Laboratory Testing for Endocrine Abnormalities

内分泌异常的发生，或者？自我定义？疾病或与其他疾病的组合。越来越多的？非内分泌？还发现疾病与内分泌异常有关。最佳使用有效的实验室检查和正确诊断内分泌疾病或内分泌成分？非内分泌？疾病显然在医学和经济上都很重要。最近，我们研究了内分泌检测中临床上重要的采血管相关分析/分析前干扰。在研究Becton-Dickinson SST采血管中发现的采血管表面活性剂对某些免疫测定（主要是总三碘甲状腺原氨酸）的干扰期间，我们观察到，与螺旋管相比，在SST中采集血液时，测得的总游离脂肪酸浓度增加。这促使对采血管的血清游离脂肪酸浓度进行详细评价。游离脂肪酸被肝脏用于能量和甘油三酯的产生，过量的游离脂肪酸可导致肝脏形成酮体，特别是β-羟基丁酸。正在测量血清总游离脂肪酸和β-羟基丁酸盐是否存在内分泌疾病。因此，我们还研究了收集管类型对血清β-羟基丁酸盐浓度测量的影响。基于我们先前的研究显示，与小玻璃管和玻璃管相比，SST中采集血液时血清总三碘甲状腺原氨酸浓度显著更高，我们研究了与小玻璃管相比，SST中观察到的血清游离脂肪酸浓度增加是否是由于与血清总三碘甲状腺原氨酸相同类型的干扰。与检查的其他管类型相比，SST、重新配制的SST和PPT管中分离凝胶的未鉴别组分似乎是游离脂肪酸浓度假性升高的原因。与总三碘甲状腺原氨酸相反，产生假性高游离脂肪酸结果需要暴露于全血，而血清暴露于试管成分时不会发生。我们还建议，在我们的调查中采用的方法被用来作为一个通用的模型来评估干扰（S）从管成分（S）。

Endocrine abnormalities occur either as ?self-defined? disorders or in combination with other diseases. An ever-increasing number of ?non-endocrine? diseases also are found to be associated with endocrine abnormalities. Optimal use of valid laboratory tests and correct diagnosis of endocrine diseases or the endocrine components of ?non-endocrine? diseases obviously are important both medically and economically. Recently, we studied clinically important blood collection tube-related analytical/preanalytical interferences in endocrine testing. During investigation of blood collection tubes for interference on some immunoassays, primarily total triiodothyronine, by the tube surfactant found in Becton-Dickinson SST tubes, we observed an increase in the measured total free fatty acid concentrations when blood was collected in SST compared to Vacuette tubes. This prompted a detailed evaluation of blood collection tubes on serum free fatty acid concentrations. Free fatty acids are used by the liver for energy and triglyceride production and excess free fatty acids can lead to ketone body formation, particularly beta-hydroxybutyrate, by the liver. Both serum total free fatty acids and beta-hydroxybutyrate are being measured for endocrine disorders. Therefore, we also investigated the effects of collection tube types on the measurement of serum beta-hydroxybutyrate concentration. Based on our previous studies showing a significantly higher serum total triiodothyronine concentration when blood was collected in SST compared to Vacuette and glass tubes, we investigated whether the observed increase in serum free fatty acid concentration in SST compared to Vacuette tubes is due to the same type of interference as that found for serum total triiodothyronine. It appears that unidentified component(s) from the separator gel in SST, reformulated SST and PPT tubes are responsible for the falsely high free fatty acid concentration compared to other tube types examined. In contrast to total triiodothyronine, generation of falsely high free fatty acid results requires exposure of whole blood and does not occur with exposure of serum to tube constituent(s). We also propose that the approach employed in our investigations be used as a general model for assessing interference(s) from tube constituent(s).