Objective To investigate the changes and clinical significance of high-density lipoprotein (HDL)-mediated cholesterol efflux capacity (CEC) in patients with diabetes mellitus. Methods Patients with diabetes attending West China Hospital of Sichuan University between January 2022 and June 2024 and healthy physical examination subjects during the same period (serving as the control group) were selected. The diabetic group was further divided into high glycated hemoglobin (HbA1c) with normal fasting plasma glucose (FPG) group and high HbA1c with high FPG group. CEC levels were compared among groups, correlations between CEC and glucose/lipid metabolism indices were analyzed, and binary logistic regression was used to assess the independent association between CEC and diabetes. Results A total of 260 patients with diabetes were enrolled, and 203 patients in the control group. Among them, there were 88 cases in the high HbA1c with normal FPG group and 172 cases in the high HbA1c with high FPG group. Compared with the control group [30.52% (26.99%, 32.25%)], CEC levels in the high HbA1c with normal FPG group [26.01% (23.81%, 28.21%)] and the high HbA1c with high FPG group [24.02% (17.40%, 27.49%)] were significantly lower (P<0.001). At the same HbA1c stratum, higher FPG was associated with lower CEC; at the same FPG stratum, higher HbA1c was associated with lower CEC. Correlation analysis showed that CEC was negatively correlated with FPG (r=?0.434, P<0.001) and HbA1c (r=–0.444, P<0.001), positively correlated with apolipoprotein A-Ⅰ (r=0.363, P<0.001), positively correlated with HDL-cholesterol (r=0.103, P=0.028). Multivariate logistic regression analysis showed that CEC was still associated with diabetes [odds ratio=0.785, 95% confidence interval (0.732, 0.842), P<0.001]. Conclusions HDL-mediated CEC is significantly impaired in patients with diabetes, and the degree of impairment worsens with increasing blood glucose and HbA1c levels. Routine lipid parameters cannot reflect HDL function, and CEC may serve as an independent indicator for evaluating the risk of diabetes and its cardiovascular complications.
Objective To investigate the consistency of 25-hydroxyvitamin D (25-OH-VD) test results before and after a reagent generation change, assess the risk of misclassification associated with continued use of the previous reference interval after reagent replacement, and provide experimental evidence for the verification and revision of reference intervals following reagent changes in clinical laboratories. Methods The comparability of the two reagent generations was evaluated by simultaneously measuring samples using the pre-upgrade reagent (25-OH-VD Ⅰ) and the post-upgrade reagent (25-OH-VD Ⅲ). Healthy individuals who underwent physical examinations at the Health Management Center of West China Hospital, Sichuan University between March and June 2024 (25-OH-VD Ⅰ group, n=8203) and between March and June 2025 (25-OH-VD Ⅲ group, n=8203) were included. The distributions of results obtained using the two reagent generations across different concentration categories were compared. The consistency of the results was further evaluated through stratified analyses according to parathyroid hormone concentrations, and differences in the reference intervals between the two reagent generations were retrospectively analyzed. Results The relative differences between the results obtained using the 25-OH-VD Ⅲ and 25-OH-VD Ⅰ reagents ranged from –17% to +6%. In the 25-OH-VD deficiency category (<30 nmol/L), 428 individuals were identified using the 25-OH-VD Ⅰ reagent and 1195 using the 25-OH-VD Ⅲ reagent. In the insufficiency category (30-50 nmol/L), the corresponding numbers were 3324 and 4171, respectively. In the three parathyroid hormone strata of <1.6, 1.6-6.9, and >6.9 pmol/L, the median (lower quartile, upper quartile) of the 25-OH-VD concentrations measured using the 25-OH-VD Ⅲ reagent were 55.0 (41.9, 63.2), 44.9 (35.4, 57.6), and 39.1 (31.3, 49.4) nmol/L, respectively, all of which were lower than the corresponding values obtained using the 25-OH-VD Ⅰ reagent [70.8 (63.9, 79.1), 53.8 (42.6, 68.2), and 46.0 (37.1, 59.1) nmol/L, respectively; all P<0.05]. The P2.5-P97.5 reference interval for the 25-OH-VD Ⅲ reagent was 23.0-96.0 nmol/L, compared with 27.6-110.6 nmol/L for the 25-OH-VD Ⅰ reagent, representing decreases of 4.6 nmol/L in the lower limit and 14.6 nmol/L in the upper limit. Conclusions Significant differences were observed between the 25-OH-VD Ⅲ and 25-OH-VD Ⅰ reagents. Direct application of the reference interval established for the previous reagent may lead to overdiagnosis of vitamin D deficiency. Following a reagent generation change, laboratories should communicate the resulting differences to clinicians and, when necessary, establish a correction equation or revise the laboratory-specific reference interval.
Objective To explore the effectiveness of passive immunization of fetus via mother on preventing the transmission of HBV from mother to infant. Methods A prospective randomized controlled study was designed. Fifty-two HBeAg positive pregnant women were randomly allocated to two groups, of which 28 women were allocated to trial group, and injected with 200 IU of hepatitis B immune globulin (HBIG) for 1 injection at the 28th, 32nd and 36th weeks of pregnancy respectively, 24 women allocated to control group were given no injection of HBIG. The samples of cord blood from the newborns in two groups were collected and tested for HBeAg and HBV-DNA by ELISA and FQ-PCR. Results The rates of HBeAg positive in the newborns were 21.4% in trial group, 79.2% in control group. There was statistically significant difference between two groups ( χ2=17.26, Plt;0.01, RR=0.27). The rates of HBV-DNA positive in newborns were 25.0% in trial group, 83.3% in control group, showing statistically significant difference between the two groups (χ2=17.62, Plt;0.01, RR=0.30). In the trial group, there were 21 newborns with HBV-DNA negative, 7 with HBV-DNA positive. HBV-DNA quantities were significantly lower in 7 newborns than in their mothers (T=28, P=0.02, Wilcoxon test). Conclusions Multiple injections of HBIG to pregnant women with HBeAg positive before labor could greatly reduce mother-infant transmission of HBV.