age

A method is described for the establishment of reference values for serum ferritin depending on sex and age. The results obtained in a stratified random sample of 353 healthy individuals from the Portuguese population revealed that 23% of the variation observed on serum ferritin values was related to sex differences and 6% of the variation was explained by age differences. Furthermore, the effect of age was different in both sexes: serum ferritin values increase with age in females over 40 years and in males under 40. The minimum and maximum reference values were established for the different subgroups of subjects as follows: for females under 40 years and males over 40, reference values were considered as the 2.5 and 97.5 percentiles from the adjusted lognormal distribution; for females over 40 years and males under 40, reference values were considered as the exponential transformation of the upper and lower limits of the 95% prediction intervals for the log of serum ferritin for each particular age point.     

年龄和性别与血清肝功能相关酶的关系探讨

目的探讨健康人群血清肝功能相关酶与年龄和性别的关系。方法依据个体的年龄和性别进行分组,通过全自动生化分析仪测定血清丙氨酸氨基转移酶(ALT)、天冬氨酸氨基转移酶(AST)、γ-谷氨酰转移酶(γ-GT)和碱性磷酸酶(ALP)活性。结果年龄和性别不同的群体,血清肝功能相关酶活性有所不同。对3～60岁之间相同年龄段的群体,男性血清ALT、AST和γ-GT活性均高于女性;男性血清ALP活性在50岁前高于女性,而50岁后低于女性。在3～60岁之间的相同性别群体,血清γ-GT活性随年龄增加而升高;血清ALT活性先随年龄增加而升高,40岁后随年龄增加而降低;AST和ALP活性随年龄增加会出现两次峰值。结论年龄和性别是影响血清肝功能相关酶活性的因素,血清肝功能相关酶的正常参考范围制定应考虑个体的年龄和性别差异。     

Determination of superoxide dismutase and glutathione peroxidase activities in blood of healthy pediatric subjects

BACKGROUND: Given the growing requirement of antioxidant enzymes measurements in laboratory and the increasing role of SOD/GPx ratio in the balance of reactive oxygen species (ROS), the aim of our study was to contribute to define reference values of enzyme activities in Italian healthy children, by determining SOD in erythrocytes and GPx in whole blood. METHODS: SOD (E.C.1.15.1.1) and GPx (E.C.1.11.1.9) activities were spectrophotometrically assayed in erythrocytes with commercial kits. SOD activity was expressed as the amount of protein causing a 50% inhibition of formazan dye (505 nm), employing xanthine and xanthine oxidase to generate superoxide radicals. Units of GPx activity were calculated following NADPH oxidation at 340 nm using cumene hydroperoxide as the substrate. RESULTS: Superoxide dismutase (SOD) and glutathione peroxidase (GPx) activities were assayed in blood of 45 healthy pediatric subjects (26 males and 19 females between 0 and 14 years of age). We found no significant differences in blood antioxidant enzymes both in all population and when we distributed the subjects for age classes and sex. CONCLUSION: the definition of pediatric values of antioxidant enzyme activities in blood of healthy children may be useful in monitoring SOD and GPx in physiologic and pathologic conditions, also for future therapeutic trials.     

Molecular exclusion electrophoresis of human serum lipoproteins: patterns in control and ischaemic heart-disease populations.

1. Electrophoresis of pre-stained lipoproteins on acrylamide-gel gradients has been carried out on serum from populations of control subjects and patients with ischaemic heart disease. The technique resolves components intermediate in position and, by inference, in size, between very-low-density and low-density lipoproteins. 2. These central band components were found in 37% of a control population but the incidence varied with age and sex, being lowest in young males and highest in elderly males. 3. The incidence of central band components in patients with ischaemic heart disease was 64% (males) and 71% (females), and the difference between these figures and those for matched control subjects was highly significant. The intensity of central band components in the group with ischaemic heart disease was significantly greater than in the control group. 4. The presence and intensity of central bands show positive correlation with serum cholesterol and triglyceride values, but many patients showing the phenomenon have normal lipid values. Of patients with ischaemic heart disease 31% showed central band components and had normal lipid values.     

Biological and pathological factors affecting plasma gamma-glutamyl transpeptidase and alkaline phosphatase activity in the elderly

A high percentage of abnormally elevated plasma alkaline phosphatase (AP) and gamma-glutamyltranspeptidase (GGT) was found in a homogeneous population of 741 elderly subjects. The respective role of pathological and biological factors (age, sex, weight) upon the two plasma enzymatic activities has been analyzed. In disagreement with previous reports, it was observed that abnormal AP and GGT values could be readily explained by their association with specific diseases. The apparent relationship between abnormal levels of plasma AP and GGT activities and age, sex or weight reflected merely a different distribution of the pathology according to these biological parameters. In the absence of non-specific elevations of plasma AP and GGT activities with age, the usual reference values for these tests, although established on younger populations, still apply to the aged.     

成都周边地区健康农民血脂水平参考值的研究

目的 确定本地区健康农民血脂项目的参考值及其临床意义。方法 对381名健康农民献血员血脂相关指标进行检测,将检测结果进行统计分析,建立其参考范围,与本实验室现行血脂参考范围进行比较。381名献血员按性别、年龄分组,观察其差异。结果 ①低密度脂蛋白（LDL）和载脂蛋白B（ApoB）与本实验室现行血脂参考值的差异较大。②按性别分组后,高密度脂蛋白（HDL）与载脂蛋白A（ApoA）的性别差异有统计学意义（P〈0.01）,其结果分别为,HDL：男性1.50±0.37mmol／L,女性：1.39±0.29mmol／L;ApoA：男性1.49±0.28（g/L）,女性1.40±0.19（g/L）。③按年龄段分组后,总胆固醇（Chol）在不同年龄段差异有统计学意义（P〈0.05）,其结果分别为：18～35岁4.48±0.73mmol／L,36～45岁4.92±0.90mmol／L,46～55岁5.08±0.95mmol／L。结论不同的区域和不同的人群有必要建立血脂项目的参考范围,对临床诊断和治疗有一定指导意义。     

Haematological laboratory findings in the elderly: influence of age and sex

The effects of age and sex on haematological laboratory parameters were studied in connection with a population study in people over the age of 65 years (n = 347). Serum vitamin B12 was the only parameter which decreased significantly with advancing age. Blood leucocyte count, haemoglobin concentration, haematocrit, erythrocyte count, mean erythrocyte volume, mean erythrocyte haemoglobin and serum ferritin values were significantly higher in males than in females. Serum iron, serum transferrin, and plasma and erythrocyte folate levels did not differ between males and females. Thirteen subjects were anaemic and three of them had iron deficiency anaemia. Five subjects had iron deficiency based on serum iron and transferrin but no anaemia. Serum ferritin measurement did not reveal any further subjects with iron deficiency. No case of folate deficiency anaemia was revealed. Although many of the participants were on medication, most of them were living at home and taking care of themselves and represent relatively fit elderly people. Therefore we suggest that these laboratory data can also serve as reference values for the elderly people.     

Sex- and age-related differences in bilirubin concentrations in serum

The relation between age and sex and the concentration of bilirubin in serum was evaluated in 6740 men and 11 215 women, ages 13 to 96 years. Mean serum bilirubin concentrations in the men significantly exceeded values in the women over all age groups examined. Further, mean serum bilirubin concentrations were greatest both in males and females in the 19-24 years age group and then declined to former values, which persisted throughout life. Pearson correlation coefficients for bilirubin with liver function indices (albumin and total protein) and with hemoglobin were low in all ages and in both sexes, suggesting that bilirubin concentrations do not correlate with those liver functions not directly concerned with bile pigment processing.     

Serum glutathione S-transferase activity in liver diseases

Assay conditions of human liver glutathione S-transferase and its activity in human serum from liver disease patients were investigated. One mmol/l reduced glutathione, and 1 mmol/l-1-chloro-2,4-dinitrobenzene, pH 6.5, were used for the measurement, because of the very low non-enzymatic conjugation. Glutathione S-transferase activity was inhibited by bilirubin, but this inhibition was counteracted by the presence of a low concentration of albumin. The normal human serum glutathione S-transferase activity was 5.2 +/- 2.4 I.U./l (mean +/- S.D.), and was not influenced by any differences of age, sex or leukocyte count. A significant increase in serum enzyme activity was noted in cases of acute hepatitis with GPT exceeding 200 I.U./l, primary hepatoma and metastatic liver cancer. Some of the cases with fulminant hepatitis showed extremely high values. The degree of correlation between serum glutathione S-transferase and GOT or GPT was high in acute hepatitis, with GOT or GPT exceeding 200 I.U./l, in fulminant hepatitis, primary hepatoma and gall stones, while in chronic hepatitis and liver cirrhosis it was low. In cases of acute hepatitis and fulminant hepatitis, the disappearance of serum glutathione S-transferase from the blood was much faster than that of GOT and GPT. Serum glutathione S-transferase measurements will provide new and unique information for the diagnosis of acute liver diseases.     

Creatinine clearance: indirect estimate (author's transl)]

The validity of some formulas proposed to estimate the creatunine clearance by values of serum creatinine and others non analytical parameters (sex, age, weight and height) was tested in a group of 200 adults (100 males and 100 females) and in a group of 134 children (80 males and 54 females). The age ranged from 1 month to 78 years; the values of serum creatinine varied from 0.3 to 10.0 mg/dl; the clearance value was calculated also in the usual way by the AutoAnalyzer (N-11 a Technicon method). The statistical analysis and the comparison of the data show good correlation between the clearance values calculated either by the direct or the indirect method. However the frequency of inacceptable disagreements does not allow the use of these formulas to evaluate the renal function and to regulate the administration of some drugs.     

呼和浩特地区不同年龄段HBV感染者血清抗体检测结果比较分析

目的 了解呼和浩特地区不同类型乙型肝炎病毒(HBV)血清抗体阳性模式者的年龄分布.方法 HBV既往或现症感染者4 662例,男性2 192例、女性2 470例,采用酶联免疫吸附法检测HBV血清抗体.结果 HBsAb阳性者男性主要分布在40～＜50岁人群(17.34%),女性以20～＜30岁人群为主(19.13%).HBsAb、HBcAb-IgG阳性者在男、女性均以40～＜50岁人群为主,分别占21.07%和21.94%.HBsAb、HBeAb、HBc-IgG阳性者在男性以30～＜40岁人群为主(22.11%),在女性以50～＜60岁人群为主(23.23%).HBc-IgG阳性者在男、女性均以40～＜50岁人群为主,分别占21.52%和22.65%.结论 呼和浩特地区HBV血清抗体阳性者以20～＜60岁人群为主.     

不同性别人群血清载脂蛋白M与高敏C反应蛋白相关性分析

目的研究健康人血清载脂蛋白M（apoM）和高敏C反应蛋白（hs-CRP）二者在不同性别之间的水平及相关性。方法采用酶联免疫吸附试验（ELISA）测定355名健康人群（男169名,女186名）血清apoM浓度,同时采用乳胶增强免疫比浊法测定血清hs-CRP浓度。分析二者在不同性别之间的水平和相关性。结果男性血清apoM水平[（1.16±0.84）μmol/L]稍低于女性[（1.30±0.90）μmol/L],hs-CRP水平[0.97（0.19～38.47）mg/L]稍高于女性[0.92（0.16～17.49）mg/L]。血清中hs-CRP与apo M呈明显负相关（r=-0.183,P=0.003）;女性apoM与hs-CRP之间呈明显负相关（r=-0.262,P=0.001）,男性二者之间相关性不明显（r=-0.021,P=0.833）。总体分析,apoM与年龄无明显相关性（r=0.085,P=0.134）;但男性血清apoM与年龄呈明显正相关（r=0.232,P=0.008）,而女性二者相关性不显著（r=-0.015,P=0.844）。结论 apoM与hs-CRP水平可能存在性别差异,二者之间的相关性及apoM与年龄的相关性和性别有关。apoM是一个负的炎性蛋白。     

Altered gamma-glutamyltransferase, aspartate aminotransferase, alanine aminotransferase and alkaline phosphatase serum activities in long-term anticonvulsive therapy--comparison of diphenylhydantoin and carbamazepine

In 110 patients receiving a long-term anticonvulsant monotherapy with Diphenylhydantoin (DPH) and Carbamazepine (CBZ) the serum activities of gamma-GT, ASAT, ALAT, and AP were examined retrospectively. Elevated serum levels of enzymes were seen predominantly concerning gamma-GT and AP. 91% resp. 39% of patients receiving DPH-therapy showed increased gamma-GT resp. AP-levels compared to 64% and 14% of gamma-GT and AP-elevations by CBZ-treatment. All enzymes evaluated were more often and higher elevated by DPH than CBZ. Frequency and extent of increased activity of gamma-GT were highly related to daily dosage in both preparations. The proportion of pathological enzyme levels was associated with age in DPH and CBZ as well but not found to be significant. Sex differences in the frequency of increased enzyme activities could not be demonstrated. The results are discussed in the context of induction of cytochrome P-450-system.     

间接法建立长春地区健康成人血清前清蛋白参考区间及与国内其他地区参考区间的比较

目的　采用间接法建立长春地区血清前清蛋白（prealbumin,PA）参考区间,并验证其适用性。方法　调取2020年6月～11月吉林大学第一医院实验室信息系统中14 003例健康体检者的PA检测结果。偏度-峰度检验分析数据正态性,杜奇法剔除离群值后入组13 772例,其中男性7 502例,女性6 270例。根据性别、年龄将受检者分组（男女各6组:18~30岁,31~40岁,41~50岁,51~60岁,61~70岁和＞70岁）,Z检验比较组间差异,非参数方法计算参考区间。将获得的参考区间与国内其他地区参考区间进行比较并验证。结果　男女PA差异有统计学意义（Z=77.48,Z*=22.72）。男性在70岁之后差异有统计学意义,其参考区间分别为230~400mg/L（18~70岁）,190~340mg/L（＞70岁）。女性无年龄差异,参考区间为190~320mg/L（18~89岁）。对建立的PA参考区间进行验证符合标准。结论　长春地区健康成人血清PA参考区间存在性别和年龄差异。间接法建立参考区间简便可行,适于临床实验室推广和应用。     

Time course of gamma glutamyl transpeptidase in the serum of low birth weight infants

The time course of gamma-glutamyl transpeptidase (GGTP) was traced during a number of weeks after birth in 31 apparently healthy low birth weight infants. Also glutamic-pyruvic transaminase (GPT), 5'-nucleotidase (5 'ND) and alkaline phosphatase (AP) were determined in most of the same samples.In many of the prematures, but not in all, the GGTP showed a transient elevation, reaching maximal levels up to 150 I.U. Most values of GPT and 5'ND, however, were within the normal range, whereas for AP rather large variations were found. No age dependency could be established for the appearance of the GGTP maximum; neither the period of its occurrence nor its height showed a correlation to birth weight and to the degree of prematurity. The significance of transient GGTP activity in prematures is discussed. The results of our investigations suggest that in such infants increased values of GGTP have to be interpreted very carefully.Other enzyme and chemical parameters have to be considered simultaneously in order to establish cholestatic liver disease.     

表面健康人群血清氨基末端B型钠尿肽原参考区间的调查

目的调查表面健康人群血清氨基末端B型钠尿肽原（NT-proBNP）的参考区间。方法参照美国临床实验室标准化委员会（NCCLS）C28-A2文件对德灵公司D imension X-PAND生化分析仪及NT-proBNP原装配套试剂（简称X-PAND NT-proBNP检测系统）的性能进行验证和评价。检测261名表面健康人群（男127名、女134名）的NT-proBNP水平,通过Z检验,按照性别分组,以第95百分位数分别建立男、女的参考区间。结果X-PANDNT-proBNP检测系统性能良好,符合临床要求。NT-proBNP随着年龄的增长呈上升趋势,且女性的水平明显高于男性。检测结果呈偏态分布,〈75岁男性的参考区间为〈64.4 ng/L,〈75岁女性的参考区间为〈122.4 ng/L。结论对于存在明显种族差异、生物变异的检测项目,每个实验室应参照NCCLS C28-A2对参考区间进行调查或采取纠正措施。建立合适的NT-proBNP参考区间对心力衰竭的诊断、鉴别诊断及预后分析具有临床应用价值。     

Early Estimation of Myocardial Damage in Conscious Dogs and Patients with Evolving Acute Myocardial Infarction

To estimate the ultimate extent of myocardial damage during evolving myocardial infarction in conscious dogs and patients, we analyzed early serum creatine phosphokinase (CPK) changes with nonlinear curve-fitting techniques. In experiments with dogs, serial serum CPK changes were fit to a log-normal function by the least squares method; the extent of the completed infarct was calculated by analysis of observed serum CPK changes and verified by measurement of myocardial CPK depletion 24 h after coronary occlusion. Early prediction of myocardial damage was based on projected serum CPK values from best fit curves based on data obtained during the first 5 h after initial elevation of enzyme activity. The correlation between predicted and observed values was close (r > 0.96, n = 11). In 11 additional conscious animals subjected to coronary occlusion, isoproterenol was administered continuously as soon as damage had been estimated from projected serum CPK values. The extent of the completed infarct was assessed by analysis of all serial serum CPK values and verified by analysis of myocardial CPK depletion 24 h after coronary occlusion. In each experiment the calculated completed infarct size exceeded infarct size projected before administration of isoproterenol (average increase = 44±10 [SE]%). When similar calculations were applied in experiments with eight dogs treated with propranolol, myocardial salvage was detected in 50% of the animals.