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Comparison between bone alkaline phosphatase immunoassay and electrophoresis technique in hemodialysis patients

Poređenje imunohemijske metode i elektroforetske tehnike za određivanje koštanog izoenzima alkalne fosfataze kod pacijenata na hemodijalizi

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COMPARISON_BETWEEN_BONE_pub_2020.pdf (403.4Kb)
Authors
Milinković, Neda
Sarić-Matutinović, Marija
Pejanović, Svetlana
Ignjatović, Svetlana
Article (Published version)
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Abstract
Background: Problem of the variability between the different methods using for bone alkaline phosphatase(bALP) determination greately influences the clinical significance of bALP as direct marker of bone metabolism.The aim of this study was to compare immunoassay with electrophoresis technique for bALP determination. Methods: We measured bALP in 71 patients on hemodialysis with agar gel electrophoresis (ISO-PAL, SEBIA) and immunoassay (OSTASE, Beckman Coulter).Results: The analyzed methods showed significant correlation (Spearman’s rho: 0.776, P < 0.01), but we found statistically significant (P < 0.01) positive bias (27%)for the results measured by immunoassay. In support of this, using electrophoresis technique we have detected presence of the intestinal isoenzymes of alkaline phosphatase in 55% of patients with median value of 30% of the total alkaline phoshatase and presence of liver-2 alkaline phosphatase... isoform in 42% of patients with median value of 16.6%. The Kendall’s W of 0.787 (P<0.0001) revealed significant concordance between two analysed methods.Cusum test showed no significant deviation from linearity(P=0.850).Conclusions:Despite good agreement between immunoassay methods and electrophoresis technique for bALP determination, interchangeability between these two methods is questionable. Although immunoassays are increasingly used, as fully automated methods, in a large number of laboratories and become routine methods for bALP determination, it should be beared in mind, besidesvarious interferences, also the heterogeneity of the bALP itself, especially in patients on hemodialysis.

Uvod: Problem varijabilnosti između različitih metoda pomoću kojih se određuje koštani izoezim alkalne fosfataze (bALP) u velikoj meri utiče na klinički značaj bALP kao direktnog markera metabolizma kostiju. Cilj ove studije bio je poređenje imunohemijskog testa sa elektroforetskom tehnikom za određivanje bALP. Metode: bALP je određen kod 71 pacijenta na hemodijalizi, agar gel elektroforetskom tehnikom (ISO-PAL, SEBIA) i imunohemijskom metodom (OSTASE, Beckman Coulter). Rezultati: Analizirane metode pokazale su značajno slaganje (Spearmanov rho: 0,776, P < 0,01), ali je uočen statistički značajan (P < 0,01) pozitivan bias (27%) za rezultate izmerene imunohemijskom metodom. U prilog ovome, primenom elektroforetske tehnike, otkrili smo prisustvo intestinalnih izoenzima alkalne fosfataze u 55% bolesnika, sa srednjom vrednosti od 30% ukupne alkalne fostataze, kao i prisustvo jetrenih izoformi alkalne fosfataze kod 42% bolesnika sa srednjom vrednosti od 16,6%. Kendall-ov W od 0,787 (P < 0,0...001) ukazivao je na značajno slaganje između dve analizirane metode. Cusumov test nije pokazao značajno odstupanje od linearnosti (P = 0,850). Zaključak: Uprkos tome što postoji dobro slaganje između imunohemijske metode i elektroforetske tehnike za određivanje bALP-a, međusobna zamenjivost ove dve metode je pod znakom pitanja. Iako se imunohemijske metode sve više koriste kao potpuno automatizovane, u velikom broju laboratorija i postaju rutinske metode za određivanje bALP-a, treba imati na umu, osim različitih interferencija, i heterogenost samog bALP, posebno kod bolesnika na hemodijalizi.

Keywords:
bone alkaline phosphatase / electrophoresis / hemodialysis / immunoassay / koštana alkalna fosfataza / elektroforeza / hemodijaliza / imunoodređvanje
Source:
Journal of Medical Biochemistry, 2020, 39, 2, 178-183
Publisher:
  • Beograd : Društvo medicinskih biohemičara Srbije
Funding / projects:
  • Biomarkers of organ damage and dysfunction (RS-175036)

DOI: 10.2478/jomb-2019-0048

ISSN: 1452-8258

WoS: 000543793500007

Scopus: 2-s2.0-85074233662
[ Google Scholar ]
URI
https://farfar.pharmacy.bg.ac.rs/handle/123456789/3617
Collections
  • Radovi istraživača / Researchers’ publications
Institution/Community
Pharmacy
TY  - JOUR
AU  - Milinković, Neda
AU  - Sarić-Matutinović, Marija
AU  - Pejanović, Svetlana
AU  - Ignjatović, Svetlana
PY  - 2020
UR  - https://farfar.pharmacy.bg.ac.rs/handle/123456789/3617
AB  - Background: Problem  of  the  variability  between  the different  methods  using  for  bone  alkaline  phosphatase(bALP)  determination  greately  influences  the  clinical significance of bALP as direct marker of bone metabolism.The  aim  of  this  study  was  to  compare  immunoassay  with electrophoresis technique for bALP determination.  Methods: We  measured  bALP  in  71  patients  on  hemodialysis with agar gel electrophoresis (ISO-PAL, SEBIA) and immunoassay (OSTASE, Beckman Coulter).Results: The   analyzed   methods   showed   significant correlation  (Spearman’s  rho:  0.776,  P  <  0.01),  but  we found statistically significant (P < 0.01) positive bias (27%)for  the  results  measured  by  immunoassay.  In  support  of this,  using  electrophoresis  technique  we  have  detected presence  of  the  intestinal  isoenzymes  of  alkaline  phosphatase in 55% of patients with median value of 30% of the total  alkaline  phoshatase  and  presence  of  liver-2  alkaline phosphatase isoform in 42% of patients with median value of 16.6%. The Kendall’s W of 0.787 (P<0.0001) revealed significant  concordance  between  two  analysed  methods.Cusum  test  showed  no  significant  deviation  from  linearity(P=0.850).Conclusions:Despite  good  agreement  between  immunoassay  methods  and  electrophoresis  technique  for  bALP determination,  interchangeability  between  these  two methods  is  questionable.  Although  immunoassays  are increasingly  used,  as  fully  automated  methods,  in  a  large number  of  laboratories  and  become  routine  methods  for bALP determination, it should be beared in mind, besidesvarious  interferences,  also  the  heterogeneity  of  the  bALP itself, especially in patients on hemodialysis.
AB  - Uvod: Problem varijabilnosti između različitih metoda pomoću kojih se određuje koštani izoezim alkalne fosfataze (bALP) u velikoj meri utiče na klinički značaj bALP kao direktnog markera metabolizma kostiju. Cilj ove studije bio je poređenje imunohemijskog testa sa elektroforetskom tehnikom za određivanje bALP. Metode: bALP je određen kod 71 pacijenta na hemodijalizi, agar gel elektroforetskom tehnikom (ISO-PAL, SEBIA) i imunohemijskom metodom (OSTASE, Beckman Coulter). Rezultati: Analizirane metode pokazale su značajno slaganje (Spearmanov rho: 0,776, P < 0,01), ali je uočen statistički značajan (P < 0,01) pozitivan bias (27%) za rezultate izmerene imunohemijskom metodom. U prilog ovome, primenom elektroforetske tehnike, otkrili smo prisustvo intestinalnih izoenzima alkalne fosfataze u 55% bolesnika, sa srednjom vrednosti od 30% ukupne alkalne fostataze, kao i prisustvo jetrenih izoformi alkalne fosfataze kod 42% bolesnika sa srednjom vrednosti od 16,6%. Kendall-ov W od 0,787 (P < 0,0001) ukazivao je na značajno slaganje između dve analizirane metode. Cusumov test nije pokazao značajno odstupanje od linearnosti (P = 0,850). Zaključak: Uprkos tome što postoji dobro slaganje između imunohemijske metode i elektroforetske tehnike za određivanje bALP-a, međusobna zamenjivost ove dve metode je pod znakom pitanja. Iako se imunohemijske metode sve više koriste kao potpuno automatizovane, u velikom broju laboratorija i postaju rutinske metode za određivanje bALP-a, treba imati na umu, osim različitih interferencija, i heterogenost samog bALP, posebno kod bolesnika na hemodijalizi.
PB  - Beograd : Društvo medicinskih biohemičara Srbije
T2  - Journal of Medical Biochemistry
T1  - Comparison between bone alkaline phosphatase immunoassay and electrophoresis technique in hemodialysis patients
T1  - Poređenje imunohemijske metode i elektroforetske tehnike za određivanje koštanog izoenzima alkalne fosfataze kod pacijenata na hemodijalizi
VL  - 39
IS  - 2
SP  - 178
EP  - 183
DO  - 10.2478/jomb-2019-0048
ER  - 
@article{
author = "Milinković, Neda and Sarić-Matutinović, Marija and Pejanović, Svetlana and Ignjatović, Svetlana",
year = "2020",
abstract = "Background: Problem  of  the  variability  between  the different  methods  using  for  bone  alkaline  phosphatase(bALP)  determination  greately  influences  the  clinical significance of bALP as direct marker of bone metabolism.The  aim  of  this  study  was  to  compare  immunoassay  with electrophoresis technique for bALP determination.  Methods: We  measured  bALP  in  71  patients  on  hemodialysis with agar gel electrophoresis (ISO-PAL, SEBIA) and immunoassay (OSTASE, Beckman Coulter).Results: The   analyzed   methods   showed   significant correlation  (Spearman’s  rho:  0.776,  P  <  0.01),  but  we found statistically significant (P < 0.01) positive bias (27%)for  the  results  measured  by  immunoassay.  In  support  of this,  using  electrophoresis  technique  we  have  detected presence  of  the  intestinal  isoenzymes  of  alkaline  phosphatase in 55% of patients with median value of 30% of the total  alkaline  phoshatase  and  presence  of  liver-2  alkaline phosphatase isoform in 42% of patients with median value of 16.6%. The Kendall’s W of 0.787 (P<0.0001) revealed significant  concordance  between  two  analysed  methods.Cusum  test  showed  no  significant  deviation  from  linearity(P=0.850).Conclusions:Despite  good  agreement  between  immunoassay  methods  and  electrophoresis  technique  for  bALP determination,  interchangeability  between  these  two methods  is  questionable.  Although  immunoassays  are increasingly  used,  as  fully  automated  methods,  in  a  large number  of  laboratories  and  become  routine  methods  for bALP determination, it should be beared in mind, besidesvarious  interferences,  also  the  heterogeneity  of  the  bALP itself, especially in patients on hemodialysis., Uvod: Problem varijabilnosti između različitih metoda pomoću kojih se određuje koštani izoezim alkalne fosfataze (bALP) u velikoj meri utiče na klinički značaj bALP kao direktnog markera metabolizma kostiju. Cilj ove studije bio je poređenje imunohemijskog testa sa elektroforetskom tehnikom za određivanje bALP. Metode: bALP je određen kod 71 pacijenta na hemodijalizi, agar gel elektroforetskom tehnikom (ISO-PAL, SEBIA) i imunohemijskom metodom (OSTASE, Beckman Coulter). Rezultati: Analizirane metode pokazale su značajno slaganje (Spearmanov rho: 0,776, P < 0,01), ali je uočen statistički značajan (P < 0,01) pozitivan bias (27%) za rezultate izmerene imunohemijskom metodom. U prilog ovome, primenom elektroforetske tehnike, otkrili smo prisustvo intestinalnih izoenzima alkalne fosfataze u 55% bolesnika, sa srednjom vrednosti od 30% ukupne alkalne fostataze, kao i prisustvo jetrenih izoformi alkalne fosfataze kod 42% bolesnika sa srednjom vrednosti od 16,6%. Kendall-ov W od 0,787 (P < 0,0001) ukazivao je na značajno slaganje između dve analizirane metode. Cusumov test nije pokazao značajno odstupanje od linearnosti (P = 0,850). Zaključak: Uprkos tome što postoji dobro slaganje između imunohemijske metode i elektroforetske tehnike za određivanje bALP-a, međusobna zamenjivost ove dve metode je pod znakom pitanja. Iako se imunohemijske metode sve više koriste kao potpuno automatizovane, u velikom broju laboratorija i postaju rutinske metode za određivanje bALP-a, treba imati na umu, osim različitih interferencija, i heterogenost samog bALP, posebno kod bolesnika na hemodijalizi.",
publisher = "Beograd : Društvo medicinskih biohemičara Srbije",
journal = "Journal of Medical Biochemistry",
title = "Comparison between bone alkaline phosphatase immunoassay and electrophoresis technique in hemodialysis patients, Poređenje imunohemijske metode i elektroforetske tehnike za određivanje koštanog izoenzima alkalne fosfataze kod pacijenata na hemodijalizi",
volume = "39",
number = "2",
pages = "178-183",
doi = "10.2478/jomb-2019-0048"
}
Milinković, N., Sarić-Matutinović, M., Pejanović, S.,& Ignjatović, S.. (2020). Comparison between bone alkaline phosphatase immunoassay and electrophoresis technique in hemodialysis patients. in Journal of Medical Biochemistry
Beograd : Društvo medicinskih biohemičara Srbije., 39(2), 178-183.
https://doi.org/10.2478/jomb-2019-0048
Milinković N, Sarić-Matutinović M, Pejanović S, Ignjatović S. Comparison between bone alkaline phosphatase immunoassay and electrophoresis technique in hemodialysis patients. in Journal of Medical Biochemistry. 2020;39(2):178-183.
doi:10.2478/jomb-2019-0048 .
Milinković, Neda, Sarić-Matutinović, Marija, Pejanović, Svetlana, Ignjatović, Svetlana, "Comparison between bone alkaline phosphatase immunoassay and electrophoresis technique in hemodialysis patients" in Journal of Medical Biochemistry, 39, no. 2 (2020):178-183,
https://doi.org/10.2478/jomb-2019-0048 . .

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