2.1 Methods
Literature collection with database NCBI and Google Scholar apply for article search during the 1913–2020 year. Searched terms were parameters of anthropometry, urine and blood biomarker in the healthy and diseased population. The content relevance of published papers influences the data selection process. The total number of selected literature at the beginning of the study was 1900. Fast skimming of the content and paper duplications striking out determined 1454 papers for further analysis. After the data extraction in Microsoft Excel 2007, based on information relevance, studies were excluded. The final selection of articles leads to a total number of 982 papers analyzed in this study. Using standardized data collection form and Microsoft Excel 2007, the following study characteristics were extracted authors last and first name with publication name, publication year, journal and publisher, country and continent, health status, assessed parameters and questioners information, number and age of participants, gender, sample types, methodology, aims, conclusions. In additional 107 papers from the 1949 to 2021 year of publishing, AChE reference range is determined. Publication year, aim, health status, anticoagulants and freezing temperature, participant number, units, sample type, the reference range of AChE and BChE during health and disease, statistical software, experimental method, wavelength, substrate, inhibitor and conclusion as a source of information is determined.
2.2 Statistical analysis
Data analysis was performed by IBM SPSS software version 23.0 with percentages (%), counts and graphs presentation.
2.3 Results
Results are present in VI main areas: (1) study characteristics; (2) sample type and biomarkers; (3) participant information; (4) material and methods; (5) aims and conclusion and (6) reference range of enzyme AChE.
2.3.1 Study characteristics
Figure 1 shows information about the paper selection process as a flow chart. The most prevalent number of papers before the intensive selection contains anthropometry parameters (25.58%). The share of the market decreased after the selection process (25.15%). This study shows a 0.43% decrease in quality data after selection. It was noticeable that the market share of blood parameters articles reached a high (8.91%) after the final article selection, with the peaks being lower before the selection process (53.72%) in comparing after the selection process (62.63%). The urine parameter decreased in publications after the selection process (20.70% to 12.22%). After the selection process, the market share of articles published regarding blood parameters arose from approximately the same level as the urine parameter decreases. However, a minority of totally selected papers (8.18%) contained more than one mentioned investigated sample parameter in the study, other sample parameters or none. In total, 982 publications remain in Microsoft Excel. The selected data summarize in Additional file 1.
The most common publications were in Journals Plos One (5%), Scientific reports (1.4%) and European Journal of Clinical Nutrition (1.4%). The most common publisher is Elsevier, with an incidence of 44.8% (440 publications). The second most common publisher is Springer Nature, with 31.3% (307 publications) incidence. These show a 1.43-fold increase (84 publications) incidence for Elsevier publishers. The market share of Wiley publishers reached a high of 8.6% during this period. Wiley publisher comparing to Elsevier and Springer Nature decreased from about 5.20 to 3.64 fold. Figure 2 summarizes percentages of published papers by year, from 1913 to 2020 year. The most prevalent year of publication is 2019 (140 publications, 14.3%), whose number rose dramatically from 1999 to the 2019 year with a rate of 15.2%. There was a 15-fold increase over the period. The number of published papers hit a percentage-wise low in the 1913 year (0.1%) and remains erratically stable to the 1987 year. It was noticeable that the article publication share started accumulating from the 1988 year, with sudden fall and then leveled off to the 1992 year. The number of publications fluctuated from 1992 to the 1999 year. We have a gradual sharp surge rise from 1999 to 2019 year. It is clear that trend of academic publication increases and is dominant over the years. During the 2014–2017 year, the proportion of publications had a fivefold increase (6.9%, 8.15%, 8.8%, 11.9%) retrospectively. There was a similar publication rate for 2018 and 2017 year (12%). So far, in 2020, we have only a few publications (16; 1.6%).
Published articles fall into several categories: observational, clinical, review, mixed study and not stated. The majority of the study type was observational (41.8%) and not stated (35.5%). The review study type was 15.4% retrospectively. The mixed study type hit the lowest point with 0.8%. The most common publishing journal for clinical study type was Drug Design and Therapy (0.2%). The abundance of mixed study type falls in the American Journal of Hypertension, Collegium Antropologicum, Environmental Health and Preventive Medicine, International Journal of Advances in Medicine, International Journal of Morphology, Lancet, Plos One (0.1%). Observational study type published in Plos One (2.5%). Review study type accounted highest for the European Journal of Clinical Nutrition (0.5%). The clinical study type is published in Plos One, while the not stated study type is in the American Journal of Hypertension and Plos One journals. Figure 3 shows the changes in the proportions of publishing articles by continent between 1913 and 2020 year, along with the total percentages of publications.
2.3.2 Sample type and biomarkers
Published literature became saturated with sample diversity. Providing information from more common samples like blood, urine, anthropometry to less common as CSF, tissue, cell lines, feces, saliva, sweating, tears, neurofilaments, pleural fluid. Only a few studies have no sample status.
Literature samples include blood, urine, anthropometry, others and not stated. The most common sample type is blood and anthropometry (39.5% and 25.2%). This study shows a 1.56-fold increase for publications with blood samples comparing to anthropometry measures. It is noticeable that other sample types have a prevalence of 20.1%, which is 1.96- and 1.25-fold higher than blood and anthropometry samples. Urine sample utilization (12.2%) hit low for 3.24-, 2.01- and 1.65-fold comparing to blood, anthropometry and other sample types. In published studies, authors usually combined blood samples with anthropometry, CSF, saliva, tissue and urine in total (54.8%) published articles. Urine sample types combine with blood and tissue samples, making a total incidence of 12.53 percent. This result means that unmixed (without these data) other and not stated sample types in the study have a prevalence of 4.68 and 3.1%. Blood sample type is the most prevalent, with an incidence of 54.58%. This result is 0.72-fold higher in comparison with the first table.
Published articles contained questionnaires with additional information regarding education, occupation, socioeconomic status, income, cognitive data, personality, family history of the disease, genetics, environment, smoking and alcohol consumption, fluid intake (coffee, water, juice), vitamin supplementation, physical activity/inactivity, cough capacity, metabolism. Anthropometry studies included a systematic measurement of the body. The majority (90% out of total number) of published articles contained information regarding: height [thigh clearance, sitting popliteal, knee, knee-heel], weight [body weight loss (BWL%), body weight change (BWC)], circumference [head, neck, chest, hip, abdomen, wrist, calf, arm (mid arm, mid-arm muscle, mid-upper arm, upper arm)], mass [body mass (BM), body mass index (BMI)]; muscle mass (MM); [skeletal mass muscle (SMM%), appendicle index (ASMI), total body (TBSM), total body index (TBSMI)]; lean mass [%, appendicle (ALM), appendicle index (ALMI), muscle (LMM), lean body mass (LBM), dry lean mass (DLM)], waist [W, hip ratio (WHR), height ratio (WHtR), stature ratio (WSR)], fat [body (BF), truncal mass (TFM), free mass (FFM), mass index (FMI), free mass index (FFMI); belly; free fat acid (FFA), adiposity, soft tissue mass (STM)], skinfold [triceps thickness, sub-scapular, sub-scapular thickness, biceps, triceps, calf, sub-scapular, supra iliac, bicipital, limb, girth, breadths, abdominal, thigh, medial calf thickness, triceps thickness], thickness [(width, chest diameter, tight muscle, skeleton)], blood pressure [systolic, diastolic], heart rate (HR)]. By contrast, the minority (10% out of total number) of published articles contained information regarding water amount [total fluid intake, total body (TBW), extracellular (ECW), intracellular (ICW), hydration/dehydration status, body temperature], nutrition status [energy intake, protein status, total calories carbohydrate]; individual organ function measurement [lung (left, right), static lung compliance (cst), VOmax, kidney (glomerular filtration rate, GFR), liver function, vertebra, brain (short-term memory, STM), severe motor impairment (SMI), mental component summary (MCS)], breadth [shoulder, hip breadth, foot, Z score], diameter [wrist, knee, ankle, femur, abdominal sagittal diameter to height (SADH), bifilac biacromin], length [arm, leg, elbow, elbow to elbow, foot, palmar, middle finger, up lift, knee-heel, trunk, finger, limb, femur], width [shoulder, hip, bicondylar and biepicondylar, palm], distance [philtrum, chanthal, palpebral fissure, elbow amplitude], index [C, bone strength index (BSI), foot index (FI), abdominal diameter index (ADI), a body shape index (ABSI), body adiposity index (BAI), appendicular lean soft tissue index (ALSTI), bust to hip ratio (BHR), cubic splines], hand dominance, biceps, triceps, grip strength (hand), area arm muscle (AMA), arm fat (AFA), mid-arm muscle (MAMA), mid-upper arm fat area (AFA), forearm muscle area (FAMA), stature, sitting [height erect, shoulder height (SSH), elbow height, elbow length (SEL), buttock popliteal length anthropometric measure chair (AMC)], metabolic state [load capacity metabolic indices (LCMI), basal metabolic rate (BMR)].
An overwhelming majority of studies with blood parameters include biochemistry parameters (75% out of total number) protein [albumin, globulin]; sugar [glucose]; ions [Na, K, P, Cl, Ca, Mg, HCO3-, Fe]; and others [blood urea nitrogen (BUN), creatinine, cholesterol, HDL, LDL, bilirubin, uric acid, urate, TSH, ALT, AST, AMT, CO2; adiponectin, leptin; ChE (AChE, BChE)]; hematological parameters following published studies claimed reports regarding WBC, RBC, PLT, NE, LY, MO, EO, BA, Hg, Ht, MCV, MCH, MCHC, MPV and CRP. The tinier part (25% out of the total number) of the articles provided a collection of factual knowledge about diverse blood parameters. Studies included markers like oxidative stress marker, inflammation marker [prostaglandin, VEGF, IL-1, 2, 6, 8, 10, 15; Ig-E, A, G; CD4, CD8; macrophage inflammatory protein (MIP-1Beta), IFN-gama, angiogenin, falistatin, kalikrein, carcinoembrionic antigen (CEA), α-synuclein (SNCA), serum amyloid P, neuroregulin 1 (NRG-1), retinal binding protein, procalcitonine]; ions [selen, zinc, magnesium, cobalt, copper, manganese, molybdenum, aluminum, barium, boron, bromide, cadmium, caesium, iodum, lithium, mercur, molibden, nickel, protactinium, rhenion, silicon]; proteomic, antigen [carcinoembrionic antigen (CEA), tumor Ag; nuclear matrix protein (NMP), MAPK, PK, interaction proteins, fibrinogen, RAS oncogen, adiponectine, ceruloplazmine, finrinogen, alfa-amilase, alcal phosphatase, aquaporine-1, perilipin 2, mioglobulin, cystein-C, insulin; macrophage inflammatory protein-1alpha (MIP-1alpha)]; transcriptomics [RNA markers (m, r, micro)]; metabolomics [carbamide nitrogen, feritin light chain, ammonia, nitrogen, norepinephrine].
Published journals with urine topics contained details about urine osmolarity and specificity, color, blood, protein (creatinine, albumin), gravity, metabolic rate, uric acid, ammonia, nitrogen, glucose, ions (Na, K, Ca). Additional tumor markers are tissue, saliva and CSF. Biomarker includes information regarding tumor size, TNM stadium, metastasis, health status, oxidative stress marker, APOE E4, chit-1, abeta42, n-tau and ceruloplasmin material. Very few studies (1% out of total number) included additional parameters from sweat and tears.
2.3.3 Participant information
Over the past hundred years, there have been a dispersing number of study participants. The minimal number of included study participants was one. By contrast, the maximum number of participants was in the range of million (65,712,029). The age of participants ranged from 0 to 100 years. Papers provide information about the stated health status of participants in the journals. In this study, health status includes health, disease, both and not stated. Group disease contained patients with the disease, ranged from cancer, neurodegeneration (ALS, AD) and others (kidney, lung, colon). By contrast, group healthy contained healthy participants. Group both have the disease and healthy control patients. The group not stated included studies without the health status of participants.
Published articles contain information about disease participants (47.5%, 466 publications), healthy participants (35.4%, 348 publication) and both participants (13.6%, 134). By contrast, fewer articles had not stated participant information, 3.5% (34 out of the total number).
For eleven decades, scientists queued to experience healthy and diseased individuals in publications. Healthy individuals apply as a reference or controlled subjects. In selected published articles, disease patients included a vast number of states: weight loss (fasting, dieticians, famine malnutrition, sarcopenia, cachexia); pituitary gland (metabolic syndrome, growth disorder); eye (glaucoma); teeth (dental problems, caries); lung (tuberculosis pleurisy, para-pneumonic effusion, pulmonary tuberculosis); liver (liver cirrhosis); pancreas (diabetes mellitus, overweight, chronic pancreatitis); gaster (gastrectomy); kidney (albuminuria, kidney stones, hemolytic uremic syndrome, renal disease, acute and chronic kidney disease, nephropathy, renal failure, nephrolithiasis); prostate (prostate hyperplasia, glucosuria); cardiovascular disease (hypertension, tachycardia, cardiometabolic risk, chronic heart failure, myocardial infarction); autoimmune disease (celiac disease, multiple sclerosis, HIV, systemic inflammation, systemic lupus erythematosus, leukemia); infectious and inflammation disease (venereal disease, bacterial infections, porphyromonas gingivalis infection, rheumatoid arthritis, gout, pyelonephritis nephrolithiasis, poliomyelitis, hepatitis B and C, syphilis, infectious mononucleosis, sepsis, ebola, human T lymphocyte virus type 1, periodontitis, malaria infection, thyroid fever, Sjogren syndrome, dengue); changes in blood (phlebotomy, hypovolemia, hyperviscosity, hematology disease, thalassemia, sickle cell disease, thrombotic disease, anemia, thrombocytopenia, leucocytosis, leucopenia, hypoglycemia, hypo/hyper kalemia, hyponatremia); brain (Parkinson disease, Alzheimer disease, amyotrophic lateral sclerosis, myasthenia gravis, cerebral palsy, epilepsy encephalopathy, Sanfilippo syndrome, mild cognitive impairment (MCI), fronto-temporal dementia (FTD), Gilbert’s syndrome, Guillain–Barre syndrome, stroke, neuromuscular disease (NMD), facioscapulohumeral muscular dystrophy (FSHD), pervasive developmental disorder, frontotemporal lobar degeneration (FTLD), progressive supranuclear palsy (PSP), multiple system atrophy (MSA), motor neuron disease (MND), spinocerebellar ataxia (SCA), Huntington disease, muscular dystrophy, acute spinal cord injury, Cushing’s syndrome, multiple myeloma, disseminated sclerosis, neurosyphilis, intrathecal tuberculin meningitis, delirium, aging, neuromuscular block, paralytic illus; loss of consciousness, cerebrovascular disease, stroke; cancer [mouth (oral squamous cell carcinoma, esophagus, nasopharynx); thyroid; lung; breast; intestine (diarrhea, ulcerative colitis, colon, rectal, gaster, pancreatic); liver (hepatoblastoma, hepatocellular carcinoma, langerhans cell histiocytosis); kidney (Wilms tumor, renal cell); gallbladder; bladder (urothelial carcinoma); reproductive organ [uterus, cervix, ovarian, prostate, testicular]; bones (Ewing sarcoma, osteo sarcoma); tissue (rhabdomyosarcoma); blood [leukemia, lymphocytes (Hodgkin lymphoma), lymphatic system (non-Hodgkin lymphoma)]; poisoning (lead, organophosphate, pesticide, soman, snake venom, toxicity); other (apoptosis, postoperative outcome, pregnancy, solid malignancy, malign pleural effusion).
2.3.4 Materials and methods
Literature collection included systematic searches and research through platforms [NCBI, Medline, PubMed, OVID SP, EMBASE, Google Scholar database, Web of Science, SCOPUS, Cochrane library], usage of keywords (ex. bladder cancer, detection/diagnosis, biomarker assay) for literature review, systematic and mini review. Statistical analyses include tests and software usage. The most prevalent software from selected publications (70% out of total selected articles) is SPSS, STATA, SAS, R, GAMLSS, MATLAB, PLOT, STATISTICA, GraphPad PRISM, StatView, MedCal Software and Microsoft Excel (2008, 2013). By contrast, less common statistical software (30% out of the total selected articles) from the publication were: discriminator function analysis, PASW, MINITAB, SIGMA STAT, JMP, GENE Spring, GMDR, ORIGIN and PASW. Trends of the statistical analysis vary in selected publications. The surge of statistical analysis (85% out of total selected articles) included descriptive statistics, regression (multiple, multivariate, linear, quadratic, log, bivariate, binary, Poisson, Box–Cox transformation), Pearson correlation, exact test, LMS method, T test (independent sample, student, unpaired, paired, two-tailed, one-sided, two-sided), ANOVA (one and two way, univariate and multivariate), mixed model multivariate analysis (MANOVA), post hoc (Turkey, Bonferroni’s, multiple comparison tests, Kramer test), X2 test, odds ratio, Fisher’s exact test, Mann–Whitney test, Kolmogorov–Smirnov test, Shapiro–Wilk test, Kruskal–Wallis test, Kaplan–Mayer method, Bland–Altman analysis, Friedman–Wilcoxon test, Cohen’s Kappa coefficient, Leuven test, power analysis, log-rank test, pairwise comparison test, hazard ratio proportional model. Less common statistical methodology in a publication (15% out of total selected articles) include Z score, relative standard error (RSE), MCNemar–Bowker test, Friedman test, first-order confirmatory factor analysis (CFA), Hotelling’s T2 test survival analysis, linkage disequilibrium, Scheffe post hoc, conditional logistic model, Cochran’s and Q Higgins test, Harris–Benedict test, Mifflin St Jear test, Mauchly’s test, Dunnett’s method, Newman–Keuls post hoc test, progression-free survival, tumor-specific survival, Dunn’s multiple comparison test, Kawasaki and Tanaka’s equation, Owen equation, Duncan’s multiple range test, partial least squares, the net reclassification index (NRI), concordance correlation coefficient, proportional hazard and Weibull assumption, log–log survival curve, Cuzic’s test.
2.3.5 Aims and conclusion
The selected majority of articles are focused on establishing healthy and disease reference values and assessing parameters as a gold standard in clinical and scientific research. Summarize the effect and importance of short and long-term physical activity, hydration/dehydration on health status. Investigate the consummation effect of supplements, alcohol, smoking and drinking. Emphasis was to discuss: current and potential biomarkers, the physiological and biochemical mechanisms of the health, disease and mortality state. Compare parameters based on gender differences and evaluate data accuracy. Examine the clinical significance of interventional trials and report the successfulness of therapy. Published articles debate the current methodology in clinical practice. Question and determine the most suitable method regarding cost, sensibility and specificity. Offer standardization protocol and methodology refinement; discuss the strengths, weaknesses and missing elements in the current literature. Provide possible goals for future research.
Selected studies created information conclusion bulk. Conclusions covered clinical relevance, hydration/dehydration, physical activity, disease, therapy and methodology. Identify risk factors for the non-homeostatic state of the organism. Data from diverse ethnicities and genders at the individual and population levels are collected. Results and administrative data are connected to medical services to enrich the dataset and facilitate cross-center sharing. The systematic and practical methodology is reproducible in larger datasets, sensitive, specific and applicable in routine monitoring. The state of hydration/dehydration has diverse effects on human health. Dehydration causes a loss of short-term memory and attention. By contrast, rehydration alleviates fatigue, improves attention and short-term memory. Coconut water has a better effect on cognitive performance as compared to plain water. Hydration status is associated with BMI. Additional fluid intake reduces BM loss and thirst sensation, and increases the risk of BM gain and gastrointestinal discomfort. Physical activity is physiological stress to a healthy organism. Faster runners lose BM when they drink less fluid. The dehydration state during the match is worsening in physically active individuals. Aerobic exercise improves the ability to use oxygen and defense mechanism. It is a powerful therapeutic tool to help delay, prevent or treat cognitive decline in ageing individuals. Enhance brain function, attention, mood and stress resistance.
Physiological and hematological parameters vary based on training intensity, duration and frequency. Distance runners (13–97 km per week) have hematological parameter fall (Hg, Ht, MCV, MCHC, MCH, bilirubin, iron and ferritin). World-class distance runners develop anemia as a consequence of Hg decrease. Regular aerobic exercise has a beneficial effect in obese patients by reducing of endothelin-1 (ER-1) molecule. Moderate-intensity aerobic exercise augments endothelium-dependent vasodilatation, increases the production of nitric oxide and increases oxidative stress. A strong correlation exists between high-intensity training and inflammatory signaling. Oral supplementation modulates inflammatory signaling associated with exercise, reduces over-expression of pro-inflammatory cytokines and increases anti-inflammatory cytokines limiting the detrimental, pro-inflammatory strenuous exercise. Supplementation does not decrease RBC, Hg, Ht, NO and EGF signaling during exercise, expressing a pro-angiogenic effect. Improve nutrients, oxygen and muscle recovery after strenuous exercise.
Urine biomarkers are an advantageous noninvasive monitoring system. Urine biomarkers can be affected by diet, dehydration, medicines, physical activity and other factors. The presence of proteins, acids, creatinine, RBC, WBC, bacteria and crystals can indicate acute kidney injury, kidney stones, urinary infection, pregnancy. Changes in investigated blood factors are associated with disease pathophysiology and progression management. Values have an impact on clinical practice. Blood factors are useful prognostic and predictor markers of the disease. Examples are cognitive decline (albumin/globulin ratio or anemia); dementia (high-density lipoprotein, vitamin D, folic acid, cholesterol, HgA1c and LDL); AD (APOE ε4, anemia complications, serum copper and ceruloplasmin level); mania (low-grade inflammation, haemodilution and thyroid function abnormalities); euthymia (high-grade inflammation, haemodilution, thyroid function abnormalities due to HPA axis and autonomic deregulation); cancer (albumin/globulin ratio, postoperative survival for colorectal, lung cancer); anemia and malignancies (age, male sex, Ht and MPV); malnutrition (high sodium and low potassium); cardiovascular disease (ischemic heart disease_increase MPV; coronary artery disease (CAD) and stenosis patients_blood hyper-viscosity and hyper-aggregation of red blood cells); Human T cell leukemia virus type 1 (Ly, anemia, decrease Eo and elevated lactate dehydrogenase levels); postmenopausal women (low Hg, high RDW and PDW in comparison with premenopausal survival women). Air pollution caused by grilling (smoked fish processing) decreases the value of lymphocytes. Increase Hb, ER, HCT, MCV, MCH, MCHC, LE, PLT, RDW and Ne. Cholinesterase activity applies for assessing exposure to pesticides and health status, determining the severity of the disease and diagnostics cost-effectively. CSF sample is a tool for following disease progression and activity in neurological disorders, guiding outcome assessments and prognostic decisions in clinical trials. The rise of y-globulin is associated with a Ly count increase in neurodegenerative diseases. Saliva biomarkers apply for clinical diagnosis of oral and systematic diseases, disease monitoring, management and decision making. Saliva is a noninvasive and accessible biofluid. The goal of therapeutic articles was to improve patient survival and quality of life by alleviating symptoms and disease eradication. Develop molecules, nanosensors and antioxidative supplements that target multiple factors and affect potency and disease pathophysiology. Implementation benefits include functional outcomes.
The development of screening routine tests enables early diagnosis and reduces survival rates associated with later detection and disease treatment. The methodology should be simple, low cost, highest precision and accuracy, sensitive and objective, with minimal time consumption.