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Helmersson, Johanna
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Publications (10 of 48) Show all publications
Helmersson-Karlqvist, J., Hammarström, K. H., Palmberg, K. & Backman-Johansson, C. (2019). Evaluation of Nova StatStrip and FreeStyle Precision Pro blood ketone tests using 3-hydroxybutyrate doped samples [Letter to the editor]. Journal of clinical laboratory analysis (Print), 33(4), Article ID e22851.
Open this publication in new window or tab >>Evaluation of Nova StatStrip and FreeStyle Precision Pro blood ketone tests using 3-hydroxybutyrate doped samples
2019 (English)In: Journal of clinical laboratory analysis (Print), ISSN 0887-8013, E-ISSN 1098-2825, Vol. 33, no 4, article id e22851Article in journal, Letter (Other academic) Published
Abstract [en]

Background The most clinically useful blood ketone in the diagnosis, management, and recovery of diabetes ketoacidosis in both adults and children is 3-hydroxybutyrate. In the absence of laboratory routine methods, several point-of-care methods are in use, but very few clinical evaluations are published. Methods This study evaluates linearity and reproducibility of two handheld point-of-care meters for blood 3-hydroxybutyrate measurement for hospital use, Nova StatStrip, and FreeStyle Precision Pro. Whole blood from healthy volunteers was spiked with different concentrations of a 3-hydroxybutyrate solution and tested on the point-of-care instruments. The results were compared with plasma 3-hydroxybutyrate that was analyzed with a laboratory enzymatic end point spectrophotometric reference method. Results Blood 3-hydroxybutyrate on StatStrip was linear with the reference method up to approximately 4 mmol/L, and FreeStyle was linear up to 6 mmol/L. At higher concentrations, the point-of-care instruments gave falsely too low results, especially the StatStrip meter. The FreeStyle meter had better precision and less bias than StatStrip. Conclusion In the acute setting of diabetes ketoacidosis, blood 3-hydroxybutyrate in the higher ranges should be interpreted with caution as the point-of-care meters are less accurate there.

Place, publisher, year, edition, pages
John Wiley & Sons, 2019
Keywords
3-Hydroxybutyrate, blood ketones, diabetes ketoacidosis, point-of-care testing
National Category
Cardiac and Cardiovascular Systems
Identifiers
urn:nbn:se:uu:diva-386374 (URN)10.1002/jcla.22851 (DOI)000468628300002 ()30811634 (PubMedID)
Available from: 2019-06-24 Created: 2019-06-24 Last updated: 2019-06-24Bibliographically approved
Helmersson, J., Ridefelt, P., Boija, E. E. & Nordin, G. (2019). Lower creatinine concentration values and lower inter-laboratory variation among Swedish hospital laboratories in 2014 compared to 1996: results from the Equalis external quality assessment program. Clinical Chemistry and Laboratory Medicine, 57(6), 838-844
Open this publication in new window or tab >>Lower creatinine concentration values and lower inter-laboratory variation among Swedish hospital laboratories in 2014 compared to 1996: results from the Equalis external quality assessment program
2019 (English)In: Clinical Chemistry and Laboratory Medicine, ISSN 1434-6621, E-ISSN 1437-4331, Vol. 57, no 6, p. 838-844Article in journal (Refereed) Published
Abstract [en]

Background:

Creatinine measurement for estimation of glomerular filtration rate (GFR) is a frequently used laboratory test. Differences in analytic creatinine methods have caused large inter-laboratory variation. International and national standardization efforts have been made in the last decade.

Methods:

This study describes the results of the standardization efforts in Sweden by summarizing data for creatinine concentration in blood plasma in the Equalis quality assessment program during 1996-2014.

Results:

Non-compensated Jaffe methods dominated in 1996-2001 (91 of 103 laboratories; 90%) and were then gradually replaced by either compensated Jaffe methods or enzymatic creatinine methods. In 2014 a majority of Swedish hospital laboratories (139 of 159; 87%) used enzymatic methods. The reported mean creatinine value by the Swedish laboratories was about 10 mu mol/L higher than the isotope dilution mass spectrometry (IDMS) assured reference value in 2003, but consistent with the reference value from 2009 to 2014. The inter-laboratory CV was 7%-9% for creatinine values until 2007, and thereafter gradually decreased to about 4%-5% in 2014.

Conclusions:

The introduction of enzymatic methods in Swedish laboratories has contributed to achieving a low inter-laboratory variation. Also, the reported values are lower for enzymatic methods compared to Jaffe methods, and the values obtained with enzymatic methods were consistent with IDMS certified values established at reference laboratories. Thus, many Swedish hospital laboratories reported 10 mu mol/L lower, and more true, creatinine concentrations in 2012 than in 2003, which may cause bias in longitudinal studies.

Keywords
creatinine methods, external quality assessment, harmonization, inter-laboratory variation, standardization
National Category
Clinical Laboratory Medicine
Identifiers
urn:nbn:se:uu:diva-384061 (URN)10.1515/cclm-2018-0670 (DOI)000466846200020 ()30982002 (PubMedID)
Available from: 2019-06-20 Created: 2019-06-20 Last updated: 2019-06-20Bibliographically approved
Peura, S., Fall, T., Almqvist, C., Andolf, E., Hedman, A., Pershagen, G., . . . Larsson, A. (2018). Normal values for calprotectin in stool samples of infants from the population-based longitudinal born into life study. Scandinavian Journal of Clinical and Laboratory Investigation, 78(1-2), 120-124
Open this publication in new window or tab >>Normal values for calprotectin in stool samples of infants from the population-based longitudinal born into life study
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2018 (English)In: Scandinavian Journal of Clinical and Laboratory Investigation, ISSN 0036-5513, E-ISSN 1502-7686, Vol. 78, no 1-2, p. 120-124Article in journal (Refereed) Published
Abstract [en]

Faecal calprotectin is a protein used as a diagnostic marker for inflammatory bowel diseases. We determined upper limits for normal calprotectin values for neonatal, 6, 12 and 24 months old children using a turbidimetric immunoassay in a cohort of Swedish children. The advantage of the method is that opposite to previously used enzyme-linked immunosorbent assay (ELISA) method, it enables measuring single samples, and thus, shortens the analysis time significantly. There were 72 samples (41.7% female) collected neonatally, 63 samples (34.9% female) at 6 months, 60 samples (40.0% female) at 12 months and 51 samples (43.1% female) at 24 months. The upper limits for normal values were 233, 615, 136 and 57 µg mg-1 for infants aged 0, 6, 12 and 24 months, respectively.

Place, publisher, year, edition, pages
Taylor & Francis Group, 2018
Keywords
Calprotectin, abdominal pain, inflammatory bowel disease, normal values, turbidimetric immunoassay
National Category
Gastroenterology and Hepatology Clinical Laboratory Medicine
Identifiers
urn:nbn:se:uu:diva-337523 (URN)10.1080/00365513.2017.1420216 (DOI)000424952600019 ()29283308 (PubMedID)
Funder
Swedish Research Council, 2015-03477 2010-15062-79050-11 2015-02434Stockholm County CouncilSwedish Heart Lung Foundation
Available from: 2017-12-30 Created: 2017-12-30 Last updated: 2018-04-10Bibliographically approved
Ridefelt, P. & Helmersson-Karlqvist, J. (2017). Albumin adjustment of total calcium does not improve the estimation of calcium status. Scandinavian Journal of Clinical and Laboratory Investigation, 77(6), 442-447
Open this publication in new window or tab >>Albumin adjustment of total calcium does not improve the estimation of calcium status
2017 (English)In: Scandinavian Journal of Clinical and Laboratory Investigation, ISSN 0036-5513, E-ISSN 1502-7686, Vol. 77, no 6, p. 442-447Article in journal (Refereed) Published
Abstract [en]

Background: There is a longstanding controversy as to whether plasma measurements of total calcium should be adjusted for albumin concentration, and if so which formulas are the most appropriate.Methods: Ionised calcium, total calcium and albumin results, analysed at the same time at Uppsala University Hospital Laboratory between February 2005 and June 2013, were retrieved from a laboratory information system. The dataset included results from 20,003 patients. Total calcium was albumin-modified by a locally derived formula, based on 3106 patients from the dataset, and formulas from the literature. The agreement between the reference method ionised calcium and unadjusted total calcium and the seven different albumin-modifying calcium formulas, respectively, were compared with intra-class correlation coefficients (ICC).Results: Total calcium showed substantial agreement to ionised calcium, ICC 0.85 (95% CI 0.84-0.86) for the whole validation cohort. Albumin-modified calcium by different formulas showed significantly less or equal agreement, however the locally determined formula performed better than formulas taken from the literature. Also, total calcium classified the patient as hypo-normo- or hypercalcemic right in 82% of the patients. The albumin-modified calcium did not classify patients significantly better except in the subgroup hypoalbuminemia (<30g/L) where the local formula classified the patients slightly better than total calcium.Conclusions: Albumin modification of total calcium determinations is unlikely to add valuable information, and this practice should be abandoned. Ionised calcium should be used more frequently when aberrant results for total calcium are followed up, or in patients with known hypoalbuminemia.

Keywords
Calcium, human, hypercalcemia, hypocalcemia, plasma albumin
National Category
Clinical Laboratory Medicine
Identifiers
urn:nbn:se:uu:diva-335545 (URN)10.1080/00365513.2017.1336568 (DOI)000409183500009 ()28613958 (PubMedID)
Available from: 2017-12-06 Created: 2017-12-06 Last updated: 2017-12-06Bibliographically approved
Fall, T., Mandic-Havelka, A., Helmersson, J., Sundstrom, J. & Sundström, J. (2017). Reference Intervals for Fecal Calprotectin in Adults Using Two Different Extraction Methods in the Uppsala-SCAPIS Cohort.. Clinical Laboratory, 63(9), 1493-1496
Open this publication in new window or tab >>Reference Intervals for Fecal Calprotectin in Adults Using Two Different Extraction Methods in the Uppsala-SCAPIS Cohort.
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2017 (English)In: Clinical Laboratory, ISSN 1433-6510, Vol. 63, no 9, p. 1493-1496Article in journal (Refereed) Published
Abstract [en]

Background: Fecal calprotectin measurement is generally recommended to exclude inflammatory bowel disease (IBD) in patients with suspected IBD. A problem with the fecal calprotectin assays so far has been the rather long test-turnaround times. Recently a particle enhanced turbidimetric immunoassay (PETIA) for fecal calprotectin with assay times of approximately 10 minutes has been introduced on the European market. The aim of this study was to define reference intervals for adults with this new fecal calprotectin PETIA using two different extraction methods.

Methods: Samples were collected from 382 healthy individuals from the Swedish CArdioPulmonary bioImage Study (SCAPIS) Uppsala cohort in the age range 50 - 65 years. 202 samples were processed with CALEX® Cap extraction device (BÜHLMANN, Schönenbuch, Switzerland) and 180 samples were extracted using weighed samples. The extracted samples were analyzed on a Mindray BS-380 using the fCal Turbo PETIA reagent (BÜHLMANN).

Results: The calculated reference values for the Calex device were < 199 µg/g for the whole cohort, < 184 µg/g for females, and < 215 µg/g for males, while the corresponding values for weighed samples were < 153 µg/g for the whole cohort, < 141 µg/g for females, and < 215 µg/g for males. There were no significant statistical differences for calprotectin levels in males and females.

Conclusions: The CALEX device yielded slightly higher calprotectin values. As there were no significant gender differences, the study indicates gender independent reference intervals of < 199 µg/g feces for the CALEX device and < 153 µg/g feces for weighed samples in patients in the 50 - 65 year age range.

Keywords
biological markers, calprotectin, feces, inflammatory bowel diseases, method validation
National Category
Gastroenterology and Hepatology Biomedical Laboratory Science/Technology
Identifiers
urn:nbn:se:uu:diva-329204 (URN)10.7754/Clin.Lab.2017.170412 (DOI)000410465900021 ()28879709 (PubMedID)
Funder
EU, European Research Council, E!7991Knut and Alice Wallenberg FoundationSwedish Research Council, 2015-03477Swedish Heart Lung Foundation, 20150 429Göran Gustafsson Foundation for Research in Natural Sciences and Medicine
Available from: 2017-09-14 Created: 2017-09-14 Last updated: 2017-12-15Bibliographically approved
Khezri, B. S., Cederblad, M., Helmersson-Karlqvist, J., Karlsson, B., Melhus, H. & Larsson, A. (2017). Seasonal variability of NT-proBNP in Swedish primary care patients. Chronobiology International, 34(10), 1473-1477
Open this publication in new window or tab >>Seasonal variability of NT-proBNP in Swedish primary care patients
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2017 (English)In: Chronobiology International, ISSN 0742-0528, E-ISSN 1525-6073, Vol. 34, no 10, p. 1473-1477Article in journal (Refereed) Published
Abstract [en]

The aim of this study was to determine if there is a seasonal variation in the widely used heart failure marker NT-proBNP. The study included all primary care requests for NT-proBNP in the county of Uppsala, Sweden, between January 2007 and December 2015. For seasonal variation, the NT-proBNP results for individual months were compared. The NT-proBNP values were highest in July to September, but there was also a minor peak in December-January. In conclusion, a seasonal periodicity for NT-proBNP was demonstrated in primary care patients. The data could be useful for practitioners for evaluation of NT-proBNP results and monitoring of patients with heart failure.

Place, publisher, year, edition, pages
Taylor & Francis, 2017
Keywords
Heart failure, natriuretic peptide, seasonal variation
National Category
Cardiac and Cardiovascular Systems
Identifiers
urn:nbn:se:uu:diva-335291 (URN)10.1080/07420528.2017.1366500 (DOI)000423083600013 ()28910541 (PubMedID)
Available from: 2017-12-03 Created: 2017-12-03 Last updated: 2018-03-15Bibliographically approved
Åkerblom, A., Helmersson, J., Weitoft, T. & Larsson, A. (2017). Seasonal variations of urate in a Swedish adult population. Clinical Rheumatology, 36(7), 1595-1598
Open this publication in new window or tab >>Seasonal variations of urate in a Swedish adult population
2017 (English)In: Clinical Rheumatology, ISSN 0770-3198, E-ISSN 1434-9949, Vol. 36, no 7, p. 1595-1598Article in journal (Refereed) Published
Abstract [en]

Seasonality in the incidence and prevalence of gout has previously been reported but the cause of this seasonality in gout is not explained. The aim of this study was to evaluate possible seasonal variations of urate in a large unselected Swedish adult population. We analyzed 170,915 urate test results from patients at a tertiary care hospital between 2000 and 2016. The results were divided according to sex and sampling month of the year. The median urate values were overall higher in males compared to females and both males and females had peak urate concentrations in the summer months (June-August). There is a seasonal pattern for urate concentrations in a large Swedish population similar to the previously reported seasonality for gout. This may be clinically important and could contribute to the circannual variation of gout. The seasonal pattern should be recognized when evaluating patient results both in clinical practice and in research studies.

Keywords
Biological markers, Circannual variation, Gout, Humans, Urate, Uric acid
National Category
Rheumatology and Autoimmunity
Identifiers
urn:nbn:se:uu:diva-317226 (URN)10.1007/s10067-017-3591-z (DOI)000403662600017 ()28283767 (PubMedID)
Available from: 2017-03-12 Created: 2017-03-12 Last updated: 2018-09-03Bibliographically approved
Feldreich, T., Carlsson, A. C., Helmersson, J., Risérus, U., Larsson, A., Lind, L. & Ärnlöv, J. (2017). Urinary Osteopontin Predicts Incident Chronic Kidney Disease, while Plasma Osteopontin Predicts Cardiovascular Death in Elderly Men. Cardiorenal Medicine, 7(3), 245-254
Open this publication in new window or tab >>Urinary Osteopontin Predicts Incident Chronic Kidney Disease, while Plasma Osteopontin Predicts Cardiovascular Death in Elderly Men
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2017 (English)In: Cardiorenal Medicine, Vol. 7, no 3, p. 245-254Article in journal (Refereed) Published
Abstract [en]

Background and Objectives: The matricellular protein osteopontin is involved in the pathogenesis of both kidney and cardiovascular disease. However, whether circulating and urinary osteopontin levels are associated with the risk of these diseases is less studied.

Design, Setting, Participants, and Measurements: A community-based cohort of elderly men (Uppsala Longitudinal Study of Adult Men [ULSAM]; n = 741; mean age: 77 years) was used to study the associations between plasma and urinary osteopontin, incident chronic kidney disease, and the risk of cardiovascular death during a median of 8 years of follow-up.

Results: There was no significant cross-sectional correlation between plasma and urinary osteopontin (Spearman. = 0.07, p = 0.13). Higher urinary osteopontin, but not plasma osteopontin, was associated with incident chronic kidney disease in multivariable models adjusted for age, cardiovascular risk factors, baseline glomerular filtration rate, urinary albumin/ creatinine ratio, and the inflammatory markers interleukin 6 and high-sensitivity C-reactive protein (odds ratio for 1 standard deviation [SD] of urinary osteopontin, 1.42, 95% CI 1.00-2.02, p = 0.048). Conversely, plasma osteopontin, but not urinary osteopontin, was independently associated with cardiovascular death (multivariable hazard ratio per SD increase, 1.35, 95% CI 1.14-1.58, p < 0.001, and 1.00, 95% CI 0.79-1.26, p = 0.99, respectively). The addition of plasma osteopontin to a model with established cardiovascular risk factors significantly increased the C-statistics for the prediction of cardiovascular death (p < 0.002).

Conclusions: Higher urinary osteopon-tin specifically predicts incident chronic kidney disease, while plasma osteopontin specifically predicts cardiovascular death. Our data put forward osteopontin as an important factor in the detrimental interplay between the kidney and the cardiovascular system. The clinical implications, and why plasma and urinary osteopontin mirror different pathologies, remain to be established.

National Category
Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
urn:nbn:se:uu:diva-326676 (URN)10.1159/000476001 (DOI)000404741600009 ()28736565 (PubMedID)
Funder
Swedish Research CouncilSwedish Heart Lung FoundationMarianne and Marcus Wallenberg Foundation
Available from: 2017-07-21 Created: 2017-07-21 Last updated: 2017-10-03Bibliographically approved
Feldreich, T. R., Carlsson, A. C., Helmersson-Karlqvist, J., Risérus, U., Larsson, A., Lind, L. & Ärnlöv, J. (2016). Higher circulating osteopontin specifically predicts cardiovascular death while urinary osteopontin predicts kidney disease progression. Paper presented at Congress of the European-Society-of-Cardiology (ESC), AUG 27-31, 2016, Rome, ITALY. EUROPEAN HEART JOURNAL, 37, 1282-1282
Open this publication in new window or tab >>Higher circulating osteopontin specifically predicts cardiovascular death while urinary osteopontin predicts kidney disease progression
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2016 (English)In: EUROPEAN HEART JOURNAL, ISSN 0195-668X, Vol. 37, p. 1282-1282Article in journal, Meeting abstract (Refereed) Published
National Category
Cardiac and Cardiovascular Systems
Identifiers
urn:nbn:se:uu:diva-313885 (URN)000383869506287 ()
Conference
Congress of the European-Society-of-Cardiology (ESC), AUG 27-31, 2016, Rome, ITALY
Available from: 2017-01-25 Created: 2017-01-25 Last updated: 2017-01-25Bibliographically approved
Helmersson, J., Ridefelt, P., Lind, L. & Larsson, A. (2016). Reference values for 34 frequently used laboratory tests in 80-year-old men and women. Maturitas, 92, 97-101
Open this publication in new window or tab >>Reference values for 34 frequently used laboratory tests in 80-year-old men and women
2016 (English)In: Maturitas, ISSN 0378-5122, E-ISSN 1873-4111, Vol. 92, p. 97-101Article in journal (Refereed) Published
Abstract [en]

OBJECTIVES: Reference values are usually based on blood samples from healthy individuals in the age range 20-50 years. Most patients seeking health care are older than this reference population. Many reference intervals are age dependent and there is thus a need to have appropriate reference intervals also for elderly individuals.

METHODS: We analyzed a group of frequently used laboratory tests in an 80-year-old population (n=531, 266 females and 265 males). The 2.5th and 97.5th percentiles for these markers were calculated according to the International Federation of Clinical Chemistry guidelines on the statistical treatment of reference values.

RESULTS: Reference values are reported for serum alanine transaminase (ALT), albumin, alkaline phosphatase, pancreatic amylase, apolipoprotein A1, apolipoprotein B, apolipoprotein B/apolipoprotein A1 ratio, aspartate aminotransferase (AST), AST/ALT ratio, bilirubin, calcium, calprotectin, cholesterol, HDL-cholesterol, creatinine kinase (CK), creatinine, creatinine estimated GFR, C-reactive protein, cystatin C, cystatin C estimated GFR, gamma-glutamyltransferase (GGT), iron, iron saturation, lactate dehydrogenase (LDH), magnesium, phosphate, transferrin, triglycerides, urate, urea, zinc, hemoglobin, platelet count and white blood cell count. The upper reference limit for creatinine and urea was significantly increased while the lower limit for iron and albumin was decreased in this elderly population in comparison with the population in the Nordic Reference Interval Project (NORIP).

CONCLUSIONS: Reference values calculated from the whole population and a subpopulation without cardiovascular disease showed strong concordance. Several of the reference interval limits were outside the 90% confidence interval of NORIP.

National Category
Clinical Laboratory Medicine
Identifiers
urn:nbn:se:uu:diva-303898 (URN)10.1016/j.maturitas.2016.07.015 (DOI)000384787700016 ()27621245 (PubMedID)
Available from: 2016-09-26 Created: 2016-09-26 Last updated: 2017-11-21Bibliographically approved
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