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Featured Reagent – Copper & Zinc
Featured Reagents | Copper & Zinc
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Nutrient Testing
Copper and zinc are essential trace minerals, found in all bodily cells and they are necessary for survival. Although, their roles within the body differ. Copper is essential to produce red blood cells and zinc is essential for the proper function of the immune system (1) (2). Whilst both of these nutrients exist naturally in the environment including water and food, both nutrients can exist in the body in higher or lower than normal concentrations which can cause major health complications (3).
Copper
A niche assay from Randox meaning that Randox are one of the only manufacturers of the clinical chemistry Copper assay
Exceptional correlation with standard methods as the Randox Copper assay showed a correlation coefficient of r=0.99 when compared against standard methods
A wide measuring range of 6.6 – 86 µmol/l for the comfortable and accurate detection of abnormal levels
Lyophilised reagents for enhanced stability
Excellent stability of 2 weeks when stored at +2 to +8°C
Applications are available detailing instrument-specific settings for the convenient use of the Randox Copper assay on a wide range of clinical chemistry analysers
Copper is mainly found in the brain, liver, kidneys, heart and skeletal muscle with the highest quantities found in the liver and muscles. It aids in some of the key bodily functions including: the production of red blood cells, the maintenance of nerve cells and the immune system, the formation of collagen to absorb iron for energy production, and the formation of melanin, bone and connective tissue. Ceruloplasmin is the protein responsible for the transportation of Copper around the body (4).
There are various health problems that can cause abnormal copper levels, however deficiency is less likely than toxicity because a normal diet contains plenty of copper including: organ meats, beans and wholegrains. Deficiency is more likely to occur in those who are malnourished, more likely children.
Deficiency more commonly occurs in premature babies, resulting in bone abnormalities and fractures. Menkes Disease is a rare inherited genetic disorder of copper metabolism and is characterised by sparse and kinky hair as children with this disorder are unable to absorb enough copper (5).
Toxicity can be caused by consuming too many dietary supplements high in copper, from drinking contaminated water, or from fungicides containing copper sulphates. Wilson disease is a rare inherited disorder that prohibits the liver from safely storing and excreting copper resulting in it seeping out of the liver and building up in the eyes, liver, kidneys and brain causing nerve damage, and if untreated, it can be fatal (6).
Zinc
A niche assay from Randox meaning that Randox are one of the only manufacturers of the clinical chemistry zinc assay
Strong correlation with standard methods as the Randox Zinc assay showed a correlation coefficient of r=0.9946 when compared against standard methods
A measuring range of 11.3 – 159 µmol/l for the comfortable and accurate detection of abnormal levels
Liquid ready-to-use reagents for convenience and ease-of-use
Stable to expiry date when stored at +15 to +25°C
Applications are available detailing instrument-specific settings for the convenient use of the Randox Zinc assay on a wide range of clinical chemistry analysers
Zinc is required for various biological processes including: cell and enzyme production; the functionality of enzymes, metabolism of carbohydrates, fat and protein from dietary intake; wound healing; and the stabilisation of DNA (7) (8).
Zinc deficiency is identified as a malnutrition problem worldwide, especially in areas of high cereal intake and low animal food intake. However, other factors may contribute to low zinc levels including: the bioavailability of zinc, chronic illnesses such as diabetes, malignancy, hepatic disease and sickle cell disease. Higher zinc requirements have been identified in infants, children, adolescents, and pregnant and lactating women compared to adults. During periods of growth, zinc deficiency can result in growth failure. The most common organs affected by zinc deficiency clinically include: central nervous, gastrointestinal, epidermal, skeletal, immune, and reproductive systems (9) (10).
References
[1] Ware, Megan. Health benefits and risks of copper. Medical News Today. [Online] October 23, 2017. [Cited: November 28, 2018.] https://www.medicalnewstoday.com/articles/288165.php.
[2] Medline Plus. Zinc in diet. Medline Plus. [Online] November 13, 2018. [Cited: November 28, 2018.] https://medlineplus.gov/ency/article/002416.htm.
[3] Jockers, Dr. David. Do You Have A Copper and Zinc Imbalance? DrJockers.com. [Online] 2017. [Cited: November 28, 2018.] https://drjockers.com/copper-zinc-imbalance/.
[4] Macfarlane, Susan. Understanding Nutrient Ratios: Zinc/Copper. Susan Macfarlane. [Online] October 29, 2017. [Cited: November 28, 2018.] https://susanmacfarlanenutrition.com/understanding-nutrient-ratios-zinccopper/.
[5] National Center for Advancing Translational Sciences. Menkes disease. National Center for Advancing Translational Sciences. [Online] Genetic and Rare Disease Information Center, April 7, 2017. [Cited: November 30, 2018.] https://rarediseases.info.nih.gov/diseases/1521/menkes-disease.
[6] Mayo Clinic. Wilson’s disease. Mayo Clinic. [Online] March 7, 2018. [Cited: November 30, 2018.] https://www.mayoclinic.org/diseases-conditions/wilsons-disease/symptoms-causes/syc-20353251.
[7] Frassinetti, S, et al. The roel of zinc in life: a review. National Center for Biotechnology Information. [Online] J Environ Pathol Toxicol Oncol, 2006. [Cited: November 28, 2018.] https://www.ncbi.nlm.nih.gov/pubmed/17073562..
[8] Jockers, Dr. David. How To Test Zinc Levels At Home. DrJockers.com. [Online] 2019. [Cited: November 28, 2018.] https://drjockers.com/test-zinc-levels-home/..
[9] Roohani, Nazanin, et al. Zinc and its importance for human health: An integrative review. National Center for Biotechnology Information. [Online] J Res Med Sci, February 18, 2013. [Cited: November 28, 2018.] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3724376/..
[10] Nordqvist, Joseph. What are the health benefits of zinc? Medical News Today. [Online] December 5, 2017. [Cited: November 28, 2018.] https://www.medicalnewstoday.com/articles/263176.php.
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Randox – Diabetes
During December, we aim to highlight how the Randox product portfolio can be used for accurate diagnosis and monitoring of diabetes, with a focus on the Randox Reagents diabetes panel which offers a total of 12 assays for accurate and reliable diabetes testing.
Diabetes is one of the leading causes of death worldwide and it is estimated by WHO (World Health Organisation) that 2.2 million additional deaths are being caused by the condition each year. The number of people with the condition has being growing rapidly in the last 30 years, the International Diabetes Federation predicts that approximately 438 million people will have diabetes by 2030. Early diagnosis and constant monitoring of diabetes is essential in order to manage the condition, as diabetes can lead to other health problems such as heart disease, kidney damage or failure, nerve damage and even blindness.
Randox knows that this condition cannot be ignored as each year it is increasingly becoming a burden on the health service. Randox Reagents are committed to advancing diabetes related testing and offer an extensive range of high quality reagents: from diabetes diagnosis, to the monitoring of diabetes-related complications, the Randox Reagents diabetes testing panel covers the full spectrum of clinical testing requirements.
Reagents Diabetes Testing Assays
To aid with the growing concern of diabetes, Randox Reagents offer a comprehensive range of 12 assays within their diabetes testing panel including assays for the diagnosis and monitoring of diabetes which includes fructosamine, glucose and HbA1c and also those which monitor diabetes-related complications such as adiponectin, cystatin c, microalbumin and NEFA. The Randox diabetes reagents offer a range liquid ready-to-use and lyophilised formats for increased efficiency, applications are also available for a wide range of biochemistry analysers.
RX series Direct HbA1c Testing Capabilities
Renowned for quality and reliability the RX series range of clinical chemistry analysers boasts a world leading test menu with an extensive range of high performing and unique assays available. In addition to NEFA, D-3-Hydroxybutyrate (Ranbut) and Fructosamine the RX series welcomes Direct HbA1c testing on the RX Daytona +, RX imola and RX modena. The latex enhanced immunoturbidimetric method improves laboratory performance and time, highly improving accuracy and precision by revolutionising your diabetes testing capabilities.
Quality Control
Designed for use in the Quality Control of both HbA1c and Total Haemoglobin assays, our Acusera HbA1c controls are an ideal match for laboratories running these parameters and POCT testing. Available in liquid ready-to-use or lyophilised formats, these controls offer attractive stability and flexibility for labs and healthcare practices of any size. Manufactured using human whole blood which ensures commutability, our controls directly mimic the performance of real patient samples helping deliver reliable results.
RIQAS Glycated Haemoglobin Programme
Designed to monitor the performance of HbA1c, our RIQAS glycated haemoglobin EQA program is suitable for both qualitative and quantitative methods of analysis. As the largest EQA scheme in the world, access to large peer groups is guaranteed. Additional benefits include; monthly analysis, user-friendly reports allowing at-a-glance performance assessment, ability to register up to five instruments per programme and cost savings via our unrivalled consolidation.
Tackling Worldwide Drugs of Abuse
Throughout November, we’ve been highlighting how the Randox clinical teams – Randox Rx series, Randox Reagents and Randox QC – are aiding the fight against drugs of abuse.
Drugs of Abuse are a growing problem worldwide and represent a significant burden to healthcare systems as well as creating problems in an individual’s lifestyle. It has been estimated by the WHO (World Health Organisation) that 31 million people globally suffer from drug use disorders and 3.3 million deaths each year are linked to the abuse of both drugs and alcohol.
The abuse of drugs is one of the most pressing issues in the United States of America. Drug abuse not only affects the individual, but also can have far-reaching consequences that affect family, employment, personal health, health care systems, local communities, and society as a whole.
- Misuse of illicit drugs affects society through secondary costs incurred such as crime, reduced productivity at work, and health care expenses.
- Substance abuse costs the US health care system about $11 billion, with overall costs reaching $193 billion.
- Substance abuse and addiction also affects other areas of life and can cause broken families, destroyed careers, death due to negligence or accident, domestic violence, physical abuse and child abuse.
- Drug abuse and addiction changes the chemistry of your brain. The longer you use your drug of choice, the more damage is caused and it becomes more difficult to return to ‘normal’ during drug rehabilitation.
- In 2013, 22.7 million Americans needed treatment for a substance use disorder – almost 9% of the population over the age of 12. Only about 2.5 million received treatment as a specialist facility with 20% of admissions for opiate addication treatment and 17% for the treatment of marijuana abuse.
To find out more about how Randox is helping in the fight against Drugs of Abuse, please visit https://www.randox.com/drugs-of-abuse/ or for more information about Randox RX, Randox Reagents or Randox QC, please email marketing@randox.com.
World Diabetes Day: The Biggest Burden on the NHS
Diabetes
Approximately 400,000 people in the UK are living with type 1 diabetes, with over 29,000 being children and young people [1]. Type 1 diabetes affects 96% of all children with diabetes in England and Wales, with incidences increasing by approximately 4% each year.
Globally, the UK has the fifth highest rate of type 1 diabetes diagnosis in children (aged up to 14) with 85% of these children having no family history of the condition. Whilst the condition isn’t fatal and can be managed, it cannot be cured. Type 1 diabetes increases the risk of developing other health problems such as heart disease, stroke, foot and circulation problems, sight problems including blindness, nerve damage and kidney problems. However, many of these related conditions are preventable and it is recommended to stabilise blood sugar levels, attend diabetes appointments regularly and complete a diabetes course to educate patients and family members and prevent the risk of further help complications[2].
Diabetes in children
Children under five are at the highest risk of developing diabetic ketoacidosis due to a late diagnosis and it is also thought to be due to of lack of public knowledge of the signs and symptoms attributed to type 1 diabetes. Such symptoms include:
- Frequent urination as the kidneys are trying to expel excess sugar in the blood, resulting in dehydration which leads to extreme thirst.
- Increased hunger or unexpected weight loss because the body is unable to attain enough energy from food
- Slow healing cuts as high blood sugar levels can affect blood flow which can cause nerve damage.
- Fatigue as the body is unable to convert sugar into energy
- Irritable behaviour combined with other symptoms can be a means of concern
Diabetes and the NHS
Diabetes costs the NHS approximately £9.8 billion per year, an estimate of 10% of total expenditures. Hospital admissions of children and young people with diabetes presents a considerable burden on themselves, their families and the NHS. It is estimated that approximately 80% of these cases are potentially avoidable.
A report produced by the National Paediatric Diabetes Audit found that although the numbers of admissions didn’t significantly differ year to year, it highlighted differences in terms of socio-economic risk factors:
- Living in a deprived area increases the risk of hospital admissions which can be attributed to lack of education in the community about diabetic symptoms and the management of diabetes.
- Children below 5 years of age have a 35% increased risk of hospitalisation compared to those aged 5-9
- Females have a 33% increased risk of developing type 1 diabetes compared to males.
- Children with poor diabetes control have a twelve-fold increased risk of hospital admission
- Insulin pump users have a 27% increased risk of hospital admission compared to those who use insulin injections.
Figure A. Number of preventable paediatric diabetes admissions [3]
Prevention
There are campaigns in place to aid in the early diagnosis of type 1 diabetes which mainly focus on raising awareness of the signs and symptoms of diabetes. On this World Diabetes Day, it is important to know that it is not just simply the responsibility of the diabetic patient to prevent admission but the main responsibility lies with the diabetic teams that inform the families with children who are diagnosed with type 1 diabetes.
Paediatric diabetes teams should ensure that the families and the children receive structured education for self-management when diagnosed and throughout the illness. In doing so, the diabetic teams should implement blood ketone testing from diagnosis and utilise the nationally agreed hypoglycaemia management guidelines. It is also important that diabetic teams are fully aware of the patient characteristics associated with a greater risk of admission and that they use this knowledge to develop anti-admission strategies specifically tailored to the needs of each individual group.
Primary care practitioners should seek access to a specialist diabetic team who they can refer to when deciding if a patient requires admission to hospital. Furthermore, they should access blood glucose and ketone testing to identify patients at risk of diabetic ketoacidosis that require hospital admission.
How Randox can Help
Randox offer a range of assays to diagnosis and monitor diabetes and to monitor associated complications. Some of these tests are unique to Randox, including:
Fructosamine
The Randox fructosamine assay employs the enzymatic method which offers improved specificity and reliability compared to conventional NBT-based methods. The Randox enzymatic method does not suffer from non-specific interferences unlike other commercially available fructosamine assays.
D-3-Hydroxybutyrate (Ranbut)
The Randox D-3-Hydroxybutyrate (Ranbut) assay detects the most abundant and sensitive ketone in the body, D-3-Hydroxybutyrate. The Randox Ranbut assay is used for the diagnosis of ketosis, more specifically diabetic ketoacidosis. Other commercially available tests, such as the nitroprusside method, are less sensitive as they only detect acetone and acetoacetate, not D-3-Hydroxybutyrate.
Adiponectin
The Randox adiponectin assay is a biomarker in diabetes testing as adiponectin is a protein hormone responsible for regulating the metabolism of lipids and glucose and influences the body’s response to insulin. Adiponectin levels inversely correlates with abdominal visceral fat levels.
Want to know more?
Contact us or visit our Diabetes panel page to learn more.
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References
[1] National Paediatric Diabetes Audit and Royal College of Paediatrics and Child Health, National Paediatric Diabetes Audit Report 2012-15: Part 2, 2017
[2] NHS, “Avoiding Complications” – Type 1 Diabetes, Available at: https://www.nhs.uk/conditions/type-1-diabetes/avoiding-complications/ [Accessed on 24th October 2018].
[3] “Potentially Preventable Pediatric Hospital Inpatient Stays for Asthma and Diabetes, 2003-2012”, www.hcup-us.ahrq.gov, 2015. [Online] Available: https://www.hcup-us.ahrq.gov/reports/statbriefs/sb192-Pediatric-Preventable-Hospitalizations-Asthma-Diabetes.jsp [Accessed 08-Nov-18]
November focus: Drugs of Abuse
Throughout November, the Randox clinical teams – Randox Reagents, Randox Rx series and Randox QC – will be highlighting how the Randox product range can be utilised to allow for the most accurate analysis of Drugs of Abuse, with a particular focus placed with the Evidence MultiSTAT. The Evidence MultiSTAT is a fast, fully automated and versatile immunoanalyser that enables on-site detection of up to 21 Drugs of Abuse from a single sample of oral fluid, urine or blood.
Drugs of Abuse are a growing problem worldwide and represent a significant burden to healthcare systems as well as creating problems in an individual’s lifestyle. It has been estimated by the WHO (World Health Organisation) that 31 million people globally suffer from drug use disorders and 3.3 million deaths each year are linked to the abuse of both drugs and alcohol.
Randox have reacted to this growing concern and are now a world leader in the Drugs of Abuse testing field. Our product range currently comprises classical, prescription and synthetic drugs.
The Evidence MultiSTAT offers a simple drug screening solution to those who have little or no knowledge of laboratory procedures. As an extremely versatile desktop analyser, it is ideally suited to a variety of settings including both the clinical laboratory and the emergency room.
Randox Reagents – Drugs of Abuse Assays
In order to assist in dealing with the ongoing burden of substance abuse, Randox Reagents offer a comprehensive range of ten assays to test for some of the top most commonly-abused substances including alcohol, methamphetamines, cocaine, methadone, cannabis, benzodiazepines, barbiturates, EDDP and ecstasy and opiates. The Randox Drugs of Abuse assays are liquid, ready-to-use for increased efficiency and applications are available for over 30 different analysers.
RX Series – Toxicology testing
Renowned for quality and reliability, the RX series range of clinical chemistry analysers boasts a world-leading test menu comprising of both therapeutic drugs and Drugs of Abuse. Our toxicology range comprises amphetamines, barbiturates, benzodiazepines, cannabinoids, cocaine metabolite, ecstasy, EDDP, ethanol, methadone and opiates. The RX series range of clinical chemistry analysers ensures a high degree of accuracy with a wide range of testing throughputs to suit all laboratories, big or small.
RIQAS Urine Toxicology Programme
Designed to monitor the performance of 20 Drugs of Abuse tests in urine, our RIQAS urine toxicology EQA program is suitable for both qualitative and quantitative methods of analysis. As the largest EQA scheme in the world, access to large peer groups is guaranteed. Additional benefits include; monthly analysis, user-friendly reports allowing at-a-glance performance assessment, ability to register up to five instruments per programme and cost savings via our unrivalled consolidation.
For more information about Randox RX, Randox Reagents or Randox QC, please email marketing@randox.com.
Iron Deficiency Anaemia during Pregnancy
On a global scale, 1.62 billion people are affected by anaemia which is equivalent to 24.8% of the population ₁. According to a review carried out by WHO of various national surveys, anaemia affects approximately 42% of pregnant women worldwide and it is also estimated that at least 50% of all anaemia cases are due to iron deficiency.
Anaemia caused by iron deficiency is usually expected during pregnancy. This is due to several reasons: the increased demand for iron by a pregnant woman’s body from increased total blood cell volume, requirements of the foetus and placenta as well as mass blood loss during labour₂. Although iron cost is unbalanced by the lack of loss of menstrual blood during pregnancy, the net cost is still high enough that iron recommendations are higher than in non-pregnant women. Also, iron is critical during pregnancy considering its involvement in foetal growth: 600-800mg of iron is required during pregnancy with around 300mg needed just for the foetus, a minimum of 25mg for the placenta and almost 500mg due to the increase in volume of red blood cells. ₃
Iron deficiency is the most common micronutrient deficiency in pregnant women leading to iron deficiency anaemia if left untreated. However, iron deficiency can be difficult to measure in some populations due to the lack of availability of field-specific biomarkers. For example, anaemia can affect up to 56% of pregnant women in developing countries, which suggests a high prevalence of iron deficiency anaemia: around 25%. In settings with endemic malaria, such as certain countries in Africa, the number of pregnant women with anaemia is much higher: around 65%.
There are various factors that may increase the risks of iron deficiency anaemia. For example, a diet influenced by religious beliefs can cause a lack of iron in the diet, such as vegetarianism which is common in countries such as India where religious beliefs dictate this. Iron levels can also be affected by consumption of nutrients which inhibit proper absorption of iron, such as calcium or ones that promote iron absorption, such as vitamin C. Other circumstantial risks include infections, multiple pregnancies and adolescent pregnancy while socioeconomic factors and access to healthcare mean some women won’t have access to anaemia control programs, iron supplements or even access to information about iron deficiency anaemia during pregnancy.
To prevent iron deficiency, international guidelines state that iron supplementation to manage iron deficiency is recommended during pregnancy. ₄ However, this is not always available, especially in developing countries.
Iron deficiency anaemia during pregnancy can cause several complications for the mother including:
- Increased fatigue
- Short-term memory loss
- Decreased attention span
- Increased pressure on the cardiovascular system due to insufficient haemoglobin and blood oxygen levels
- Lower resistance to infections
- Reduced tolerance to significant blood loss and surgical implications during labour.
As expected, neonates with mothers who suffered from iron deficiency anaemia during pregnancy will also be confronted with risks and, even if iron deficiency is only mild to moderate, can result in a premature birth, complications with foetal brain development, low birth weight and even foetal death. Additionally, it has been proven that cognitive and behavioural abnormalities can be seen in children for up to ten years after iron insufficiency in the womb.
Randox Soluble Transferrin Receptor (sTfR) Reagent
Randox Reagents offer a Soluble Transferrin Receptor assay to expand upon our current iron testing offering.
In iron deficiency anaemia, soluble transferrin receptor levels are significantly increased, however, remain normal in acute phase conditions including: chronic diseases and inflammation. As such, sTfR measurements are useful in the differential diagnosis of anaemia: anaemia of chronic disease or iron deficiency anaemia.
In iron deficiency anaemia, increased sTfR levels have also been observed in haemolytic anaemia, sickle cell anaemia and B12 deficiency.
The benefits of the Randox Soluble Transferrin Receptor (sTfR) Reagent include:
- Latex enhanced immunoturbidimetric method facilitating testing on biochemistry analysers and eliminating the need for dedicated equipment.
- Liquid ready-to-use reagents for convenience and ease-of-use
- Stable to expiry date when stored at +2 to +8 °C
- Excellent measuring range of 0.5 – 11.77mg/L, comfortably detecting levels outside of the normal health range of 0.65 – 1.88mg/L
- Excellent correlation coefficient of r=0.977 when compared against other commercially available methods
- Applications available detailing instrument-specific settings for a wide range of clinical chemistry analysers
Find out more at: https://www.randox.com/stfr/
References:
- de Benoist B et al., eds.Worldwide prevalence of anaemia 1993-2005. WHO Global Database on Anaemia Geneva, World Health Organization, 2008.
- Harvey et al, Assessment of Iron Deficiency and Anemia in Pregnant Women: An Observational French Study, Women’s Health, Vol 12 Issue 1, 2016
- Burke et al, Identification, Prevention and Treatment of Iron Deficiency during the First 1000 Days, Nutrients, Vol 6 Issue 10, 2014
- Guideline: Daily Iron and Folic Acid Supplementation in Pregnant Women. World Health Organization; Geneva, Switzerland: 2012
If you are a clinician or laboratory who are interested in running assays to test iron status, Randox offer a range of assays, including: Iron, Total Iron-Binding Capacity (TIBC), Transferrin and Ferritin . These assays can be run on most automated biochemistry analysers.
Instrument Specific Applications (ISA’s) are available for a wide range of biochemistry analysers. Contact us to enquire about your specific analyser.
For more information, visit: https://www.randox.com/stfr / or email: reagents@randox.com
The Keto Diet: Are the risks worth the benefits?
Diet trends have continued to evolve throughout the years with a strong influence from celebrities. Beginning in the 1930s the grapefruit diet aka the “Hollywood diet” started which encouraged eating a grapefruit with every meal. More recently an increasing amount of extreme diet trends have emerged. In 2004, Beyoncé started the master cleanse involving a concoction of hot water, lemon juice, maple syrup and cayenne pepper and even crazier was Reese Witherspoon’s “baby food diet”. The newest trend to materialise is the keto diet favoured by celebrities including Halle Berry and the Kardashians. However, the results for long term weight loss and the safety of the diet is still questioned.
What is the ketogenic diet?
The ketogenic diet is a low carb diet which involves drastically reducing carbohydrate intake and replacing it with fat. Initially, the purpose of the ketogenic diet was not to aid weight loss but was prescribed to aid in the treatment of tough-to-control epileptic seizures that were unresponsive to drugs. In the 1920s the diet was found to significantly reduce the frequency of seizures in children. However, the benefits for weight loss have also been realised as the carbohydrate reduction kicks the body into a natural fat burning state called ketosis. By starving the body of carbohydrates and sugars, the first fuel the body burns, the body looks for another source of fuel to retrieve its energy. The body becomes efficient at burning fat for energy whilst also turning fat into ketones in the liver which can supply the brain with energy.
Ketosis
The metabolism of fatty acids in the liver results in the production of ketone bodies. These comprise of three chemicals consisting of acetone (2%), acetoacetate (20%) and D-3-Hydroxybutyrate (78%) and this production is called ketogenesis. The ketone bodies are produced by the chemical acetyl-CoA predominantly in the mitochondrial matrix of liver cells. This process is necessary in small amounts particularly when carbohydrates are scarce, and glucose is not available as a fuel source.
The ketone bodies are water soluble allowing for the transportation across the inner mitochondrial membrane as well as across the blood brain barrier and cell membranes. This allows them to source the brain, heart and muscle with fuel. Interestingly, during starvation they are the major energy source for the brain, providing up to 75%.
The excess production of ketones can accumulate in the body creating a state of ketosis. This stage, although abnormal, is not considered harmful, which is why it is being promoted as a diet craze. However, due to the acidic nature of the ketone bodies, particularly D-3-Hydroxybutyrate, larger amounts of ketone bodies can cause the pH levels in the body to drop to dangerously acidic levels creating a state of ketoacidosis.
Ketoacidosis
The benefits of the keto diet have been well advertised and received a lot of celebrity support. With powerful celebrities such as Halle berry ‘swearing by it’ as it allows her to manage her diabetes, it is easy to see why so many are keen to try it. However, with little to no information about the long-term effects, should we be finding out more before trying it ourselves?
In 2006, a study was conducted reviewing the influence of a low-carbohydrate diet can have on ketoacidosis. In this study the patient who had no history of diabetes was placed on a strict low carbohydrate diet for four years. Although the patient showed a significant decrease in weight on the diet, they also experienced four episodes of ketoacidosis. Each time an episode occurred the patient was administered intravenous fluids and insulin which lead to their recovery, however each time they returned to the diet it wasn’t long before another ketoacidosis episode occurred. When the patient was placed on a diet containing normal amounts of carbohydrates their glucose levels returned to normal, preventing a ketoacidosis episode from occurring again. The more ketones in the blood, the more ill a person with ketoacidosis will become. Left untreated ketoacidosis can cause potentially fatal complications such as severe dehydration, coma and swelling of the brain.
Randox D-3-Hydroxybutyrate (Ranbut) Reagent
Randox Reagents offer a D-3-Hydrobutyrate assay designed to measure the major ketone lvels in the body, D-3-Hydroxybutyrate, allowing for an efficient diagnosis to be implemented. The superior methodology provides more accurate, reliable and specific results compared to the traditional dipstick method of ketone body measurement.
The benefits of the Randox D-3-Hydroxybutyrate (Ranbut) assay include:
- Excellent precision of less than 3.5% CV
- Exceptional correlation coefficient of r=0.9954 when compared against other commercially available methods.
- A wide measuring range of 0.100 – 5.75mmol/l, comfortably detecting levels outside of the healthy range, 0.4 – 0.5mmol/l.
- Enzymatic method for accurate and reliable results
- Reconstituted stability of 7 days when stored between +2 to +8⁰C
References
- Ketoacidosis during a low-carbohydrate diet. Shah, Panjak and Isley, William. s.l. : The new england journal of medicine, 2006, Vol. 354.
Instrument Specific Applications (ISA’s) are available for a wide range of biochemistry analysers. Contact us to enquire about your specific analyser.
For more information, visit: https://www.randox.com/homocysteine or email: reagents@randox.com
The Correlation Between Liver Cirrhosis and Lactic Acidosis
Lactic acid is an organic compound which produces the conjugate base lactate through a dissociation reaction. Due to it being a chiral compound, two optical isomers of lactate exist; D-Lactate and L-Lactate. The lactate dehydrogenase (LDH) enzyme can produce and metabolise both isomer forms to pyruvate, however due to the isomer-specific nature of LDH different forms of the enzyme are required. D-Lactate requires a D-LDH form whereas L-Lactate requires L-LDH. As a result of this requirement, combined with the fact that mammalian cells only contain L-LDH, the lactate produced in humans is almost exclusively L-Lactate.
One of the roles of L-Lactate is its involvement in the Cori Cycle, a metabolic pathway involved in the production of glucose. The cycle involves the rotatory transportation of lactate and glucose from the liver and the muscle. Lactate is produced in the muscle through glycolysis which is then transported to the liver through the blood stream. In the liver, the lactate is oxidised to pyruvate and then converted to glucose by gluconeogenesis, which is then transported back to the muscle for the process to start again. 1500 mmol of lactate is produced daily by the body and is cleared at a constant rate via the liver.
Problems can arise if the liver fails to regulate the lactate produced. Hyperlactamia is the name given to elevated levels of lactate in the body, as a result of the rate of production exceeding the rate of disposal. This is due to a lack of oxygen that reduces blood flow to the tissues. If levels continue to rise a patient is at risk of lactic acidosis.
The liver is an important tissue in the regulation of lactate, it is therefore no surprise that liver damage can prevent this process resulting in a further diagnosis of lactic acidosis. A healthy liver is a vital part of lactate regulation as it acts as the main consumer of lactate and contributes to 30-40% of lactate metabolism. Potential victims are patients who suffer with cirrhosis, a complication of liver disease, which is commonly caused by alcohol abuse and viral Hepatitis B and C.
Patients with liver cirrhosis have a higher risk of increased lactate levels. Increased levels of the lactate ions disturbs the acid-base equilibrium, causing a tilt towards lactic acidosis. The mortality rate of patients who develop lactic acidosis is high, prompt recognition and treatment of the underlying cause remain the only realistic hope for improving survival.
The Randox L-Lactate reagent allows for a prompt and accurate diagnosis of lactic acidosis.
Randox L-Lactate Reagent
The Randox L-Lactate key benefits include:
- Excellent working reagent stability of two weeks when stored at + 15 – +25°C
- Exceptional correlation of r = 0.99 when compared against other commercially available methods
- A wide measuring range of 0.100 – 19.7 mmol/l and so is capable of detecting abnormal levels in a sample
Other features:
- Colorimetric method
- Lyophilised reagents for enhanced stability
If you are a clinician or laboratory who are interested in running assays for Lactic Acidosis or Liver Disease, Randox offer a range of high-quality routine and niche assays including:L- Lactate, Ethanol, Alanine Aminotransferase (ALT), Aspartate Aminotransferase (AST) and Albumin which can be used to diagnose conditions commonly affecting the liver. These assays can be run on most automated biochemistry analysers.
Instrument Specific Applications (ISA’s) are available for a wide range of biochemistry analysers. Contact us to enquire about your specific analyser.
For more information, visit: https://www.randox.com/lactate/ or email: reagents@randox.com
Securing the future with in vitro diagnostic tests
The aim of Biomedical Science Day is to raise the public’s awareness of the importance of biomedical science and the vital role it plays in the world. Randox are dedicated to improving healthcare worldwide through placing a major focus on research and development. The Randox scientists work in pioneering research into a range of common illnesses such as cancer, cardiovascular disease and Alzheimer’s disease.
A recent blog from Doris-Ann Williams, the Chief Executive at BIVDA, explains how “increased funding is not enough to sustain the NHS” and how “we need to make better use of in vitro diagnostics to ensure a successful future”.
The National Health Service (NHS) is a publicly funded, primarily taxation, national healthcare system in the United Kingdom. It was first set-up on July 5th, 1948 by Aneurin Bevan as he believed that everyone, regardless of wealth, should have access to good healthcare. Whilst the NHS is an extremely important aspect of healthcare in the UK, in vitro diagnostics are the heart and soul of the healthcare system as healthcare professionals not only rely on blood tests to diagnose and treat patients, but also to rule out the different contributing causes to a disease state. In vitro diagnostics also plays a key role in monitoring chronic disease states. In vitro diagnostics can also aid in reducing hospital stays, reduce misdiagnosis and support patients in looking after their own health and to deliver personalised treatment plans.
The Randox scientists have developed several niche assays to improve patient diagnosis, monitor treatment and eliminate misdiagnosis.
Adiponectin
Adiponectin is a protein hormone secreted by adipocytes with anti-inflammatory and insulin-sensitising properties. It plays an important role in a number of metabolic processes including glucose regulation and fatty acid oxidation. Adiponectin levels are inversely correlated with abdominal visceral fat which have proven to be a strong predictor of several pathologies, including: metabolic syndrome, type 2 diabetes mellitus (T2DM), cancers and cardiovascular disease (CVD). For more information on the importance of testing Adiponectin levels, check out our Adiponectin Whitepaper.
Cystatin C
Cystatin C is an early risk marker for renal impairment. The most commonly run test for renal impairment is Creatinine. Creatinine measurements have proven to be inadequate as certain factors must be taken into consideration, including age, gender, ethnicity etc. The National Institute for Health and Care Excellence (NICE) have updated their guidelines, which now recommends Cystatin C as a more superior test for renal impairment due to its higher specificity for significant disease outcomes than those based on Creatinine. For more information on the importance of testing Cystatin C levels, check out our Cystatin C Whitepaper.
Small-dense LDL Cholesterol (sdLDL-C)
LDL Cholesterol (LDL-C) consists of two parts: the large and buoyant LDL Cholesterol and the small and dense LDL Cholesterol. Whilst all LDL-C transports triglycerides and cholesterol to bodily tissues, their atherogensis varies according to their size. As sdLDL-C is small and dense, they can more readily permeate the arterial wall and are more susceptible to oxidation. Research indicates that individuals with a predominance of sdLDL-C have a 3-fold increased risk of myocardial infarction. It has been noted that sdLDL-C carries less Cholesterol than large LDL, therefore a patient with predominately sdLDL-C particle may require nearly 70% more sdLDL-C particles to carry the same amount of cholesterol as the patient with predominately LDL-C particles. For more information on the importance of testing sdLDL-C levels, check out our sdLDL-C Whitepaper.
These three niche in vitro diagnostics tests developed by Randox scientists can aid in reducing NHS costs due to their higher performance compared to the traditional tests. Randox are constantly striving to improve healthcare worldwide.
For more information on the extensive range of Randox third-party in vitro diagnostic reagents, visit: https://www.randox.com/diagnostic-reagents/ or contact reagents@randox.com.
