Theis S Itenov1, Nikolai S Kirkby2, Morten H Bestle3, Anna C Nilsson4, Erland J Erlandsen5, Lars Peters6, Jens-Ulrik Jensen6,7. 1. Department of Anesthesiology, Nordsjaellands Hospital, University of Copenhagen, Copenhagen, Denmark. Theis.skovsgaard.itenov@regionh.dk. 2. Department of Medical Microbiology, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark. 3. Department of Anesthesiology, Nordsjaellands Hospital, University of Copenhagen, Copenhagen, Denmark. 4. Department of Clinical Immunology, Odense University Hospital, Denmark. 5. Department of Clinical Biochemistry, Viborg Regional Hospital, Viborg, Denmark. 6. Department of Infectious Diseases and Rheumatology, Rigshospitalet, University of Copenhagen, CHIP, Finsencentret, Copenhagen, Denmark. 7. Department of Clinical Microbiology, Hvidovre Hospital, Hvidovre, Denmark.
Abstract
BACKGROUD: Hyaluronic acid (HA) is proposed as a marker of functional liver capacity. The aim of the present study was to compare a new turbidimetric assay for measuring HA with the current standard method. METHODS: HA was measured by a particle-enhanced turbidimetric immunoassay (PETIA) and enzyme-linked immunosorbent assay (ELISA) in a 40-sample dilution series and 39 intensive care unit (ICU) patients. Agreement was assessed with Bland-Altman's method. RESULTS: In the ICU patients, the median HA concentration was 159.0 ng/ml (interquartile range (IQR) 117.5-362.5 ng/ml) with ELISA and 157.5 ng/ml (IQR 92.5-359.6 ng/ml) with PETIA. The mean difference was 12.88 ng/ml (95% CI, -4.3 to 30.1 ng/ml, P = 0.14) and the 95% limits of agreement were -91.17 to 116.9 ng/ml. In the dilution series, the mean difference was -59.26 ng/ml (95% CI, -74.68 to 43.84 ng/ml, P < 0.0001) and the 95% limits of agreement were 35.23 to -153.8 ng/ml. CONCLUSION: We found random variation between the PETIA and ELISA test that could affect performance in a clinical context, but only to a lesser extent in a research context. The new clinical biochemistry assay for HA determination will allow for large studies of the clinical utility of HA.
BACKGROUD: Hyaluronic acid (HA) is proposed as a marker of functional liver capacity. The aim of the present study was to compare a new turbidimetric assay for measuring HA with the current standard method. METHODS: HA was measured by a particle-enhanced turbidimetric immunoassay (PETIA) and enzyme-linked immunosorbent assay (ELISA) in a 40-sample dilution series and 39 intensive care unit (ICU) patients. Agreement was assessed with Bland-Altman's method. RESULTS: In the ICU patients, the median HA concentration was 159.0 ng/ml (interquartile range (IQR) 117.5-362.5 ng/ml) with ELISA and 157.5 ng/ml (IQR 92.5-359.6 ng/ml) with PETIA. The mean difference was 12.88 ng/ml (95% CI, -4.3 to 30.1 ng/ml, P = 0.14) and the 95% limits of agreement were -91.17 to 116.9 ng/ml. In the dilution series, the mean difference was -59.26 ng/ml (95% CI, -74.68 to 43.84 ng/ml, P < 0.0001) and the 95% limits of agreement were 35.23 to -153.8 ng/ml. CONCLUSION: We found random variation between the PETIA and ELISA test that could affect performance in a clinical context, but only to a lesser extent in a research context. The new clinical biochemistry assay for HA determination will allow for large studies of the clinical utility of HA.
Authors: Jens U Jensen; Lars Hein; Bettina Lundgren; Morten H Bestle; Thomas T Mohr; Mads H Andersen; Klaus J Thornberg; Jesper Løken; Morten Steensen; Zoe Fox; Hamid Tousi; Peter Søe-Jensen; Anne Ø Lauritsen; Ditte Strange; Pernille L Petersen; Nanna Reiter; Søren Hestad; Katrin Thormar; Paul Fjeldborg; Kim M Larsen; Niels E Drenck; Christian Ostergaard; Jesper Kjær; Jesper Grarup; Jens D Lundgren Journal: Crit Care Med Date: 2011-09 Impact factor: 7.598