AACC 2019: Genetic Testing, Preeclampsia Prevention, & Effects of Hormone Therapy on Common Lab Tests in Transgender Patients

By the bioMérieux Connection Editors

Well over 20,000 clinical chemists, physicians and other healthcare professionals gathered at the Anaheim Convention Center in early August for the 71st American Association of Clinical Chemistry’s  (AACC) Annual Scientific Meeting & Clinical Lab Expo.

This year’s meeting included 300 educational opportunities in the form of lectures, plenary sessions, scientific sessions, and roundtable sessions. And the Expo hosted 835 exhibitors, which is the highest number of exhibitors in AACC’s history.

The conference featured five plenary talks presented by life sciences visionaries on accelerating the development of new medical tests, the genetic basis of human behavior, tailored breast cancer therapies, the future of precision medicine, and extremely rapid molecular diagnostics.

Lab automation, sepsis, HIV, infectious disease biomarkers, machine learning, artificial intelligence, and data science took center stage at the educational sessions. 

Direct-to-Consumer Genetic Testing

A popular session focused on direct-to-consumer genetic testing, which provided expert insight into how consumer genetic testing fits into the current healthcare paradigm. This session tackled everything from the differences among consumer testing options to the regulations that can either speed up or slow down their proliferation.

Reducing Maternal Deaths Due to Preeclampsia in Developing Nations

Another presentation proposed that the high maternal death rate from preeclampsia in developing nations could be reduced with a simple questionnaire. A research team led by Enoch Anto, a Ph.D. candidate at Edith Cowan University in Perth, Australia, discussed how a simple, low-cost algorithm can identify pregnant women who are at risk for preeclampsia. The survey assesses a patient’s overall health by asking questions about fatigue levels, cardiovascular health, digestive health, immune health, and mental health.

The survey is based on the much-debated concept of Suboptimal Health Status (SHS), which has been described as a “third state” between good health and a diagnosed disease or condition. SHS is built on the premise that “sub-healthy” individuals have a range of subtle symptoms or discomforts that point toward later disease, but who are still too early in the progress of pathology for a definitive diagnosis. There has been much research into SHS, particularly to address illness in the developing world, where modern diagnostic and monitoring technologies are too often lacking.

According to Anto, SHS could theoretically lower the high maternal death rate from preeclampsia in resource-limited countries by identifying women who need treatment for this often-fatal condition.

“Women develop this condition at an outrageous rate in Ghana, but its early clinical signs often go undetected,” Anto said. “Why not try to develop a new approach that identifies clinical manifestations of preeclampsia before it happens?”

Preeclampsia is a multisystem disorder that can cause devastating complications for mothers and babies, from brain and liver injury in mothers to premature birth. It is one of the top causes of maternal-fetal mortality worldwide, and it disproportionately affects women in resource-limited countries.

While preeclampsia is fatal for only 1 out of every million births in the U.K., it is responsible for more than 570 deaths per million births in Ghana. Preeclampsia often kills because healthcare providers aren’t able to monitor pregnant women for its onset.

Based on the questionnaire scores, the Australian research team classified 49.8% of the women as being in poor overall health (high SHS) and 50.2% as being in good health (low SHS). Ultimately, 61.7% of the high SHS women went on to develop preeclampsia, compared with just 17.6% of the low SHS women.

Understanding Effects of Hormone Therapy on Common Lab Tests in Transgender Patients

Another presentation provided follow-up data to a preliminary paper presented at last year’s AACC conference on the potential for interference in results for common lab tests by the prolonged use of hormone therapy in transgender individuals.

Last year, researchers from the University of Texas Southwestern Medical Center in Dallas (UT Southwestern) reported that 6 months of hormone therapy markedly changed the results for common lab tests in their study of transgender patients.

In their latest study, the UT Southwestern team tracked a comprehensive metabolic panel, complete blood count, and lipid test results for 147 healthy transgender patients on hormone therapy over the course of 5 years. This is the longest time that any study has monitored lab values in transgender individuals to date.

“Out of all the test values the study examined, red blood cell and creatinine levels (a measure of kidney health) underwent the largest shifts when transgender individuals started hormone therapy,” according to the UT Southwestern team. “These values then typically stabilized after 6 months. In transgender women specifically, platelet and low-density lipoprotein levels (a measure of cardiovascular health) increased after several years of hormone therapy, while alkaline phosphatase (a marker of liver and bone health) decreased steadily for a few years before returning to baseline levels in the long term. Knowledge of these trends could greatly improve healthcare providers’ ability to interpret transgender patients’ results for routine lab tests, and to monitor these patients for conditions ranging from anemia to heart disease and kidney failure.”

Opinions expressed in this article are not necessarily those of bioMérieux, Inc.

Leave a Reply

Your email address will not be published. Required fields are marked *