911 analyzer

Within 1 week of their ultrasound-based HS diagnosis, blood samples were collected from the participants after they had fasted for at least 10 h. The plasma levels of glucose, insulin, total cholesterol, triglyceride, high-density lipoprotein (HDL) cholesterol, and low-density lipoprotein cholesterol were measured through enzyme-linked immunosorbent assay (Mercodia, Uppsala, Sweden) by using the Hitachi 911 analyzer. Furthermore, the plasma levels of aspartate transaminase, alanine transaminase, alkaline phosphatase, and gamma-glutamyl transferase were measured in accordance with the standard protocols (ITC Diagnostics, Taipei, Taiwan). Insulin resistance was evaluated using the homeostatic model assessment of insulin resistance (HOMA-IR) method; the HOMA-IR score was calculated by dividing the product of the fasting blood glucose level (mmol/L) and the fasting insulin level (mU/L) by 22.5 [33 (link)]. The fasting plasma folate level was measured using radioimmunoassay kits (Becton Dickinson, Franklin Lakes, NJ, USA), and the plasma homocysteine level was measured using a commercially available kit for fluorescence polarization immunoassay and the Abbott 130 AxSYM system (Becton Dickinson). The fasting plasma betaine and free choline levels were measured through liquid chromatography/electrospray ionization–isotope dilution mass spectrometry [9 (link)].

This test was completed on refrigerated serum. During the 2007–2010 cycles, plasma was used on the Hexokinase-mediated reaction Roche/Hitachi Modular P Chemistry Analyzer. The 2005–2006 results were completed on the Roche/Hitachi 911 Analyzer. Results were reported in millimoles per liter (mmol/L) [26 –28 ].