WO2017200025A1 - 糖尿病を判定するための血液試料の分析方法及びシステム - Google Patents
糖尿病を判定するための血液試料の分析方法及びシステム Download PDFInfo
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- WO2017200025A1 WO2017200025A1 PCT/JP2017/018592 JP2017018592W WO2017200025A1 WO 2017200025 A1 WO2017200025 A1 WO 2017200025A1 JP 2017018592 W JP2017018592 W JP 2017018592W WO 2017200025 A1 WO2017200025 A1 WO 2017200025A1
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- G—PHYSICS
- G01—MEASURING; TESTING
- G01N—INVESTIGATING OR ANALYSING MATERIALS BY DETERMINING THEIR CHEMICAL OR PHYSICAL PROPERTIES
- G01N33/00—Investigating or analysing materials by specific methods not covered by groups G01N1/00 - G01N31/00
- G01N33/48—Biological material, e.g. blood, urine; Haemocytometers
- G01N33/50—Chemical analysis of biological material, e.g. blood, urine; Testing involving biospecific ligand binding methods; Immunological testing
- G01N33/68—Chemical analysis of biological material, e.g. blood, urine; Testing involving biospecific ligand binding methods; Immunological testing involving proteins, peptides or amino acids
- G01N33/6893—Chemical analysis of biological material, e.g. blood, urine; Testing involving biospecific ligand binding methods; Immunological testing involving proteins, peptides or amino acids related to diseases not provided for elsewhere
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- G—PHYSICS
- G01—MEASURING; TESTING
- G01N—INVESTIGATING OR ANALYSING MATERIALS BY DETERMINING THEIR CHEMICAL OR PHYSICAL PROPERTIES
- G01N33/00—Investigating or analysing materials by specific methods not covered by groups G01N1/00 - G01N31/00
- G01N33/48—Biological material, e.g. blood, urine; Haemocytometers
- G01N33/50—Chemical analysis of biological material, e.g. blood, urine; Testing involving biospecific ligand binding methods; Immunological testing
- G01N33/68—Chemical analysis of biological material, e.g. blood, urine; Testing involving biospecific ligand binding methods; Immunological testing involving proteins, peptides or amino acids
- G01N33/6803—General methods of protein analysis not limited to specific proteins or families of proteins
- G01N33/6806—Determination of free amino acids
- G01N33/6812—Assays for specific amino acids
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- G—PHYSICS
- G01—MEASURING; TESTING
- G01N—INVESTIGATING OR ANALYSING MATERIALS BY DETERMINING THEIR CHEMICAL OR PHYSICAL PROPERTIES
- G01N33/00—Investigating or analysing materials by specific methods not covered by groups G01N1/00 - G01N31/00
- G01N33/48—Biological material, e.g. blood, urine; Haemocytometers
- G01N33/50—Chemical analysis of biological material, e.g. blood, urine; Testing involving biospecific ligand binding methods; Immunological testing
- G01N33/68—Chemical analysis of biological material, e.g. blood, urine; Testing involving biospecific ligand binding methods; Immunological testing involving proteins, peptides or amino acids
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- G—PHYSICS
- G01—MEASURING; TESTING
- G01N—INVESTIGATING OR ANALYSING MATERIALS BY DETERMINING THEIR CHEMICAL OR PHYSICAL PROPERTIES
- G01N2800/00—Detection or diagnosis of diseases
- G01N2800/04—Endocrine or metabolic disorders
- G01N2800/042—Disorders of carbohydrate metabolism, e.g. diabetes, glucose metabolism
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- G—PHYSICS
- G01—MEASURING; TESTING
- G01N—INVESTIGATING OR ANALYSING MATERIALS BY DETERMINING THEIR CHEMICAL OR PHYSICAL PROPERTIES
- G01N2800/00—Detection or diagnosis of diseases
- G01N2800/70—Mechanisms involved in disease identification
- G01N2800/7042—Aging, e.g. cellular aging
Definitions
- the present invention relates to a blood sample analysis method for determining diabetes based on amino acid amounts of D-form and L-form from a blood sample, a test method for diabetes, and a sample analysis system for outputting pathological information about diabetes.
- Diabetes is a metabolic disorder characterized by hyperglycemia and is roughly divided into type 1 and type 2 diabetes.
- Type 1 diabetes is a disease that develops when an immune reaction is induced by genetic factors and viral infection, and ⁇ -cells are selectively destroyed, and is usually caused by autoimmunity but rarely occurs spontaneously.
- Type 2 diabetes is diabetes that is caused by two causes: decreased insulin secretion and decreased sensitivity.
- Type 2 diabetes is classified as a lifestyle-related disease, but its cause has not been fully clarified. It is believed that type 2 diabetes develops when a person who is genetically prone to diabetes (genetic factor) sends a lifestyle habit of becoming susceptible to diabetes (environmental factor).
- Insulin mainly has an action of suppressing blood sugar, promotes uptake of glucose, amino acids and potassium in skeletal muscle and promotes protein synthesis, inhibits gluconeogenesis in the liver, inhibits synthesis and degradation of glycogen, and in adipose tissue It has the effect of suppressing blood sugar by promoting sugar uptake and utilization, promoting fat synthesis and inhibiting decomposition, and promoting the formation of various storage substances such as glycogen and fat.
- blood sugar in the blood is always kept within a certain range by the action of insulin.
- HbA1C hemoglobin A1C
- HbA1C which is usually a protein biomarker
- HbA1C serves as a long-term measure of blood glucose control.
- HbA1C has also been used to confirm the effectiveness of treatment for diabetes in patients, but inconsistent results sometimes occurred in patients who received treatment. Therefore, for the determination of diabetes, HbA1C and fasting blood glucose level are usually used in combination as markers, and when both markers indicate diabetes, only one marker indicates diabetes while diagnosis is made for diabetes. In some cases, the diagnosis of diabetes is further made by observing typical symptoms of diabetes. Therefore, it will still ultimately depend on the interpretation and judgment of the diagnosing physician.
- HbA1C is not suitable for determination of short-term therapeutic effects in patients who have been treated for diabetes, and its therapeutic effects can be achieved by combining short-term diabetes markers such as 1,5-andro-D-glycitol and glucoalbumin. Judgment and follow-up are performed.
- Diabetic nephropathy is known as a complication of diabetes. If the blood glucose level continues to be high due to diabetes, the glomeruli of the kidney are damaged and the renal function is reduced. Diabetes is cited as one of the causes of chronic renal failure, and the treatment policy differs between patients with renal failure who have diabetes and those who do not have diabetes. There is a need to do high. In patients with renal failure, urinary albumin level or urinary albumin / creatinine ratio is known as a marker for diabetes mellitus, but there are problems in terms of quantitativeness, sensitivity, cost, and the like.
- Patent Document 4 D-amino acids, which have been conventionally considered not to exist in mammalian organisms (Patent Document 4), have some physiological functions. It was expected to bear. Some D-amino acids in body fluids have been shown to vary independently of L-amino acids, and have been shown to vary depending on the type of disease (Patent Document 5). In Patent Document 5, changes in D-amino acids and L-amino acids in diabetic patients were examined. Of these 40 chiral amino acids, D-alanine, L-cysteine and L-glutamic acid were found in diabetic patients. While it was confirmed that it fluctuated, fluctuations in other amino acids could not be confirmed.
- the present inventors have analyzed chiral amino acids in the blood of a cohort suffering from renal impairment, and found that in this cohort, some chiral amino acids surprisingly fluctuate in relation to diabetes. Invented.
- the present invention relates to a blood sample analysis method for determining diabetes, and relates to an analysis method capable of determining diabetes based on the amount of at least one amino acid among chiral amino acids.
- the present invention relates to a sample analysis system capable of performing the analysis method of the present invention.
- a sample analysis system includes a storage unit, an input unit, an analysis measurement unit, a data processing unit, and an output unit, and can analyze a blood sample and output diabetic condition information. .
- the present invention relates to a program that can be installed in the sample analysis system of the present invention and a storage medium that stores the program.
- It can provide a novel diabetes marker that can fluctuate based on a principle different from the amount of albumin appearing in urine due to protein glycation or decreased renal function, and it can be used with multiple chiral amino acid amounts in combination for higher accuracy Enable judgment.
- FIG. 1-A shows an ROC curve for the sensitivity and specificity of diabetes diagnosis by D-Asp.
- FIG. 1-B shows an ROC curve for the sensitivity and specificity of diabetes diagnosis by D-Pro.
- FIG. 1-C shows an ROC curve for the sensitivity and specificity of diabetes diagnosis by L-Gln.
- FIG. 1-D shows an ROC curve for the sensitivity and specificity of diabetes diagnosis by L-Ile.
- FIG. 2-A shows the amount of D-Asp in a subject suffering from diabetes and a subject not suffering from diabetes.
- FIG. 2-B shows the amount of D-Pro in a subject suffering from diabetes and a subject not suffering from diabetes.
- FIG. 2-C shows the amount of L-Gln in a subject with diabetes and a subject without diabetes.
- FIG. 3-A is a diagram showing the correlation between age and D-Ala value (1), a diagram showing a ROC curve (2), and a diagram showing a ROC curve between age and D / L% value (3).
- FIG. 3B is a diagram showing the correlation between age and D-Pro value (1), a diagram showing a ROC curve (2), and a diagram showing a ROC curve between age and D / L% value (3).
- FIG. 3C is a diagram (1) showing the correlation between the age and the D-allo-Ile value, and a diagram (2) showing the ROC curve.
- FIG. 3D is a diagram (1) showing the correlation between the age and the D-Leu value, and a diagram (2) showing the ROC curve.
- FIG. 3E is a diagram (1) showing the correlation between the age and the L-Ile value, and a diagram (2) showing the ROC curve.
- FIG. 3F is a diagram (1) showing the correlation between the age and the L-Ser value, and a diagram (2) showing the ROC curve.
- FIG. 4-A shows the correlation between the estimated glomerular filtration rate (eGFR) and (1) L-Asn value, (2) D-Asn value, and (3) D / L-Asn value.
- FIG. 4-B is a diagram showing the correlation between the estimated glomerular filtration rate (eGFR) and (1) L-Ser value, (2) D-Ser value, and (3) D / L-Ser value.
- FIG. 4-C shows the correlation between the estimated glomerular filtration rate (eGFR) and (1) L-Asp value, (2) D-Asp value, and (3) D / L-Asp value.
- FIG. 4-D is a diagram showing a correlation between the estimated glomerular filtration rate (eGFR) and (1) L-Ala value, (2) D-Ala value, and (3) D / L-Ala value.
- FIG. 4-E is a diagram showing the correlation between the estimated glomerular filtration rate (eGFR), (1) L-Ile value, and (2) D-allo-Ile value.
- FIG. 4-F is a diagram showing the correlation between the estimated glomerular filtration rate (eGFR) and (1) L-Phe value, (2) D-Phe value, and (3) D / L-Phe value.
- FIG. 4-G is a diagram showing a correlation between the estimated glomerular filtration rate (eGFR) and (1) L-Lys value, (2) D-Lys value, and (3) D / L-Lys value.
- FIG. 4-H is a diagram showing a correlation between the estimated glomerular filtration rate (eGFR), (1) L-Thr value, and (2) D-Allo-Thr value.
- FIG. 4-I shows the correlation between the estimated glomerular filtration rate (eGFR) and (1) L-Pro value, (2) D-Pro value, and (3) D / L-Pro value.
- FIG. 4-J is a diagram showing the correlation between the estimated glomerular filtration rate (eGFR) and (1) L-Leu value, (2) D-Leu value, and (3) D / L-Leu value.
- FIG. 4-K is a diagram showing the correlation between the estimated glomerular filtration rate (eGFR) and (1) L-Trp value.
- FIG. 4-L is a diagram showing the correlation between the estimated glomerular filtration rate (eGFR) and (1) L-Tyr value.
- FIG. 5 is a block diagram of the analysis system of the present invention.
- FIG. 6 is a flowchart showing an example of an operation for determining diabetes combination.
- FIG. 7 is a flowchart showing an example of an operation for determining a renal disorder and diabetes complication.
- the present invention relates to a blood sample analysis method for determining diabetes in a subject, comprising the steps of measuring the amount of at least one amino acid among chiral amino acids, and the measured amount of the at least one amino acid.
- the present invention relates to an analysis method including a step of determining diabetes. Since the pathological condition of diabetes can be determined by the analysis method of the present invention, in another aspect, the present invention can also be called a diagnostic method.
- the step of measuring the amount of chiral amino acid only the target chiral amino acid may be measured, or it may be measured together with other chiral amino acids. Chiral amino acids can also be diagnostic markers for other diseases. Therefore, from the viewpoint of analyzing a plurality of diseases at once, it is preferable to measure D-form and L-form collectively for 20 types of protein-constituting amino acids in a blood sample.
- a step of acquiring a blood sample and a step of processing the acquired blood sample may be performed prior to the step of measuring the amount of chiral amino acid.
- the blood sample may be any sample as long as it is a sample derived from blood such as blood, serum, or plasma.
- the presence or absence of diabetes can be determined by comparing a specific chiral amino acid amount with a cutoff value. Whether the cut-off value exceeds the high value side or the low value side can be appropriately selected depending on whether the chiral amino acid used increases or decreases when suffering from diabetes. For example, in the case of D-Asp, D-Pro, and L-Gln, it is decreased in diabetic patients. Therefore, when belonging to the low value group, it can be determined that the patient suffers from diabetes, and when belonging to the high value group, diabetes is Can be determined not to be affected.
- the measured value includes an index value obtained from the measured amount.
- the index value may be a measured amount of amino acid or may be calculated based on the measured amount. For example, a corresponding isomer (ie, L-form for D-form, D-form for L-form) ) And the ratio, etc.
- a variable in addition to the amount of the corresponding isomer, any variable that can influence the amount of chiral amino acid such as age, weight, sex, BMI, etc. can be used.
- the amount of at least one chiral amino acid in a blood sample is classified into two or more groups based on the cutoff value, and diabetes can be determined according to the classification.
- the inventors have found that when the amount of a specific chiral amino acid in the blood is high or low, it has been found to develop diabetes. Can be determined to be suffering from. Therefore, the determination may be performed by a medical assistant who is not a doctor, or may be performed by an analysis organization or the like. Therefore, it can be said that the analysis method of the present invention is a preliminary method or an auxiliary method of diagnosis.
- the analysis method of the present invention may include a step of calculating as a disease state index value for determining diabetes instead of the step of determining diabetes.
- the specific chiral amino acid used for the determination of diabetes refers to D-form or L-form of protein-constituting amino acids. Since D body and L body have different dynamics and metabolism in the body, prognosis can be predicted with high accuracy by discriminating between D body and L body.
- the protein constituting amino acids include alanine (Ala), arginine (Arg), asparagine (Asn), aspartic acid (Asp), cysteine (Cys), glutamine (Gln), glutamic acid (Glu), glycine (Gly), histidine (His).
- Isoleucine Ile
- leucine Leu
- lysine Lys
- methionine Met
- proline Pro
- Ser proline
- Ser serine
- Thr tryptophan
- Trp tryptophan
- Tr tyrosine
- Val valine
- D-aspartic acid D-Asp
- D-proline D-Pro
- L-glutamine L-Gln
- L-isoleucine L-Ile
- D-Asp D-aspartic acid
- D-Pro D-proline
- L-glutamine L-Gln
- L-isoleucine L-Ile
- the boundary for determining diabetes can be arbitrarily determined by analyzing the cohort and performing statistical processing.
- the statistical processing method may be any method known to those skilled in the art, for example, ROC analysis, t-test, etc. may be used, and the average value, median value, X percentile value of the healthy group or diabetic group Can also be used.
- any numerical value can be selected for X, and 3, 5, 10, 15, 20, 30, 40, 60, 70, 80, 85, 90, 95, and 97 can be appropriately used.
- the cut-off value may be one, or the disease state can be classified according to the severity of the disease.
- the cut-off value that defines the boundary varies depending on the type of cohort, but as an example, the cut-off value for determining diabetes by ROC analysis of the cohort used in the present example is 0.1 ⁇ g for D-aspartic acid. / Ml, 2.5 ⁇ g / ml for D-proline, 665 ⁇ g / ml for L-glutamine, and 49.3 ⁇ g / ml for L-isoleucine. If the subject's blood D-amino acid concentration is higher or lower than these cut-off values, it can be determined that diabetes has developed. However, it is not intended that the cut-off value used be limited to the cut-off value.
- the target may be any target, and for example, the analysis method of the present invention can be performed on a healthy person or a person who may have diabetes.
- the subject may include any subject because the method of analyzing the present invention is used in a medical examination.
- the subject is a subject suffering from a renal disorder.
- the determination of diabetes in the present invention makes it possible to determine whether or not the patient has diabetes as a complication in a patient who has been determined to suffer from a renal disorder. Therefore, in one aspect, the subject in the present invention refers to a patient diagnosed or determined as having a renal disorder. Renal disorder refers to a condition in which renal function is reduced, and is roughly classified into acute renal failure and chronic renal failure. A decrease in renal function is determined by a decrease in glomerular filtration rate (GFR), but it may be determined by an estimated glomerular filtration rate (eGFR) calculated from creatinine values based on variables such as age and sex. Good.
- GFR glomerular filtration rate
- eGFR estimated glomerular filtration rate
- a renal disorder marker showing a decrease in renal function such as serum creatinine concentration, KIM-1 or NGAL.
- a patient determined to have renal disorder can be determined in advance or simultaneously based on the measured amount of at least one amino acid used to determine renal disorder among chiral amino acids. .
- a further aspect of the present invention relates to a method for analyzing a blood sample for the purpose of determining a renal disorder and determining diabetic complications in any subject.
- a step of measuring the amount of at least one amino acid used for determination of renal disorder and at least one amino acid used for determination of diabetes mellitus, and at least one used for determination of the renal disorder A step of determining renal damage based on the measured amount of amino acid of the step, and a step of determining diabetes combined based on the measured amount of at least one amino acid used for determination of the diabetes combined when it is determined to be renal disorder including.
- Determination of kidney damage is made based on the amount of at least one chiral amino acid in the blood sample.
- nephropathy can be determined by applying the amount of at least one chiral amino acid in a blood sample to two or more pre-classified groups, and in a further aspect the severity of nephropathy. The severity can be determined.
- the boundary for determining renal impairment can be arbitrarily determined by analyzing the cohort and performing statistical processing.
- the statistical processing method may be a method known to those skilled in the art. For example, ROC analysis, t-test or the like may be used, and the average value, median value, and X percentile value of the healthy group or patient group may be used. It can also be used. Here, any numerical value can be selected for X, and 3, 5, 10, 15, 20, 30, 40, 60, 70, 80, 85, 90, 95, and 97 can be appropriately used.
- the cut-off value may be one, or the disease state can be classified according to the severity of the disease.
- the chiral amino acids used for the determination of renal damage include D-asparagine, D-serine, D-aspartic acid, D-allo-threonine, D-alanine, D-proline, D-leucine, L-histidine, and L-serine.
- L-aspartic acid, L-alanine, L-isoleucine, L-phenylalanine, L-tryptophan, L-lysine, and L-tyrosine, and their cut-off values can be arbitrarily determined by cohort analysis. it can. If the blood D-amino acid concentration in the subject is higher than the cut-off value, it can be determined that the renal disorder has occurred.
- the invention in a further aspect of the invention, relates to a method for determining an eGFR value based on the amount of at least one chiral amino acid in a blood sample.
- This method includes the steps of measuring the amount of at least one chiral amino acid in a blood sample and determining an eGFR value based on the measured value of the at least one chiral amino acid.
- the step of determining the eGFR value based on the measured value of the chiral amino acid can be determined based on a predetermined regression curve.
- the step of determining the eGFR value based on the measured value of the chiral amino acid comprises dividing the cohort into a plurality of groups according to the amount of the chiral amino acid, and the group and the eGFR value or the range thereof are associated in advance.
- the measured values may be classified into the group.
- Such chiral amino acids include D-asparagine, D-serine, D-aspartic acid, D-allo-threonine, D-alanine, D-proline, D-leucine, L-histidine, L-serine, L-asparagine.
- At least one amino acid selected from the group consisting of acid, L-alanine, L-isoleucine, L-phenylalanine, L-tryptophan, L-lysine, and L-tyrosine can be used.
- Chiral amino acids can be used as markers of renal damage and diabetes depending on the type of the amino acid. By measuring chiral amino acids comprehensively, it is possible to determine complications of diabetes after determining renal damage. be able to.
- Chiral amino acids that do not increase or decrease in patients with renal impairment are preferred in determining diabetes complications in patients with renal impairment, such as D-aspartic acid (D-Asp), L-glutamine (L-Gln), and L- At least one amino acid selected from the group consisting of isoleucine (L-Ile), or any combination thereof is used.
- D-Asp D-aspartic acid
- L-Gln L-glutamine
- L-Ile L- At least one amino acid selected from the group consisting of isoleucine
- the measurement of the amount of chiral amino acid in the sample may be performed using any method known to those skilled in the art.
- OPA o-phthalaldehyde
- Boc-L-Cys N-tert-butyloxycarbonyl-L-cysteine
- other modifying reagents are derivatized stereospecifically with D- and L-amino acids, and then By using a analytical column such as ODS-80TsQA to separate a mixture of 100 mM acetate buffer (pH 6.0) and acetonitrile by gradient elution, it is possible to simultaneously measure D-form and L-form of amino acids. Can be used.
- D- and L-amino acids are derivatized with a fluorescent reagent such as 4-fluoro-7-nitro-2,1,3-benzoxadiazole (NBD-F) in advance, and then ODS-80TsQA, Mightysil RP.
- a fluorescent reagent such as 4-fluoro-7-nitro-2,1,3-benzoxadiazole (NBD-F) in advance, and then ODS-80TsQA, Mightysil RP.
- NBD-F 4-fluoro-7-nitro-2,1,3-benzoxadiazole
- ODS-80TsQA Mightysil RP.
- the optical resolution column system in the present specification refers to a separation analysis system using at least an optical resolution column, and may include a separation analysis using an analysis column other than the optical resolution column. More specifically, passing a sample containing components having optical isomers along with a first liquid as a mobile phase through a first column filler as a stationary phase to separate the components of the sample; Individually holding each of the components of the sample in a multi-loop unit, each of the components of the sample individually held in the multi-loop unit as a stationary phase together with a second liquid as a mobile phase Supplying the second column packing material having an optically active center through a flow path to split the optical isomers contained in each of the sample components, and the optical isomerism contained in each of the sample components
- the D- / L-amino acid concentration in the sample can be measured by using an optical isomer analysis method characterized by including a step of detecting a body ( Patent No.
- D-amino acids can be quantified by immunological techniques using monoclonal antibodies that identify optical isomers of amino acids, such as monoclonal antibodies that specifically bind to D-leucine, D-aspartic acid, etc. (JP 2009-184981 specification).
- the amount of chiral amino acid in the blood sample may be used alone for the determination of diabetes, or may be used in combination with the amount of one or more other chiral amino acids that can be used for the determination of diabetes.
- the analysis method of the present invention may further include a step of measuring a variable related to diabetes, and the amount of chiral amino acid and such a variable can be combined and used for determination of diabetes.
- variables include a history of diabetes, age, sex, presence or absence of fasting blood glucose, and known diabetes markers and markers associated with diabetes.
- known markers include HbA1C, fasting blood glucose level, 1,5-andro-D-glycitol, glucoalbumin, urinary albumin level or urinary albumin / creatinine ratio.
- treatment suitable for diabetes and / or diabetic nephropathy is selected and performed.
- it is necessary to further perform treatment such as blood glucose level management and lifestyle improvement.
- blood glucose control biguanide, thiazolidine, sulfonylurea, insulin secretagogue, DPP4 inhibitor, ⁇ -glucosidase inhibitor, SGLT2
- Dosing treatment such as inhibitors is performed.
- improvement of lifestyle habits for example, smoking cessation, exercise for lowering the BMI value, and dietary restrictions are instructed.
- These treatment policies are determined based on the amount of chiral amino acid after an inquiry with a doctor.
- the present invention relates to a method for treating diabetic renal disorder, which comprises carrying out the analysis method of the present invention and further treating renal disorder complicated with diabetes.
- a method for treating diabetic renal disorder which comprises carrying out the analysis method of the present invention and further treating renal disorder complicated with diabetes.
- the detail of the treatment method it can select suitably by referring the nonpatent literature 1 and the nonpatent literature 2, for example. These references are incorporated herein.
- a further aspect of the present invention relates to a method for determining an estimated age in a subject using chiral amino acids.
- This method comprises at least one amino acid selected from the group consisting of D-alanine, D-leucine, D-allo-isoleucine, D-proline, L-serine, and L-isoleucine in a blood sample. Measuring the amount, and determining the age based on a measured amount of the at least one amino acid and a correlation curve between a predetermined age and a D-amino acid value. This method is based on the finding that some of the chiral amino acids in blood are correlated with age (FIGS. 3A-F).
- Estimate based on the chiral amino acid value for age determination by acquiring regression curves and cut-off values between age and chiral amino acid for age determination in an arbitrary cohort in advance.
- the age can be determined. According to this method, it is possible to estimate the age of an unconscious person or a patient with dementia.
- a cut-off value capable of discriminating subjects over 70 years old is 4.7 ⁇ g / ml or more in the case of D-alanine (D-Ala) when calculated using the cohort of the present invention.
- D-proline D-Pro
- D-alloisoleucine D-allo-Ile
- L-serine L-Ser
- L-isoleucine L-Ile
- a cut-off value for age can be selected as appropriate.
- a cut-off value for age can be selected as appropriate.
- FIG. 5 is a configuration diagram of the sample analysis system of the present invention.
- a sample analysis system 10 includes a storage unit 11, an input unit 12, an analysis measurement unit 13, a data processing unit 14, and an output unit 15, analyzes a target blood sample, and provides pathological information. Can be output.
- the storage unit 11 stores a cut-off value of the amount of chiral amino acid in blood and diabetes pathological information for determining diabetes input from the input unit 12,
- the analytical measurement unit 13 separates and quantifies a chiral amino acid for distinguishing at least one of the protein-constituting amino acids in the target blood sample,
- the data processing unit 14 determines the target diabetes information by comparing the measured value of the amount of the at least one chiral amino acid with the cut-off value stored in the storage unit 11,
- the output unit 15 can output pathological information about the target diabetes.
- the storage unit 11 further stores a cutoff value of the amount of chiral amino acid in the blood and information on the renal disorder for determining the renal disorder input from the input unit 12,
- the analytical measurement unit 13 separates and quantifies a chiral amino acid for determining at least one renal disorder among protein-constituting amino acids in the subject blood sample,
- the data processing unit 14 compares the measured value of the amount of the chiral amino acid for determining the at least one renal disorder with the cutoff value of the chiral amino acid for determining the renal disorder stored in the storage unit 11.
- it may include determining information on the renal disorder of the target, whereby the output unit 15 can output the pathological information on diabetes together with the information on the renal disorder of the target.
- the storage unit 11 includes a memory device such as a RAM, a ROM, and a flash memory, a fixed disk device such as a hard disk drive, or a portable storage device such as a flexible disk and an optical disk.
- the storage unit 11 is a computer program used for various processes of the information processing apparatus, in addition to the data measured by the analysis measurement unit, the data and instructions input from the input unit 12, the arithmetic processing results performed by the data processing unit 14, etc. Memorize the database.
- the computer program may be installed via a computer-readable recording medium such as a CD-ROM or DVD-ROM, or via the Internet.
- the computer program is installed in the storage unit using a known setup program or the like.
- the input unit 12 is an interface or the like, and includes operation units such as a keyboard and a mouse. As a result, the input unit can input data measured by the analysis measurement unit 13, instructions for calculation processing performed by the data processing unit 14, and the like. For example, when the analysis measurement unit 13 is outside, the input unit 12 may include an interface unit that can input measured data or the like via a network or a storage medium, separately from the operation unit.
- the analytical measurement unit 13 performs a process for measuring the amount of chiral amino acid in the blood sample. Therefore, the analytical measurement unit 13 has a configuration that enables separation and measurement of chiral amino acids. Amino acids may be analyzed one by one, but some or all types of amino acids can be analyzed together.
- the analytical measurement unit 13 is not intended to be limited to the following, but may be, for example, a high performance liquid chromatography system (HPLC) including a sample introduction unit, an optical resolution column, and a detection unit.
- HPLC high performance liquid chromatography system
- the analysis measurement unit 13 may be configured separately from the sample analysis system 10, and measured data or the like may be input via the input unit 12 using a network or a storage medium.
- the data processing unit 14 is configured to determine the complication of diabetes by comparing the measured amount of chiral amino acid with the cutoff value stored in the storage unit 11.
- the data processing unit 14 executes various arithmetic processes on the data measured by the analysis measurement unit 13 and stored in the storage unit 11 in accordance with a program stored in the storage unit 11.
- the arithmetic processing is performed by a CPU included in the data processing unit 14.
- the CPU includes a functional module that controls the analysis measurement unit 13, the input unit 12, the storage unit 11, and the output unit 15, and can perform various controls.
- Each of these units may be configured by an independent integrated circuit, a microprocessor, firmware, and the like.
- the output unit 15 is configured to output a pathological condition index value and / or pathological condition information that is a result of performing the arithmetic processing in the data processing unit 14.
- the calculation processing result in the data processing unit 14 may be directly output to the output unit 15 or may be output to the output unit 15 as needed after being temporarily stored in the storage unit 11.
- the output unit 15 may be a display device such as a liquid crystal display that directly displays the result of the arithmetic processing, an output unit such as a printer, or an interface unit for outputting to an external storage device or via a network. There may be.
- FIG. 6 is a flowchart showing an example of an operation for determining diabetes by the program of the present invention.
- the program of the present invention is a program that causes an information processing apparatus including the input unit 12, the output unit 15, the data processing unit 14, and the storage unit 11 to determine diabetes information.
- the program of the present invention is as follows: A predetermined cutoff value of at least one chiral amino acid input from the input unit 12 and diabetes information are stored in the storage unit 11; A measured value of the amount of at least one chiral amino acid input from the input unit 12 is stored in the storage unit 11; In the data processing unit 14, the cutoff value stored in the storage unit 11 is compared with the measurement value stored in the storage unit 11 to determine diabetes information; and the diabetes information is output to the output unit 15. And a command for causing the information processing apparatus to execute the operation.
- the program of the present invention may be stored in a storage medium or provided via an electric communication line such as the Internet or a LAN.
- FIG. 7 is a flowchart showing an example of an operation for determining the complication of diabetes together with the pathological information of the renal disorder by the program of the present invention.
- the program of the present invention is a program that causes an information processing apparatus including the input unit 12, the output unit 15, the data processing unit 14, and the storage unit 11 to determine information on diabetes mellitus.
- the program of the present invention is as follows: The at least one chiral amino acid for determining renal impairment and the predetermined cutoff value of at least one chiral amino acid for determining diabetes input from the input unit 12 are combined with information on renal impairment and diabetes combined, respectively.
- the measured values of at least one chiral amino acid for determining renal impairment and at least one chiral amino acid for determining diabetes input from the input unit 12 are respectively stored in the storage unit 11;
- the cut-off value stored in the storage unit 11 and the measurement value stored in the storage unit 11 are respectively compared to determine information on renal disorder and diabetes combination; It includes a command for causing the information processing apparatus to output information on renal disorder and diabetes to the output unit 15.
- the program of the present invention may be stored in a storage medium or provided via an electric communication line such as the Internet or a LAN.
- the system of the present invention may be an estimated age determination system.
- the system includes a storage unit, an input unit, a data processing unit, and an output unit, and includes the following: From the input unit, an amount of at least one kind of amino acid in the blood chiral amino acids for determining the age, and a regression curve or cut-off value with age are input, and stored in the storage unit, From the input unit, a measurement value of the amount of at least one of the chiral amino acids in the target blood sample is input, and stored in the storage unit, A data processing unit determines an estimated age of the subject based on the stored measurement value of the amino acid amount and the regression curve or cutoff value; Can be output to the estimated age output section.
- the present invention also relates to an eGFR value determination system that performs the method for determining an eGFR value of the present invention.
- the system includes a storage unit, an input unit, a data processing unit, and an output unit, and includes the following: From the input unit, the amount of at least one amino acid among the chiral amino acids in blood for determining the eGFR value and the regression curve or cut-off value of the eGFR value are input, and stored in the storage unit, From the input unit, a measurement value of the amount of at least one of the chiral amino acids in the target blood sample is input, and stored in the storage unit, A data processing unit determines a target eGFR value based on the stored measurement value of the amino acid amount and the regression curve or cut-off value; The eGFR value can be output to the output unit.
- the analysis measurement unit 13 measures the value from the blood sample and stores it in the storage unit 11.
- a command for causing the information processing apparatus to execute the storage may be included.
- eGFR estimated glomerular filtration rate
- the formula is as follows: ⁇ Wherein the unit of age is years, the unit of SCr is mg / dL, and the unit of glomerular filtration rate (GFR) is mL / min / 1.73 m 2 body surface ⁇ . For female patients, a correction factor of 0.739 was applied to the calculated value of the mathematical formula.
- Serum creatinine was measured by an enzymatic method in the same facility. Random urine samples (10 ml) were collected at baseline determination and the ratio of urine protein to creatinine was measured. Other variables at baseline are age, gender, diabetes, systolic blood pressure, diastolic blood pressure, hemoglobin, and renin-angiotensive system inhibitors defined according to codes E10-E14 of the International Classification of Diseases 10th Edition (ICD10) , Beta blockers, and calcium blockers. Patient baseline characteristics are as follows:
- the first endpoint defined as “kidney outcome” was the sum of end-stage renal disease (ESKD) requiring renal replacement therapy and all-cause mortality.
- EKD end-stage renal disease
- the patient received regular follow-up care in an outpatient setting. Data was collected as a source document at the end of 2011. Baseline and follow-up data were collected from hospital medical records and discharge summaries, outpatient records, first visits and visits to dialysis care physicians, and death certificates. Endpoints were confirmed by at least two physicians. Patient follow-up was available accurately. Because (i) this facility is a central hospital in the southern part of Osaka, and there are no other central hospitals in this region, and (ii) the local partnership with doctors in the first visit and dialysis care was good. It is.
- Sample preparation from human plasma was carried out by modification as described in Journal of Chromatography. B, Analytical technologies in the biomedical and life sciences 966, 187-192 (2014). Briefly, 20 times the amount of methanol was added to the plasma, and an aliquot (10 ⁇ l of supernatant from methanol homogenate) was taken into a cathode ray tube and NBD derivatized (0.5 ⁇ l of plasma was used for the reaction). ).
- the solution was dried under reduced pressure and 20 ⁇ l of 200 mM sodium borate buffer (pH 8.0) and 5 ⁇ l of fluorescent labeling reagent (40 mM 4-fluoro-7-nitro-2,1,3-benzooxadiazole (NBD- Anhydrous MeCN) containing F) was added and then heated at 60 ° C. for 2 minutes. 0.1% TFA aqueous solution (75 ⁇ l) was added and 2 ⁇ l of the reaction mixture was subjected to 2D-HPLC.
- fluorescent labeling reagent 40 mM 4-fluoro-7-nitro-2,1,3-benzooxadiazole (NBD- Anhydrous MeCN) containing F
- the target amino acid fraction was automatically collected using a multi-loop valve and enantioselective column (KSAACSP-001S or Sumichiral oA-3200, 1.5 mm. e. ⁇ 250 mm; self-filling, material was obtained from Shiseido and Sumika Chemical Analysis Service))).
- KSAACSP-001S or Sumichiral oA-3200, 1.5 mm. e. ⁇ 250 mm; self-filling, material was obtained from Shiseido and Sumika Chemical Analysis Service
- Ile and Thr having four stereoisomers (L-form, D-form, L-allo-form, D-allo-form), L-form and D-form, and diastereoisomers (L-allo-form and D alloisomers) from the first-dimensional reversed-phase mode (these diastereoisomers are separated in reversed-phase mode).
- the enantiomers (L and D, L-Allo and D-Allo) were then separated in two dimensions by an enantioselective column.
- the mobile phase was a mixed solution of MeOH-MeCN containing citric acid or formic acid, and NBD-amino acid fluorescence was excited at 470 nm and detected at 530 nm. All quantitative data were acquired by fluorescence detection. HPLC-MS / MS was used to confirm the presence of D-amino acids in the actual biological matrix.
- the cut-off value for determining diabetes was calculated based on the ROC curve, and was 0.1 ⁇ g / ml for D-aspartic acid, 2.5 ⁇ g / ml for D-proline, 665 ⁇ g / ml for L-glutamine, And 49.3 ⁇ g / ml for L-isoleucine.
- D-Allo-Ile is 0.1 ⁇ g / ml or more, D-Leu is 0.5 ⁇ g / ml or more, L-Ser is 134.6 or less, and L-Ile is 58. It was 6 or less. In the case of D / L% -Ala, it was 1.3 or more, and in the case of D / L% -Pro, it was 1.1 or more.
Abstract
Description
本発明者らにより、血液中のD-アスパラギン、D-セリン、D-アスパラギン酸、D-アロ-スレオニン、D-アラニン、D-プロリン、D-ロイシン、L-ヒスチジン、L-セリン、L-アスパラギン酸、L-アラニン、L-イソロイシン、L-フェニルアラニン、L-トリプトファン、L-リジン、及びL-チロシンからなる群から選ばれる少なくとも1のキラルアミノ酸の量が、eGFR値と相関することが見出されている(図4A-L)ことから、これらのキラルアミノ酸量を用いて、腎障害を判別できる。より具体的には、腎障害は、血液試料中の少なくとも1のキラルアミノ酸の量を、予め分類された2又はそれ以上の群に当てはめることにより腎障害を判定でき、さらなる態様では腎障害の重篤度を判定することができる。
記憶部11は、入力部12から入力された糖尿病を判別するための、血中キラルアミノ酸量のカットオフ値と糖尿病の病態情報を記憶し、
分析測定部13は、前記対象の血液試料中のタンパク質構成アミノ酸のうちの少なくとも1の糖尿病を判別するためのキラルアミノ酸を分離して定量し、
データ処理部14は、前記少なくとも1のキラルアミノ酸の量の測定値を、記憶部11に記憶されたカットオフ値と比較することにより、対象の糖尿病の情報を決定し、
出力部15が対象の糖尿病についての病態情報を出力することができる。
記憶部11は、入力部12から入力された腎障害を判別するための血中キラルアミノ酸量のカットオフ値と腎障害の情報を記憶し、
分析測定部13は、前記対象の血液試料中のタンパク質構成アミノ酸のうちの少なくとも1の腎障害を判定するためのキラルアミノ酸を分離して定量し、
データ処理部14は、前記少なくとも1の腎障害を判別するためのキラルアミノ酸の量の測定値を、記憶部11に記憶された腎障害を判別するためのキラルアミノ酸のカットオフ値と比較することにより、対象の腎障害の情報を決定すること
を含んでもよく、これにより出力部15が、対象の腎障害の情報と共に糖尿病についての病態情報を出力することができる。
具体的に、本発明のプログラムは、入力部12、出力部15、データ処理部14、記憶部11とを含む情報処理装置に糖尿病の情報を決定させるプログラムである。本発明のプログラムは、以下の:
入力部12から入力された少なくとも1のキラルアミノ酸の予め決定されたカットオフ値と糖尿病の情報を記憶部11に記憶させ;
入力部12から入力された少なくとも1のキラルアミノ酸の量の測定値を記憶部11に記憶させ、
データー処理部14において、記憶部11に記憶されたカットオフ値と、記憶部11に記憶させた測定値とを比較させて、糖尿病の情報を決定し;そして
糖尿病の情報を出力部15に出力させる
ことを前記情報処理装置に実行させるための指令を含む。本発明のプログラムは、記憶媒体に格納されてもよいし、インターネット又はLAN等の電気通信回線を介して提供されてもよい。
具体的に、本発明のプログラムは、入力部12、出力部15、データ処理部14、記憶部11とを含む情報処理装置に糖尿病合併の情報を決定させるプログラムである。本発明のプログラムは、以下の:
入力部12から入力された腎障害判定のための少なくとも1のキラルアミノ酸及び糖尿病の判定のための少なくとも1のキラルアミノ酸の予め決定されたカットオフ値をそれぞれ腎障害及び糖尿病合併の情報と併せて記憶させ;
入力部12から入力された腎障害判定のための少なくとも1のキラルアミノ酸及び糖尿病判定のための少なくとも1のキラルアミノ酸の測定値をそれぞれ記憶部11に記憶させ、
データー処理部14において、記憶部11に記憶されたカットオフ値と、記憶部11に記憶させた測定値とをそれぞれ比較させて、腎障害及び糖尿病合併の情報を決定し;
腎障害及び糖尿病の情報を出力部15に出力させる
ことを前記情報処理装置に実行させるための指令を含む。本発明のプログラムは、記憶媒体に格納されてもよいし、インターネット又はLAN等の電気通信回線を介して提供されてもよい。
入力部から、年齢を判定するための血中キラルアミノ酸のうちの少なくとも1種類のアミノ酸の量と、年齢との回帰曲線又はカットオフ値が入力され、記憶部に記憶し、
入力部から、対象の血液試料中のキラルアミノ酸のうちの少なくとも1種類のアミノ酸の量の測定値が入力され、記憶部に記憶し、
データ処理部が、記憶された前記アミノ酸の量の測定値と、前記回帰曲線又はカットオフ値とに基づいて、対象の推定年齢を決定し;
推定年齢の出力部に出力する
ことができる。
入力部から、eGFR値を判定するための血中キラルアミノ酸のうちの少なくとも1種類のアミノ酸の量と、eGFR値との回帰曲線又はカットオフ値が入力され、記憶部に記憶し、
入力部から、対象の血液試料中のキラルアミノ酸のうちの少なくとも1種類のアミノ酸の量の測定値が入力され、記憶部に記憶し、
データ処理部が、記憶された前記アミノ酸の量の測定値と、前記回帰曲線又はカットオフ値とに基づいて、対象のeGFR値を決定し;
eGFR値を出力部に出力する
ことができる。
本発明者らは、2005年8月~2009年1月にわたり、りんくう総合医療センター(Rinku General Medical Centre)の第一腎臓内科から、透析を受けていないCKDステージ3、4及び5を患う118名の継続患者を、前向き調査に登録した。一晩の絶食後に、患者からベースライン血液試料を取得し、プラスチック製チューブに入れて血漿を調製した。不十分な血液試料しか取得できなかった患者を先んじて取り除いた。
本試験は、りんくう総合医療センターの倫理委員会により承認された試験であり、そしてヘルシンキ宣言に基づいて行われた。
式は以下の通りである:
女性患者には、数式の計算値に補正係数0.739をかけた。
ヒト血漿からのサンプル調製は、Journal of Chromatography. B, Analytical technologies in the biomedical and life sciences 966, 187-192 (2014)の記載に従い改変して行った。簡潔に記載すると、20倍量のメタノールを血漿に加え、そして一定量(メタノールホモジネートから得た10μlの上清)を、褐色管にとり、そしてNBD誘導化した(0.5μlの血漿を反応に用いた)。溶液を減圧下で乾燥し、20μlの200mMホウ酸ナトリウム緩衝液(pH8.0)及び5μlの蛍光標識試薬(40mMの4-フルオロ-7-ニトロ2,1,3-ベンゾオキサジアゾール(NBD-F)をいれた無水MeCN)を加え、次に60℃で2分間加熱した。0.1%TFA水溶液(75μl)を加え、そして2μlの反応混合液を2D-HPLCに供した。
アミノ酸のエナンチオマーを、J Chromatogr A 1217, 1056-1062 (2010)やJournal of chromatography. B, Analytical technologies in the biomedical and life sciences 877, 2506-2512 (2009)に記載される通りに、マイクロ2D-HPLCプラットフォームを用いて定量した。簡潔に記載すると、アミノ酸のNBD-誘導体を、逆相カラム(モノリシックODSカラム、0.53mmi.d.×100mm;資生堂)を用い、MeCN、THF及びTFAを含む水性移動相を用いて勾配溶出した。D体及びL体を分離して測定するために、標的アミノ酸の画分をマルチループバルブを用いて自動的に回収し、そしてエナンチオ選択カラム(KSAACSP-001S又はSumichiral oA-3200, 1.5mmi.e. ×250mm;自己充填、材料を資生堂及びSumika Chemical Analysis Serviceから取得した))に供した。4種の立体異性体(L体、D体、L-アロ体、D-アロ体)を有するIleやThrの計測には、L体及びD体と、ジアステレオ異性体(L-アロ体及びDアロ体)とを第一次元の逆相モードにより分離した(これらのジアステレオ異性体は、逆相モードで分離される)。次にそのエナンチオマー(LとD、L-アロとD-アロ)をエナンチオ選択カラムにより二次元で分離した。移動相は、クエン酸又はギ酸を含むMeOH-MeCNの混合溶液であり、そしてNBD-アミノ酸の蛍光を、470nmで励起し、530nmで検出した。全ての定量データを蛍光検出により取得した。HPLC-MS/MSを用いて、実際の生物的マトリクス中のD-アミノ酸の存在を確認した。
糖尿病の判定は、International Classification of Diseases, Tenth Revision (ICD - 10) codes E10 - E14 に基づき、二人の医師によって判定された。分離した各キラルアミノ酸量を、糖尿病患者及び糖尿病を患わない患者とで分けたところ、D-Asp、D-Pro、及びL-Gleで有意に低値を示し、L-Ileで有意に高値を示した(図2A-2D)。次にこれらの各キラルアミノ酸の糖尿病の診断特異性を調べるため、本コホートについてROC曲線を描いた(図1A-D)。かかるROC曲線に基づき糖尿病判定のためのカットオフ値を求めたところ、D-アスパラギン酸の場合0.1μg/ml、D-プロリンの場合2.5μg/ml、L-グルタミンの場合665μg/ml、及びL-イソロイシンの場合49.3μg/mlであった。
Claims (13)
- 対象において、糖尿病を判定するための血液試料の分析方法であって、
D-アスパラギン酸、D-プロリン、L-グルタミン、及びL-イソロイシンからなる群から選ばれるアミノ酸のうちの少なくとも1種類のアミノ酸の量を測定する工程、
前記少なくとも1種類のアミノ酸の測定量を予め決定されたカットオフ値と比較し、糖尿病を判定する工程
を含む、前記分析方法。 - 前記カットオフ値が、ROC曲線に基づいて求められる、請求項1に記載の分析方法。
- 前記カットオフ値が、D-アスパラギン酸の場合0.1μg/ml、D-プロリンの場合2.5μg/ml、L-グルタミンの場合665μg/ml、及びL-イソロイシンの場合49.3μg/mlである、請求項1又は2に記載の分析方法。
- 前記対象が、腎障害を患う対象である、請求項1~3のいずれか一項に記載の分析方法。
- 記憶部、入力部、データ処理部、及び出力部を含む対象において、糖尿病を判定するための血液分析システムであって、
入力部から、糖尿病を判定するための血中キラルアミノ酸のうちの少なくとも1種類のアミノ酸の量のカットオフ値と糖尿病の病態情報が入力され、記憶部に記憶し、
入力部から、対象の血液試料中のキラルアミノ酸のうちの少なくとも1種類のアミノ酸の量の測定値が入力され、記憶部に記憶し、
データ処理部が、記憶された前記アミノ酸の量の測定値を、記憶されたカットオフ値と比較して、対象の糖尿病の病態情報を決定し;
糖尿病の病態情報を出力部に出力する
を含み、前記糖尿病を判定するための血中キラルアミノ酸が、D-アスパラギン酸、D-プロリン、L-グルタミン、及びL-イソロイシンからなる群から選ばれる少なくとも1のアミノ酸である、前記血液分析システム。 - 分析測定部をさらに含み、該分析測定部が、対象の血液試料から前記血中キラルアミノ酸を分離して定量して測定値を決定し、入力部に代わり又は入力部を介して測定値を入力する、請求項5に記載の血液分析システム。
- 前記カットオフ値が、ROC曲線に基づいて求められる、請求項5又は6に記載の血液分析システム。
- 前記カットオフ値が、D-アスパラギン酸の場合0.1μg/ml、D-プロリンの場合2.5μg/ml、L-グルタミンの場合665μg/ml、及びL-イソロイシンの場合49.3μg/mlである、請求項5~7のいずれか一項に記載の血液分析システム。
- 対象において、年齢の推定方法であって、
血液試料中のD-アラニン、D-ロイシン、D-アロ-イソロイシン、D-プロリン、L-セリン、及びL-イソロイシンからなる群から選ばれるアミノ酸のうちの少なくとも1種類のアミノ酸の量を測定する工程、
前記少なくとも1種類のアミノ酸の測定量と、予め決定された年齢とアミノ酸値とに基づき年齢を決定する工程
を含む、前記推定方法。 - 前記年齢を決定する工程が、カットオフ値に基づき決定される、請求項9に記載の推定方法。
- 前記カットオフ値が、ROC曲線に基づき決定され、70歳以上を推定するためのカットオフ値が、D-アラニンの場合4.7μg/ml以上であり、D-プロリンの場合2.5μg/ml以上であり、D-アロ-イソロイシンの場合0.1μg/ml以上である、D-ロイシンの場合0.5以上であり、L-セリンの場合134.6以下であり、L-イソロイシンの場合58.6以下である、請求項10に記載の推定方法。
- 前記年齢を決定する工程が、予め決定された回帰曲線に基づき決定される、請求項9に記載の推定方法。
- 記憶部、入力部、データ処理部、及び出力部を含む対象の推定年齢の決定システムであって、
入力部から、年齢を判定するための血中キラルアミノ酸のうちの少なくとも1種類のアミノ酸の量と、年齢との回帰曲線又はカットオフ値が入力され、記憶部に記憶し、
入力部から、対象の血液試料中のキラルアミノ酸のうちの少なくとも1種類のアミノ酸の量の測定値が入力され、記憶部に記憶し、
データ処理部が、記憶された前記アミノ酸の量の測定値と、前記回帰曲線又はカットオフ値とに基づいて、対象の推定年齢を決定し;
推定年齢の出力部に出力する
を含み、前記年齢を判定するための血中キラルアミノ酸が、D-アラニン、D-ロイシン、D-アロ-イソロイシン、D-プロリン、L-セリン、及びL-イソロイシンからなる群から選ばれる少なくとも1のアミノ酸である、前記決定システム。
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