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Apolipoprotein B-48 (apo B-48) is a constituent of chylomicrons and chylomicron remnants, and its fasting concentration has been reported to be a marker of postprandial hyperlipidemia, which is thought to be a risk factor of atherosclerosis.We evaluated the serum apo B-48 concentrations by chemiluminescence enzyme immunoassay (CLEIA), which was recently introduced as Lumipulse f fully automated immunosaasy analyzer by Fujirebio Inc (Tokyo, Japan), and performed immunoblotting on agarose gel electrophoresis with anti-apo B-48 antibody.Apo B-48 assay was intra-assay reproducible (CVs: 1.9-3.1%) and inter-assay reproducible (CVs: 2.2-4.4%). The assay range for apo B-48 was from 0.2 to 40.0 microg/ml. The effects of interfering substances such as free/conjugated birirubin, hemoglobin, Intrafat, ascorbic acid and rheumatoid factor were negligible. For storage, it was preferable to freeze, and to avoid frozen-thaw process as much as possible. Anti-apo B-48 antibody was reactive over a wide range from origin to the position of very-low-density lipoproteins in immunoblotting after agarose gel electrophoresis.Apo B-48 measurement by CLEIA was feasible to clinical use for the assessment of lipoprotein metabolism.

Creatinine clearance (Ccr) is generally used as a halmark of glomerular filtration rate (GFR) in clinical medicine. Recently, it has been suggested that serum cystatin C measurement in serum reflects GFR. We compared serum cystatin C, serum creatinine, and serum beta2-microgrobrin in 70 patients with renal diseases in reference to creatinine clearance. The correlation between Ccr and 1/cystatin C was higher (r = 0.830) than that between Ccr and 1/serum creatinine (r = 0.789) or 1/serum beta2-microgroburin (r = 0.732). The levels of serum cystatin C in patients with Ccr ranging from 51 to 70 ml/min were significantly higher than those in patients with Ccr ranging more than 91 ml/min. Receiver-operated characteristic (ROC) analysis revealed that serum cystatin C showed the highest area under the curve among the three when Ccr = 90 ml/min was used as the cutoff point. We conclude that serum cystatin C is more useful than serum creatinine to detect early renal dysfunction.

A patient consulted the emergency room with acute pancreatitis, hypertriglyceridemia, and diabetes mellitus, and was later admitted to the hospital. Serum levels of total cholesterol(TC) and total triglyceride (TTG), and the cholesterol(Chol) versus triglyceride(TG) ratio(Chol/TG) for lipoprotein fractions were examined periodically during the course of treatment using Chol/Trig Combo, which identifies Chol and TG by differential staining. On admission, the patient's TTG, pancreatic amylase and glucose levels were 4020 mg/dl, 2012 IU/l, and 242 mg/dl, respectively. Clinofibrate administration resulted in a decrease in Chol and TG values for all fractions. However, the Chol/TG ratios were unchanged(HDL of 0.2 to 0.4, VLDL of approximately 0.13, and LDL of 0.1 to 0.2: Reference values from 103 healthy students were as follows: HDL 5.8 +/- 2.0, VLDL 0.39 +/- 0.1, and LDL 4.9 +/- 1.3[Mean +/- SD].). During clinofibrate treatment, TC and TG values gradually increased. Clinofibrate was discontinued and fenofibrate administration was initiated. This was followed by a dramatic improvement in TC, TTG and Chol/TG values for both HDL and LDL. The monitoring of lipoprotein fraction values proved useful for determining the treatment regimen for this patient with hypertriglyceridemia.

Quantitative measurement of serum hepatitis C virus(HCV) RNA is important in predicting and monitoring interferon(IFN) therapy. We compared the sensitivity of HCV RNA measurement of different HCV genotypes between two available assays, Roche Monitor 1.0(v1.0) and Roche Monitor 2.0(v2.0). We also evaluated serum level of HCV RNA as the predictors of a long-term response to IFN therapy by distinguishing the complete responders(CR), partial responders(PR) and non-responders(NR) for IFN therapy. We quantified the serum HCV RNA levels in 151 patients and determined the genotypes; 96(64%) with genotype 1b(1b), 42(28%) with genotype 2a(2a), and 6(4%) was not identified. The relationship between the genotype and effects of IFN treatment was as follows: 23CR(1b:11, 2a:9), 15PR(1b:8, 2a:7), 20NR(1b:14, 2a:6). The RNA levels of 2a measured by v2.0 were significantly higher than those by v1.0(p0.05), although no significant difference was found in 1b between two assays. By using v2.0, when the cut-off level was set at 200 x 10(3) IU/ml before IFN therapy, CR was discriminated from PR, NR with a predicting efficiency of 88%. HCV RNA levels before IFN therapy were significantly lower in patients who became HCV RNA negative within 2 weeks than in patients who did at 4 weeks or longer. These results suggest that v2.0 is more sensitive and accurate than v1.0 for the quantification of 2a. Using v2.0 assay, it was shown that low viral titre at pretreatment and loss of viraemia within 2 weeks after treatment might be important markers for a long-term response to IFN therapy, irrespective of viral genotype. The v2.0 assay was found to be more useful in predicting effectiveness of IFN therapy.