Clinical Chemistry Podcast

Mendelian randomization is a genetic epidemiological approach that is made substantial inroads into our understanding of the causes and consequences of disease, but can that same technique be run in reverse? In the March 2019 issue of Clinical Chemistry, a paper investigated potential blood markers of early chronic kidney disease which are caused by loss of kidney function, using an innovative reverse Mendelian randomization approach. That same issue included an editorial that was authored by Dr. Michael Holmes from the University of Oxford and by Dr. George Davey Smith from the University of Bristol, both from the United Kingdom and both are our guests in this podcast.

Polycystic ovary syndrome is a complex endocrine-mediated disorder in women with an estimated prevalence of about 10%. Women with PCOS typically present with heterogeneous clinical signs and symptoms such as excess hair growth, irregular menstrual cycles, infertility and metabolic issues. Currently, there are no universal criteria for diagnosis of this condition and as a result, women with the disorder often reports significant delays in diagnosis and poor follow-up care. A Q&A feature in the March 2019 issue of Clinical Chemistry asked five experts with different roles in this field to discuss recent advances and ongoing challenges surrounding the current diagnostic criteria, available biomarkers, and the timely diagnosis and management of women with polycystic ovary syndrome.

Identifying markers of chronic kidney disease that occur early in the disease process and are specific to loss of kidney function may allow timely more accurate identification of patients who will eventually develop the disease. In the March 2019 issue of Clinical Chemistry, a paper investigated potential blood markers of early chronic kidney disease which are caused by loss of kidney function using an innovative reverse Mendelian randomization approach.

Glomerular filtration rate, or GFR, is generally accepted as the best overall index of kidney function, and a decrease in GFR has important implications for prognosis in patient management.  GFR is most commonly estimated by calculation, using the serum concentration of an endogenous filtration marker such as creatinine and demographic variables such as age, sex, and race.  In the March 2019 issue of Clinical Chemistry, a paper investigated the possibility of developing a more accurate estimate of GFR, using a panel of metabolites measured by quantitative liquid chromatography, tandem mass spectrometry without creatinine, cystatin C, or demographic variables.

In the March 2019 issue of Clinical Chemistry, Professor Andrew Levey and others from a multinational consortium of institutions, published a study titled, “Validation of a Metabolite Panel for a More Accurate Estimation of Glomerular Filtration Rate Using Quantitative LC-MS-MS.”  In fact, we have another podcast from one of the authors of that paper available.  But today, we’re joined by Dr. Anders Berg, the Associate Medical Director of the Core Laboratories at Cedars-Sinai in Los Angeles, who co-authored an editorial that accompanied the paper. Dr. Berg is here to help us deconvolute the significance of this intriguing study and where this research might lead us in the future. 

Acute abdominal pain is one of the most common presenting symptoms in emergency department patients and its differential diagnosis can be extensive and challenging.  Rapid and accurate diagnosis of urgent causes of abdominal pain is essential for the early initiation of effective therapy and efficient patient flow. To see how the clinical laboratory can help in this process, a recent study that appeared in the February 2019 issue of Clinical Chemistry examined inflammatory biomarkers in the emergency diagnosis of urgent abdominal pain.

Cardiovascular risk is so high in type III hyperlipoproteinemia that is typically a “treat immediately on diagnosis” disorder.  In the February 2019 issue of Clinical Chemistry, a paper presented the advantages of a non-high density lipoprotein cholesterol ratio with apolipoprotein B as a diagnostic tool for type III hyperlipoproteinemia.  In the same issue, an accompanying editorial entitled “Type III Hyperlipoproteinemia: The Forgotten, Disregarded, Neglected, Overlooked, Ignored but Highly Atherogenic, and Highly Treatable Dyslipo-proteinemia” was also published.  The author of that article is Dr. Allan Sniderman, the Edwards Professor of Cardiology at McGill University in Montreal, Quebec, Canada, and he is our guest in this podcast.