Clinical evaluation of an automated chemical inhibition assay for lactate dehydrogenase isoenzyme 1.
We evaluated an automated assay for lactate dehydrogenase (LD; EC 1.1.1.27) isoenzymes, supplied by Boehringer Mannheim Diagnostics (BMD) and based on selective chemical inhibition of non-LD-1 isoenzymes by guanidine thiocyanate. Results were compared with the Roche Isomune LD-1 method. The Hitachi 717 analyzer was used to measure enzyme activity for both procedures in 229 serum samples. One hundred specimens were also analyzed by the Helena rapid electrophoresis (REP) method. We determined the limit of linearity of the BMD method to be about 1200 U of LD-1 per liter. The analytical correlation of BMD (y) with Isomune (x) yielded y = 1.0x + 0.5 U/L, r = 0.997, Sy/x = 16.9 (range 20-1397 U/L). The regression equation for BMD vs REP was y = 1.1x + 7.2% (r = 0.800, Sy/x = 7.4, range 14-83%). Average values for within-run precision for low (38 U/L), medium (180 U/L), and high (865 U/L) controls were 4.1%, 1.0%, and 0.5%, respectively (16 trials of six each). The average values for run-to-run precision were 4.1%, 1.7%, and 1.1%, respectively, for these controls (n = 16). We used receiver-operating characteristic curves to determine optimum decision limits. Using an LD-1 cutoff of 40% of total LD, we obtained a clinical sensitivity of 97-100% and a specificity of 95% when blood was collected during the optimum interval, 24-48 h after the onset of chest pain. We conclude that the BMD LD-1 assay is equivalent to the immunochemical and electrophoretic assays for measuring the LD-1 isoenzyme.
Department of Pathology and Laboratory Medicine, University of Texas Medical School, Texas Medical Center, Houston 77225.
T A
TA
Onigbinde
A H
AH
Wu
M
M
Johnson
Y S
YS
Wu
W L
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Collinsworth
M J
MJ
Simmons
D001322:Autoanalysis; D004563:Electrochemistry; D004587:Electrophoresis, Agar Gel; D006146:Guanidines / Q000494:pharmacology; D006801:Humans; D007527:Isoenzymes; D007770:L-Lactate Dehydrogenase / Q000037:antagonists & inhibitors* / Q000097:blood; D009203:Myocardial Infarction / Q000201:enzymology*; D012372:ROC Curve; D013861:Thiocyanates / Q000494:pharmacology
D006146:Guanidines; D007527:Isoenzymes; D013861:Thiocyanates; C054436:guanidine thiocyanate; D007770:L-Lactate Dehydrogenase