Pediatric reference intervals for 32 routine biochemical markers using the siemens healthineers atellica® CH assays in healthy children and adolescents

2021 ◽  
Author(s):  
Mary Kathryn Bohn ◽  
Paul Horn ◽  
Donna League ◽  
Paul Steele ◽  
Alexandra Hall ◽  
...  
Keyword(s):  
Children And Adolescents ◽  
Biochemical Markers ◽  
Reference Intervals ◽  
Healthy Children

scholarly journals Advances in Pediatric Reference Intervals for Biochemical Markers: Establishment of the Caliper Database in Healthy Children and Adolescents/Napredak U Oblasti Pedijatrijskih Referentnih Intervala Za Biohemijske Markere: Izrada Baze Podataka Caliper Kod Zdrave Dece I Adolescenata

2014 ◽  
Vol 34 (1) ◽  
pp. 23-30 ◽  
Author(s):  
Kimiya Karbasy ◽  
Petra Ariadne ◽  
Stephanie Gaglione ◽  
Michelle Nieuwesteeg ◽  
Khosrow Adeli
Keyword(s):  
Children And Adolescents ◽  
Biochemical Markers ◽  
Clinical Laboratory ◽  
Reference Interval ◽  
Reference Intervals ◽  
Healthy Children ◽  
Medical Practitioners ◽  
Laboratory Test Results ◽  
Laboratory Reference ◽  
And Gender

Summary Clinical laboratory reference intervals provide valuable information to medical practitioners in their interpretation of quantitative laboratory test results, and therefore are critical in the assessment of patient health and in clinical decisionmaking. The reference interval serves as a health-associated benchmark with which to compare an individual test result. Unfortunately, critical gaps currently exist in accurate and upto-date pediatric reference intervals for accurate interpretation of laboratory tests performed in children and adolescents. These critical gaps in the available laboratory reference intervals have the clear potential of contributing to erroneous diagnosis or misdiagnosis of many diseases. To address these important gaps, several initiatives have begun internationally by a number of bodies including the KiGGS initiative in Germany, the Aussie Normals in Australia, the AACC-National Children Study in USA, the NORICHILD Initiative in Scandinavia, and the CALIPER study in Canada. In the present article, we will review the gaps in pediatric reference intervals, challenges in establishing pediatric norms in healthy children and adolescents, and the major contributions of the CALIPER program to closing the gaps in this crucial area of pediatric laboratory medicine. We will also discuss the recently published CALIPER reference interval database (www.caliperdatabase.com) developed to provide comprehensive age and gender specific pediatric reference intervals for a larger number of biochemical markers, based on a large and diverse healthy children cohort. The CALIPER database is based on a multiethnic population examining the influence of ethnicity on laboratory reference intervals. Thus the database has proved to be of global benefit and is being adopted by hospital laboratories worldwide.

scholarly journals Marked Influence of Adiposity on Laboratory Biomarkers in a Healthy Cohort of Children and Adolescents

2019 ◽  
Vol 105 (4) ◽  
pp. e1781-e1797 ◽  
Author(s):  
Victoria Higgins ◽  
Arghavan Omidi ◽  
Houman Tahmasebi ◽  
Shervin Asgari ◽  
Kian Gordanifar ◽  
...  
Keyword(s):  
Uric Acid ◽  
Waist Circumference ◽  
Children And Adolescents ◽  
Biochemical Markers ◽  
Biochemical Marker ◽  
Reference Intervals ◽  
Healthy Children ◽  
Height Ratio ◽  
Waist To Height Ratio ◽  
Age And Sex

Abstract Background The prevalence of pediatric obesity is increasing worldwide and strongly associates with metabolic abnormalities, including inflammation, insulin resistance, and dyslipidemia. This study assessed the influence of 3 measures of adiposity on levels of routinely assessed biochemical markers in apparently healthy children and adolescents. Methods The influence of adiposity on 35 biochemical markers was examined in the Canadian Laboratory Initiative on Pediatric Reference Intervals (CALIPER) cohort of healthy children and adolescents by comparing serum biomarker levels between subjects with a normal weight, overweight, and obese body mass index (BMI). The cohort comprised 1332 subjects 5.1 to 19.0 years of age with a BMI ranging from 13.4 to 65.0 kg/m2. The association between each biochemical marker and BMI, waist circumference, and waist-to-height ratio z-scores was assessed, while adjusting for age and sex. Reference intervals were established for all biochemical markers before and after removing overweight/obese subjects. Results In children and adolescents, levels of 13 routinely assessed biochemical markers, including alanine aminotransferase, apolipoprotein B, complement components 3 and 4, cholinesterase, high sensitivity C-reactive protein, gamma-glutamyl transferase, haptoglobin, high-density lipoprotein cholesterol, iron, transferrin, triglycerides, and uric acid, were significantly different between BMI categories. BMI, waist circumference, and/or waist-to-height ratio were significantly associated with the serum concentration of 24 of the 35 markers examined, after adjusting for age and sex. Conclusions Excess adiposity significantly influences circulating levels of routinely assessed laboratory markers, most notably liver enzymes, lipids/lipoproteins, inflammatory markers, and uric acid in children and adolescents. Although it is unknown whether altered biochemical marker levels in subjects with overweight/obesity reflect health or indolent disease, clinicians should be aware of the effect of weight status on several laboratory tests.

Pediatric reference intervals for 1,25-dihydroxyvitamin D using the DiaSorin LIAISON XL assay in the healthy CALIPER cohort

2018 ◽  
Vol 56 (6) ◽  
pp. 964-972 ◽  
Author(s):  
Victoria Higgins ◽  
Dorothy Truong ◽  
Nicole M.A. White-Al Habeeb ◽  
Angela W.S. Fung ◽  
Barry Hoffman ◽  
...  
Keyword(s):  
Children And Adolescents ◽  
Critical Role ◽  
Reference Interval ◽  
Reference Intervals ◽  
Biologically Active ◽  
Specific Reference ◽  
Healthy Children ◽  
Serum Samples ◽  
Dihydroxyvitamin D ◽  
1,25 Dihydroxyvitamin D

Abstract Background: 1,25-dihydroxyvitamin D (1,25(OH)2D), the biologically active vitamin D metabolite, plays a critical role in calcium and phosphate homeostasis. 1,25(OH)2D is measured to assess calcium and phosphate metabolism, particularly during periods of profound growth and development. Despite its importance, no reliable pediatric reference interval exists, with those available developed using adult populations or out-dated methodologies. Using the fully automated chemiluminescence immunoassay by DiaSorin, we established 1,25(OH)2D pediatric reference intervals using healthy children and adolescents from the CALIPER cohort. Methods: Serum samples from healthy subjects (0 to <19 years) were analyzed for 1,25(OH)2D using the DiaSorin LIAISON XL assay and age-specific reference intervals were established. The Mann-Whitney U-test was used to determine seasonal differences. Pooled neonatal and infantile samples were quantified using liquid chromatography tandem mass spectrometry (LC-MS/MS) to determine if elevated concentrations during the first year of life may be attributed to cross-reacting moieties. Results: Three reference interval age partitions were required with highest levels in subjects 0 to <1 year (77–471 pmol/L), which declined and narrowed after 1 year (113–363 pmol/L) and plateaued at 3 years (108–246 pmol/L). 1,25(OH)2D concentration was not significantly affected by seasonal variation or sex. Elevated 1,25(OH)2D concentrations in neonatal and infantile samples may be the result of an interfering substance. The absence of 3-epi-1,25-dihydroxyvitamin D in the pooled samples makes it unlikely to be the interfering moiety. Conclusions: Pediatric reference intervals for 1,25(OH)2D were established to improve test result interpretation in children and adolescents. 1,25(OH)2D is elevated in a proportion of neonates and infants, which may be the result of a cross-reacting moiety.

Establishing reference intervals of 20 biochemical markers for children in Southwestern Fujian, China based on the UniCel DxC 800 system

2020 ◽  
Vol 57 (6) ◽  
pp. 435-443
Author(s):  
Jiming Li ◽  
Huifen Zhang ◽  
Haichen Chen ◽  
Yuebin Gan ◽  
Juan Li ◽  
...  
Keyword(s):  
Biochemical Markers ◽  
Venous Blood ◽  
Reference Intervals ◽  
Healthy Children ◽  
Gamma Glutamyl Transpeptidase ◽  
Indirect Bilirubin ◽  
Blood Biochemical ◽  
Industry Standard ◽  
Upper Limits ◽  
Calcium Magnesium

Background To date, China has no industry standard for reference intervals of paediatric blood biochemical markers. This study aimed to evaluate changes in biochemical markers in the venous blood of healthy children aged 29 days to 12 years, derived from the UniCel DxC 800 system, and establish appropriate reference intervals. Methods We analysed venous blood from 1980 healthy children for 20 biochemical markers. Reference intervals were established according to the Clinical and Laboratory Standards Institute C28-A3c guideline and compared with those of adults in China. Results All markers except for sodium and chlorine required partitioning by age, but not by sex. The reference intervals of total protein, albumin, globulin, carbon dioxide, urea nitrogen, creatinine and uric acid consistently increased with age in children, but were always lower than those of adults. Children aged 29 days to 12 years had a single combined RI for sodium and chloride, respectively; although the reference intervals in children were similar to those of adults, their upper limits were lower. The reference intervals of direct bilirubin, alanine aminotransferase, aspartate aminotransferase, alkaline phosphatase, potassium, calcium, magnesium, and phosphorus continued to decline with age. The reference intervals of total bilirubin, indirect bilirubin, and gamma-glutamyl transpeptidase initially declined followed by a slight rebound. Conclusions While establishing reference intervals, most markers required partitioning by age (aged 29 days to 12 years); the partitioning scheme differed for each marker, and paediatric reference intervals differed from those for adults. It is therefore necessary to establish separate paediatric reference intervals.

scholarly journals Marked Biological Variance in Endocrine and Biochemical Markers in Childhood: Establishment of Pediatric Reference Intervals Using Healthy Community Children from the CALIPER Cohort

2013 ◽  
Vol 59 (9) ◽  
pp. 1393-1405 ◽  
Author(s):  
Dana Bailey ◽  
David Colantonio ◽  
Lianna Kyriakopoulou ◽  
Ashley H Cohen ◽  
Man Khun Chan ◽  
...  
Keyword(s):  
Reference Values ◽  
Biochemical Markers ◽  
Troponin I ◽  
Reference Intervals ◽  
Thyroid Stimulating Hormone ◽  
Healthy Children ◽  
Free Triiodothyronine ◽  
Laboratory Test Results ◽  
Total Triiodothyronine ◽  
Total Thyroxine

BACKGROUND Reference intervals are indispensable in evaluating laboratory test results; however, appropriately partitioned pediatric reference values are not readily available. The Canadian Laboratory Initiative for Pediatric Reference Intervals (CALIPER) program is aimed at establishing the influence of age, sex, ethnicity, and body mass index on biochemical markers and developing a comprehensive database of pediatric reference intervals using an a posteriori approach. METHODS A total of 1482 samples were collected from ethnically diverse healthy children ages 2 days to 18 years and analyzed on the Abbott ARCHITECT i2000. Following the CLSI C28-A3 guidelines, age- and sex-specific partitioning was determined for each analyte. Nonparametric and robust methods were used to establish the 2.5th and 97.5th percentiles for the reference intervals as well as the 90% CIs. RESULTS New pediatric reference intervals were generated for 14 biomarkers, including α-fetoprotein, cobalamin (vitamin B12), folate, homocysteine, ferritin, cortisol, troponin I, 25(OH)-vitamin D [25(OH)D], intact parathyroid hormone (iPTH), thyroid-stimulating hormone, total thyroxine (TT4), total triiodothyronine (TT3), free thyroxine (FT4), and free triiodothyronine. The influence of ethnicity on reference values was also examined, and statistically significant differences were found between ethnic groups for FT4, TT3, TT4, cobalamin, ferritin, iPTH, and 25(OH)D. CONCLUSIONS This study establishes comprehensive pediatric reference intervals for several common endocrine and immunochemical biomarkers obtained in a large cohort of healthy children. The new database will be of global benefit, ensuring appropriate interpretation of pediatric disease biomarkers, but will need further validation for specific immunoassay platforms and in local populations as recommended by the CLSI.

Influence of ethnicity on biochemical markers of health and disease in the CALIPER cohort of healthy children and adolescents

2020 ◽  
Vol 58 (4) ◽  
pp. 605-617 ◽  
Author(s):  
Houman Tahmasebi ◽  
Shervin Asgari ◽  
Alexandra Hall ◽  
Victoria Higgins ◽  
Ashfia Chowdhury ◽  
...  
Keyword(s):  
Children And Adolescents ◽  
Clinical Decision Making ◽  
Pediatric Population ◽  
Statistical Significance ◽  
Immunoglobulin A ◽  
Clinical Decision ◽  
Reference Intervals ◽  
Immunoglobulin M ◽  
Healthy Children ◽  
Pediatric Study

AbstractBackgroundAccurate pediatric reference intervals (RIs) for laboratory tests determined in a healthy pediatric population are essential for correct laboratory test interpretation and clinical decision-making. In pediatrics, RIs require partitioning by age and/or sex; however, the need for partitioning based on ethnicity is unclear. Here, we assessed the influence of ethnicity on biomarker concentrations in the Canadian Laboratory Initiative on Pediatric Reference Intervals (CALIPER) cohort of healthy children and adolescents and compared the results with the National Health and Nutrition Examination Survey (NHANES).MethodsA total of 52 biomarkers were measured in a multiethnic population of 846–1179 healthy children (aged 5 to <19 years) upon informed consent. Biomarker concentrations were retrospectively compared between four major ethnic groups (i.e. Black, Caucasian, East Asian, and South Asian, determined by parental ethnicity). Retrospective results were verified prospectively using an additional 500 healthy pediatric samples with equal sample size across ethnicities. Ethnic-specific differences were assessed based on statistical significance and biological and analytical variations. Appropriate age-, sex-, and ethnic-specific RIs were calculated.ResultsEthnic-specific differences were not observed for 34 biomarkers examined in the retrospective analysis, while 18 demonstrated statistically significant ethnic differences. Among these, seven analytes demonstrated ethnic-specific differences in the prospective analysis: vitamin D, amylase, ferritin, follicle-stimulating hormone (FSH), immunoglobulin A (IgA), immunoglobulin G (IgG), and immunoglobulin M (IgM). Analysis of select NHANES data confirmed CALIPER findings.ConclusionsThis is the first comprehensive Canadian pediatric study examining ethnic-specific differences in common biomarkers. While the majority of biomarkers did not require ethnic partitioning, ethnic-specific RIs were established for seven biomarkers showing marked differences. Further studies in other populations are needed to confirm our findings.

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