title: Diagnostic performance of urinary metanephrines for the postmortem diagnosis of hypothermia.
abstract: The purpose of this study was to assess the diagnostic potential of urinary metanephrines and 3-methoxytyramine compared to urinary catecholamine determination in diagnosing antemortem cold exposure and fatal hypothermia. 83 cases of fatal hypothermia and 144 control cases were included in this study. Catecholamines (adrenaline, noradrenaline and dopamine), metanephrines (metanephrine, normetanephrine) and 3-methoxytyramine were measured in urine collected during autopsy. All tested analytes were significantly higher in hypothermia cases compared to control subjects and displayed a generally satisfying discriminative value, thus indicating urinary catecholamines and their metabolites as reliable markers of cold-related stress and hypothermia related-deaths. Metanephrine and adrenaline had the best discriminative value between hypothermia and control cases compared to other tested analytes, though with different sensitivity and specificity. These can therefore be considered the most suitable markers of cold-related stress.
authors.affiliation: University Centre of Legal Medicine, Lausanne University Hospital (CHUV), Rue du Bugnon 21, 1011, Lausanne, Switzerland, cristian.palmiere@chuv.ch.
authors.forename: Cristian
authors.initials: C
authors.lastname: Palmiere
authors.forename: Grzegorz
authors.initials: G
authors.lastname: Teresiński
authors.forename: Petr
authors.initials: P
authors.lastname: Hejna
authors.forename: Patrice
authors.initials: P
authors.lastname: Mangin
authors.forename: Eric
authors.initials: E
authors.lastname: Grouzmann
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001344:Autopsy; D015415:Biomarkers / Q000652:urine; D016022:Case-Control Studies; D002423:Cause of Death; D058639:Cold-Shock Response; D004298:Dopamine / Q000031:analogs & derivatives / Q000652:urine; D004837:Epinephrine / Q000652:urine; D005260:Female; D006801:Humans; D007035:Hypothermia / Q000175:diagnosis / Q000401:mortality / Q000652:urine*; D008297:Male; D008676:Metanephrine / Q000652:urine*; D008875:Middle Aged; D011237:Predictive Value of Tests; D015854:Up-Regulation; D016482:Urinalysis; D055815:Young Adult
chemical_list: D015415:Biomarkers; D008676:Metanephrine; C001746:3-methoxytyramine; D004298:Dopamine; D004837:Epinephrine