ln EDITOR University Sale Lake Edward R. Ashwood M.D. Professor of Pi Unie of Ul beiel of Mevicine Chief Medicsl Officer and Laboratory Ditector ARUP Laboratories Sale Lake City, Urah David E. Bruns, M.D. Professor of Pathology University of Virginia Medical School, £ Director of Clinical Chemistry and Associate Director of Molecular Diagnostics University of Virginia Health System Charlottesville, Virginia; Editor, Clinical Chemistry ‘Washington, D.C. Consulting Editor Barbara G. Sawyer, Ph.D., M.T.(A.S.C:P.), C.L.8.(N.C.A.), C.L.Sp(M.B.) Professor OT Department of Laboratory Sciences and Primary Care School of Allied Health Sciences Texas Tech University Health Sciences Center Lubbock, Texas with 548 illuseracions, GAZ DNIVERSITESE a MER iiaGazi UNIVERSTTES MERKEZ KULUPHANESL 19 64172 SAUNDERS HLSEVIER 11830 Westie Intnl Dive Se Lony Miso 63146 ‘TIETZ FUNDAMENTALS OF CLINICAL CHEMISTRY ISBN, 978.0-7216-3865.2 Copyeight © 2008 by Saunders, a inprin of Hever Inc. All sights reserved. 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Dovel Desir: Mange Reid Working together to grow libraties in developing countries Prin in the United Senso Amen wenederecon | wemtsisong wiser Lose digt isthe prt mimber 9876.5 $3.21 esau lasGazi Oniversites! Merker Ki hi) i (ill ‘25se7e2010608016317 To family members, friends, and the many colleagues who have had positive impacts on our lives.CONTRIBUTORS ‘Thomas M. Annesley, Ph.D. Professor of Clinical Chemistry University of Michigan Medical Schoo! ‘Ann Arbor, Michigan; Associate Editor, Clinical Chemistry ‘Washington, D.C, Mass Spectrometry Fred S. Apple, Ph.D. Medical Director of Clinical Laboratories Hennepin County Medical Oxnter, Professor of Laboratory Medicine and Pathology University of Minnesota School of Medicine Minneapolis, Minnesota Cardiovascular Disease Edward R. Ashwood, M.D. Professor of Pathology University of Utah School of Medicine Chief Medical Officer and Laboratory Director ARUP Laboratories Salt Lake City, Utah Disorders of Pregnancy Malcolm Baines, F.RS.C., ER.CPath, Principal Clinical Scientist Department of Clinical Biochemistry Royal Liverpool University Hespital Liverpool, United Kingdom Vitamins and Trace Elements Renze Bais, Ph.D. ARCP.A. Senior Clinical Associate Department of Medicine University of Sydney, Principal Hospital Scientist Department of Clinical Biochemistey Pacific Laboratory Medicine Services Sydney, NSW, Australia Principles of Clinical Enzymology; Eneymes Edward W. Bermes, Jr, Ph. Professor Emeritus Department of Pathology Loyola University Medical Center Maywood, linois Introduction to Principles of Laboratory Analyses and Safety; Specimen Collection and Other Preanalytical Variables Emest Beutler, M.D. Chairman Deparcment of Molecular and ‘The Scripps Research Institute La Jolla, California Hemoglobin, Irom, and Bilin perimental Medicine Ronald A. Booth, PheD., F.C.A. Aasistant Professor Department of Pathology and Laboratory Medicine University of Orrawa, Clinical Biochemise Division of Biochemistry ‘The Ottawa Hospital Ottawa, Ontario, Canada, Tumor Markers Be Patrick MM. Bossuyt, Ph-D. Professor of Clinical Epidemiology ‘Chair of the Department of Clinical Epidemiology, Biostatistics & Bioinformaties Academic Medical Center University of Amsterdam Aamsterdam, The Netherlands Tnsroduction to Clinical Chemistry and Evidence-Based Laboratory Medicine James C. Boyd, M.D. ‘Associate Professor of Pathology University of Virginia Medical School, Director of Systeins Engineering and Core Lab Automation, Associate Director of Clinical Chemistry and Toxicology University of Virginia Health System Charlottesville, Virginias Deputy Editor, Clinical Chemistry Washington, DC. Automation in the Clinical Laboratory; Selection and Analytical Boaluation of Methods—With Statistical Techniques David E. Bruns, M.D. Professor of Pathology University of Virginia Medical School, Director of Clinical Chemistry and Associate Director of Molecular Diaynosties University of Virginia Health System Charlottesville, Virginia; Eulitor, Clinical Chemistry Washington, D.C, Intvoduction to Clinical Chemistry and Bvidence-Based Laboratory Medicine; Reference Information for the Clinical Laboratory Mary F. Burritt, Ph.D. Professor of Laboratory Medicine Mayo Clinic Scottsdale, Arizona Toxic Metals Catl A. Burtis, Ph.D. Health Services Division ak Ridge National Laboratory Oak Ridge, Tennessee: Clinical Professor of Pathology University of Utah School of Medicine Salt Lake City, Utah (Chromatography; Reference Enformation for the Chaieal Laboratory vitvil CONTRIBUTORS. John A. Bute, IIL, BA. Laboratory Supervisor Metals Laboratory Mayo Clinic Rochester, Minnesota ‘Toxic Metals Daniel W. Chan, Ph.D,, DABC.C., FACE. Professor of Pathology, Oncology, Radiology and Urology Director of Clinical Chemistry Division. Department of Pathology, Director, Center for Biomarker Discovery Johns Hopkins Medical Institutions Baltimore, Maryland Tumor Markers Rossa W.K. Chit M.B.B.S., Ph.D. BLKAM. (Pathology), F.R.C.P.A- Associate Professor Department of Chemical Pathology The Chinese University of Hong Kong, Honorary Senioe Medical Officer Department of Chemical Pathology Prince of Wales Hespital Hong Kong SAR, China Nucleic Acids Allan Deacon, B.S.C., Ph.D., Consultant Clinical Scientist Clinical Biochemistry Department Bedford Hospital Bedfordshire, United Kingdom Porphyrins and Disorders of Porpiyrin Metabolism Michael P. Delaneys M.D., ERCP, Consultant Nephrologist East Kent Hospitals NHS Trust Kent and Canterbury Hospital Canterbury, Kent United Kingdom Kidney Fuoction and Disease Laurence M. Demers; Ph.D., D.A.B.C.C, RACB. Distinguished Professor of Pathology and Medicine Penn State University College of Medicine, Director, Core Endocrine Laboratory and GCRC Core Laboratory University Hospital Hershey, Pennsylvania Picitary Disorders; Adrenal Corical Disorders; Thyroid Disorders Eleftherios P. Diamandis, M.D., Ph.D., F.R.C.PAC.) Professor and Head, Clinical Biochemistry University of Toronto, Biochemistin-Chief Mount Sinai Hospital and University Health Networi ‘Toronto, Ontario, Canada Tumor Markers Paul D'Orazio, Ph.D. Director, Critical Care Analytical Instrumentation Laboratory Lexington, Massachusetts Electrochemistry and Chemical Sensors Basil T. Doumas, Ph.D. Professor Emeritus Department of Pathology Medical College of Wisconsin, Milwaukee, Wisconsin. Hemoglobin, Iron, and Bilirubin D. Robert Dufour, M.D. Consultant Pathologist Veterans Affairs Medical Center, Emeritus Professor of Pathology George Washington University Medical Center Washington, D.C. Liver Disease Gracie Bisenhofer, Ph.D. Staff Scientist, Clinical Neurocardiology Section National Institutes of Neurological Disordets and Stroke: ‘National Institutes of Health Bethesda, Maryland Catecholarines and Serotenin George H. Eller, M.D. Emeritus Professor Department of Medical Biochemistry and Immunology University of Wales College of Medicine Cardiff, United Kingdom Poxphyrins and Disorders of Porphyrin Metabolism David B. Endres, Ph.D. Professor of Clinical Pathology Keck School of Medicine University of Southern California Los Angeles, California Disorders of Bone ‘Ann M. Gronowski, Ph.D. Associate Professor of Pathology and Immunology and. ‘Obstetries and Gynecology Washington University School of Medicine, Associate Director of Chemistry, Serology and Immunology Bames-Jewish Hospital St. Louis, Missouri Reproductive Disorders, James H. Harrison, Jroy M.D.» Ph.D. ‘Associate Professor of Public Health Sciences and Pathology, Director of Clinical Informatics Univenity of Virginia Medical School, Associate Director of Clinical Chemistry University of Virginia Health System Charlottesville, Virginia Clinical Laboratory Informatics