CLINICAL BIOCHEMISTRY临床生物化学
CLINICAL BIOCHEMISTRY(英文缩写 CLIN BIOCHEM),ISSN 0009-9120,eISSN 1873-2933,中文译名:临床生物化学 是一本学术期刊。本页汇总该期刊的最新影响因子、分区信息以及最新收录于 PubMed 的文献,帮助您快速了解期刊全貌。
发文量统计区间：2025-09-27 至 2026-09-27，按本站收录文献的发表日期统计。
期刊介绍
历年影响因子趋势
| JCR 数据年份 | 影响因子 | JCR 分区 |
|---|---|---|
| 2021 | 3.625 | Q2 |
| 2022 | 2.800 | Q2 |
| 2023 | 2.500 | Q2 |
| 2024 | 2.100 | Q2 |
| 2025 | 2.300 | Q2 |
CLINICAL BIOCHEMISTRY 最新收录文献
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1. Intraoperative PTH monitoring during parathyroid surgery: when 10 minutes is not enough-Can delayed decline be predicted?
PMID:日期:2026-10-01A substantial proportion of patients undergoing focused parathyroidectomy fail to meet the "≥50% intraoperative parathyroid hormone (ioPTH) drop" criterion at 10 min despite ultimately achieving biochemical cure. This study aimed to determine the frequency of delayed ioPTH decline and associated factors. We conducted a retrospective cohort study including patients with primary hyperparathyroidism undergoing successful parathyroidectomy for uniglandular disease with ioPTH monitoring between 2017 and 2023. Blood samples were obtained at baseline, 5, 10, and 15-20 min after gland excision. Additional measurements beyond 20 min were collected at the surgeon's discretion. Delayed responders (DR) were defined as patients achieving a ≥ 50% ioPTH decrease from the pre-incision baseline later than 10 min. Univariable analyses and multivariable Firth-penalized logistic regression identified predictors of delayed response. A total of 190 patients were included. A ≥ 50% ioPTH decline was achieved at 10 min in 160/190 patients (84.2%), whereas 30/190 (15.8%) were classified as DR. Of these, 22/190 (11.6%) met the criterion at 15-20 min and 8/190 (4.2%) beyond 20 min. Half of DR exhibited a 10-min ioPTH decline within the 40.0%-49.9% range. A manipulation-induced 5-min ioPTH spike occurred exclusively among DR (44.8% vs 0%; p < 0.001). Baseline ioPTH <100 pg/mL (10.6 pmol/L) was also strongly associated with delayed biochemical decline (50.0% vs 12.2%; p = 0.0003). Both factors remained significant in multivariable analysis. One in six patients undergoing successful parathyroidectomy exhibited a delayed biochemical response. Low baseline ioPTH levels and manipulation-induced PTH spikes were strong independent predictors. Careful interpretation of early ioPTH kinetics and delayed sampling, particularly after a substantial but insufficient 10-min decline, may reduce unnecessary bilateral neck exploration in selected patients.
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2. Unexpected increase in false-positive results following benzodiazepine immunoassay reformulation.
PMID:日期:2026-10-01Benzodiazepine immunoassays are commonly used for urine drug screening but have historically demonstrated poor detection of glucuronidated metabolites, resulting in false-negative results. A reformulated Roche benzodiazepine immunoassay (BNZ2) incorporating β-glucuronidase was developed to improve detection of glucuronidated benzodiazepines. This study evaluated the impact of BNZ2 implementation on false-positive rates in a tertiary medical center. A retrospective observational study compared urine benzodiazepine screening results from 12 months before and after BNZ2 implementation. Screening was performed using Roche BENZ Plus or BNZ2 reagents on the Roche Cobas Pro c503 analyzer. Presumptive positive results underwent reflex confirmatory testing by liquid chromatography-tandem mass spectrometry (LC-MS/MS). Amphetamine screening served as an internal control. With BENZ Plus, 363/4513 (8.0%) screens were presumptive positive, compared with 827/4665 (17.7%) following BNZ2 implementation. Confirmatory testing demonstrated false-positive rates of 1.2-1.5% with BENZ Plus and 5.9-7.8% with BNZ2 (p < 0.001). Medication review for patients with false-positive samples identified some common prescriptions but could not identify a causal agent. Amphetamine false-positive rates remained stable across periods (16.2% vs 16.3%, p > 0.05). Following BNZ2 implementation, lorazepam became the most frequently confirmed benzodiazepine (36.7%, n = 269), with substantial increases in lorazepam-only positive samples. BNZ2 reformulation improved detection of glucuronidated benzodiazepines, particularly lorazepam, but was associated with a significant increase in false-positive results. In this population, 1 in 8 additional presumptive positive samples on BNZ2 was a false positive. These findings demonstrate a trade-off between improved analytical sensitivity and reduced specificity, resulting in increased confirmatory testing requirements and potential downstream effects on laboratory workflow and clinical decision-making.
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3. Implementation of rules for the estimation of compensatory responses in acid-base analysis: A review and proposal for laboratory practice.
PMID:日期:2026-10-01Acid-base homeostasis is essential for cellular and systemic function. Its maintenance requires tightly regulated compensatory mechanisms capable of correcting disturbances that threaten physiological balance, as dysregulation can be life-threatening. When a primary metabolic disturbance occurs and alters bicarbonate concentration (HCO₃), the main compensatory mechanism is a respiratory response that adjusts the partial pressure of carbon dioxide (PCO₂). Conversely, a primary respiratory disturbance, whether acute or chronic, leads to changes in PCO₂, and compensatory response occurs through a metabolic response that modifies HCO₃ levels. Mixed disturbances are also common and may represent a diagnostic challenge in clinical practice. To assess acid-base status, clinical laboratories use blood gas analyzers, which provide information to identify metabolic, respiratory, or mixed disorders. Several formulas are available to estimate the compensatory response according to the primary disturbance. These formulas take into account parameters such as PCO₂, actual bicarbonate (HCO₃c), and standard base excess, all of which are reported in blood gas analysis. The implementation of expert rules within Laboratory Information Systems or Clinical Decision Support tools, which automatically apply these formulas, could facilitate the evaluation of whether compensatory response is appropriate or if a mixed disorder is present, potentially improving the diagnostic accuracy of blood gas analysis and adding value to laboratory reports. This review summarizes the main approaches described in the literature and proposes a standardized procedure to incorporate the study of compensatory mechanisms into the interpretation of acid-base disorders, with the aim of improving diagnostic accuracy and supporting clinicians in patient management.
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4. Short-term storage of pediatric cerebrospinal fluid and serum requires standardized handling to preserve neurological injury biomarker stability.
4. 儿科脑脊液和血清的短期储存需要标准化处理，以保持神经损伤生物标志物的稳定性PMID:日期:2026-10-01Neuron-specific enolase (NSE), S100 protein, and β2-microglobulin (B2M) are neurological biomarkers used to support early assessment of brain injury in neonatal and pediatric neurological disorders. Their clinical utility depends on pre-analytical conditions and may be affected by routine storage when immediate analysis or ultra-low temperature freezing is unavailable, potentially affecting interpretation. 74 CSF and 70 serum samples from 36 pediatric patients were analyzed at baseline and after storage under room temperature, +4 °C, -20 °C, -80 °C, and mixed freezing conditions. Storage times ranged from 12 h to 10 days, with primary analyses focused on the first 72 h. Biomarker variation was expressed as percentage change and interpreted according to predefined maximum permissible error (MPE) thresholds. CSF and serum were analyzed separately to assess matrix-dependent effects. CSF NSE decreased progressively at +4 °C (-4.5% to -10.9% up to 72 h) and showed a reduction of -61.3% after 24 h at -20 °C. Serum NSE decreased at +4 °C (-4.75% to -12.3%) and showed limited variation after -20 °C storage (-5.4%). CSF S100 decreased at +4 °C (-3.1% to -8.6%) and more markedly at room temperature (up to -36.6% at 72 h), while serum S100 showed decreases at +4 °C (up to -12.3%) and no relevant instability under freezing conditions. B2M concentrations remained within predefined MPE thresholds in both CSF and serum under all storage conditions. Short-term storage conditions significantly influence neurological biomarker concentrations in a biomarker- and matrix-dependent manner. These findings support standardized pre-analytical handling in pediatric neurological biomarker assessment, as variability may affect clinical interpretation and patient management.
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5. β2-microglobulin, not muscle mass, accounts for the association between eGFR discordance and mortality in CKD.
PMID:日期:2026-10-01Introduction The discordance between cystatin C- and creatinine-based eGFR (eGFRdiff) predicts mortality in CKD, but what this index actually reflects remains unclear. We examined the relative contributions of several biomarkers, representing muscle mass, middle-molecule retention, cardiac injury, inflammation, and physical function, to the eGFR-mortality association in a nationally representative US population. Materials and Methods We analyzed 1503 adults with CKD stages 1-4 from NHANES 1999-2004 with mortality follow-up through 2019. The exposure was percentage eGFR. Survey-weighted Cox models estimated HRs for mortality. Attenuation analyses quantified the contribution of each candidate biomarker. Residualization analyses decomposed the B2M signal by adjusting for creatinine-based, cystatin C-based, and combined eGFR estimates separately. Results 911 all-cause and 313 cardiovascular deaths occurred. Each 1-SD more negative eGFR was associated with higher all-cause (HR 1.29; 95%CI 1.15-1.46) and cardiovascular mortality (HR 1.46; 95%CI 1.23-1.72). DXA-derived muscle mass yielded negligible attenuation (1.3%), and physical limitation produced modest attenuation (11.2%). In contrast, B2M produced the largest attenuation (73.4%), followed by hs-cTnT (32.0%) and NT-proBNP (23.0%). Residualization on eGFR preserved the B2M attenuation (80.1%), whereas residualization on eGFR abolished it (-7.9%). B2M residualized on eGFR retained 21.9% attenuation. Conclusions Middle-molecule retention (represented by B2M), not muscle mass, is the primary contributor to the prognostic value of eGFR, with cardiac biomarkers contributing secondarily. Residualization patterns support a biological signal consistent with shrunken pore syndrome rather than a mathematical artifact of how eGFR is estimated. Calculable from routine assays, eGFR may offer a practical indicator of middle-molecule burden and cardiac stress for CKD risk stratification.
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6. Reference intervals for plasma renin and aldosterone concentrations in healthy normotensive multi-ethnic Malaysian adults using DiaSorin chemiluminescent immunoassay.
PMID:日期:2026-10-01Accurate interpretation of plasma renin concentration (PRC) and plasma aldosterone concentration (PAC) requires population-specific reference intervals, which remain scarce in Southeast Asian populations. Manufacturer-derived reference intervals are based predominantly on Western cohorts and may not be directly applicable to regional populations. This cross-sectional study recruited 300 healthy, normotensive, non-obese adults (149 males, 151 females; mean age 34.4 ± 10.7 years) from a multi-ethnic Malaysian cohort in Sarawak to establish reference intervals for PAC and PRC. Strict exclusion criteria were applied to minimize confounding from medications, smoking, obesity, renal dysfunction, and hypokalemia. PAC and PRC were measured under standardized seated morning conditions using the DiaSorin Liaison® XL chemiluminescent immunoassay (CLIA). Reference intervals were derived using the IFCC-recommended non-parametric method, with sex- and age-stratified analyses. The reference intervals were 2.13-30.1 ng/dL (2.5th to 97.5th percentile) for PAC (range 1.25-42.30 ng/dL) and 7.4-66.4 μIU/mL (5th to 95th percentile) for PRC (range 1.31-107.80 μIU/mL). Participants aged ≥40 years had significantly lower PAC and PRC than younger participants. On multivariable regression analysis, PAC was independently associated with serum potassium and estimated 24-h urine sodium excretion, whereas PRC was independently associated with age, sex, systolic blood pressure, and estimated 24-h urinary sodium excretion. No significant difference in PAC and PRC was observed across ethnic groups. We report the first platform-specific, sex- and age-stratified reference intervals for PAC and PRC in a healthy Southeast Asian population using the DiaSorin Liaison® XL CLIA platform. The derived intervals differed from manufacturer-provided values, highlighting the importance of locally validated reference data for accurate interpretation of RAAS biomarkers and clinical evaluation of endocrine and hypertensive disorders.
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10. Reference interval evolution: what moving to the 99th percentile looks like for a comprehensive metabolic panel in an outpatient setting.
PMID:日期:2026-10-01In clinical laboratory practice, reference intervals (RIs) for chemistry analytes are commonly adopted directly from manufacturer package inserts. These intervals are typically verified locally according to regulatory requirements rather than independently derived, under the assumption that manufacturer-reported RIs are broadly applicable across patient populations. In low pre-test probability settings such as routine outpatient testing or wellness testing, this approach can generate a high frequency of flagged abnormalities that more likely reflects biological variation rather than disease. Expanding RIs to the central 99% has been proposed as a strategy to improve specificity. The 99% RIs were derived for CMP analytes using retrospective data from 23,422 unique adult outpatients tested at a single institution in September 2025. Results were compared with 95% RIs and manufacturer-provided RIs across analytes. Flagging performance was evaluated using an independent retrospective dataset of 28,006 adult outpatients tested between December 2025 and January 2026. Analyses focused on the proportion of results flagged outside each RI. Electrolytes, including sodium, chloride, calcium, and CO₂, showed minimal differences in flagging between manufacturer RIs and 99%-derived intervals, with differences consistently under 7%. In contrast, kidney and liver analytes demonstrated substantial variability. Manufacturer RIs flagged a markedly higher proportion of results outside the interval for creatinine, AST, ALT, ALP, BUN, potassium, and total protein compared with the 99% approach. Electrolyte RIs are consistent across manufacturer-provided RIs and population-derived 99% intervals. In contrast, kidney and liver analytes show pronounced differences between historical package insert RIs and contemporary percentile-based distributions, resulting in substantial variation in abnormal result flagging. These findings highlight the impact of using alternate approaches to derive our kidney and liver RIs.