Abstract 15230: Sex and Racial Differences in Normative Reference Ranges and Healthy Aging on Diastolic Function in Ethnic Asians: 2016 Ase Guideline Revisited

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Sheng Nan Chang ◽  
Kuo-Tzu Sung ◽  
Wen-Hung Huang ◽  
Jou-Wei Lin ◽  
Shih-Chieh Chien ◽  
...  
Keyword(s):  
Diastolic Dysfunction ◽  
Racial Differences ◽  
Reference Values ◽  
Healthy Aging ◽  
Population Based ◽  
Advanced Age ◽  
Healthy Population ◽  
Reference Ranges ◽  
Using Data ◽  
Age And Sex

Introduction: However, the reference ranges for echocardiography might be varying due to ethnicity, gender and age. Therefore, the normal reference ranges obtained from the healthy Asians are important for clinical utility of echocardiography in Asia. Methods: Population-based echocardiography dataset from 6,023 healthy ethnic Asians (47.1±10.9 years, 61.3% men) were divided into 6 age decades: ≤29, 30-39, 40-49, 50-59, 60-69 and ≥70 years. We explored age- and sex-related structural/functional alterations according to 2016 American Society of Echocardiography (ASE) diastolic dysfunction (DD) criteria and their correlates with clinical N-terminal pro-brain natriuretic peptide (NT-proBNP) cut-off for heart failure (HF). Racial comparisons were made using data from London Life Sciences Prospective Population (LOLIPOP) study. Results: Age- and sex-based normative reference ranges (including mean, median, 10% and 90% lower and upper reference values) were extracted from our large healthy population. In fully adjusted models, advanced age (treated as linear) was independently associated with cardiac structural remodeling and worsened diastolic parameters: larger indexed LA volume (LAVi), lower e’, higher E/e’, and higher TR velocity; all p <0.001), and were broadly more prominent in women (P interaction : <0.05). in general, markedly lower e’, higher E/e’ and smaller LAVi were observed in ethnic Asians compared to Whites. DD defined by 2016 ASE criteria, despite at low prevalence (0.42%) in current healthy population, increased drastically with advanced age and performed perfectly in excluding abnormal NT-proBNP (≥125 pg/ml) (Specificity: 99.8%, NPV: 97.6%). Conclusions: This is to date the largest cohort exploring the normative reference values using guideline-centered diastolic parameters from healthy Asians, with senescence process played as central role in diastolic dysfunction. Observed sex and ethnic differences in defining healthy diastolic cut-offs likely impact future clinical definition for DD.

Age- and sex-specific pediatric reference intervals for biochemistry analytes as measured with the Ektachem-700 analyzer.

1988 ◽  
Vol 34 (8) ◽  
pp. 1622-1625 ◽  
Author(s):  
G Lockitch ◽  
A C Halstead ◽  
S Albersheim ◽  
C MacCallum ◽  
G Quigley
Keyword(s):  
Calcium Phosphate ◽  
Total Protein ◽  
Reference Intervals ◽  
Specific Reference ◽  
Healthy Population ◽  
Reference Ranges ◽  
Older Children ◽  
Related Difference ◽  
Film Analyzer ◽  
Age And Sex

Abstract Using the Ektachem-700 multilayer film analyzer, we defined age- and sex-specific reference intervals for 20 analytes in sera from a healthy population of neonates and children ages one to 19 years. Upper and lower normal reference intervals for each analyte were determined by nonparametric methods as the 0.975 and 0.025 fractiles, respectively. Newborns have lower concentrations of total protein and albumin, and higher concentrations of phosphate, bilirubin, and enzymes in serum than older children do. Concentrations of urea, glucose, calcium, phosphate, and bilirubin change rapidly postnatally. Outside the neonatal period, no significant age- or sex-related difference was found for plasma glucose, serum amylase, conjugated or unconjugated bilirubin, or lipase. There was no sex-related difference in reference intervals for albumin, total protein, calcium, phosphate, or urea. However, concentrations of uric acid and creatine kinase are much higher in postpubertal boys than in girls. Alkaline phosphatase values peak later in boys. Except for lactate dehydrogenase and gamma-glutamyltransferase, the reference intervals defined here do not differ strikingly from data derived with use of other analyzers. The age- and sex-related trends are independent of method. However, each laboratory should determine the degree to which these reference ranges can be directly applied to analyses performed with another analyzer.

scholarly journals Aortic Root Remodeling as an Indicator for Diastolic Dysfunction and Normative Ranges in Asians: Comparison and Validation with Multidetector Computed Tomography

Diagnostics ◽  
2020 ◽  
Vol 10 (9) ◽  
pp. 712
Author(s):  
Lawrence Yu-min Liu ◽  
Chun-Ho Yun ◽  
Jen-Yuan Kuo ◽  
Yau-Huei Lai ◽  
Kuo-Tzu Sung ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Diastolic Dysfunction ◽  
Multidetector Computed Tomography ◽  
Aortic Root ◽  
Asian Population ◽  
Population Based ◽  
Root Diameter ◽  
Left Ventricular ◽  
Aortic Diameter ◽  
Reference Ranges

Background: The aortic root diameter (AoD) has been shown to be a marker of cardiovascular risk and heart failure (HF). Data regarding the normal reference ranges in Asians and their correlates with diastolic dysfunction using contemporary guidelines remain largely unexplored. Methods: Among 5343 consecutive population-based asymptomatic Asians with echocardiography evaluations for aortic root diameter (without/with indexing, presented as AoD/AoDi) were related to cardiac structure/function and N-terminal pro-brain B-type natriuretic peptide (Nt-ProBNP), with 245 participants compared with multidetector computed tomography (MDCT)-based aortic root geometry. Results: Advanced age, hypertension, higher diastolic blood pressure, and lower body fat all contributed to greater AoD/AoDi. The highest correlation between echo-based aortic diameter and the MDCT-derived measures was found at the level of the aortic sinuses of Valsalva (r = 0.80, p < 0.001). Age- and sex-stratified normative ranges of AoD/AoDi were provided in 3646 healthy participants. Multivariate linear regressions showed that AoDi was associated with a higher NT-proBNP, more unfavorable left ventricular (LV) remodeling, worsened LV systolic annular velocity (TDI-s′), a higher probability of presenting with LV hypertrophy, and abnormal LV diastolic indices except tricuspid regurgitation velocity by contemporary diastolic dysfunction (DD) criteria (all p < 0.05). AoDi superimposed on key clinical variables significantly expanded C-statistic from 0.71 to 0.84 (p for ∆AUROC: < 0.001). These associations were broadly weaker for AoD. Conclusion: In our large asymptomatic Asian population, echocardiography-defined aortic root dilation was associated with aging and hypertension and were correlated modestly with computed tomography measures. A larger indexed aortic diameter appeared to be a useful indicator in identifying baseline abnormal diastolic dysfunction.

Abstract W P155: Racial Differences in Ischemic Stroke Subtypes: The Greater Cincinnati/Northern Kentucky Stroke Study (GCNKSS)

Stroke ◽  
2015 ◽  
Vol 46 (suppl_1) ◽  
Author(s):  
Brett Kissela ◽  
Jane Khoury ◽  
Kathleen Alwell ◽  
Charles J Moomaw ◽  
Daniel Woo ◽  
...  
Keyword(s):  
Racial Differences ◽  
Small Vessel Disease ◽  
Population Based ◽  
Incidence Rates ◽  
Small Vessel ◽  
Point Estimate ◽  
Stroke Incidence ◽  
Statistical Variation ◽  
Stroke Study ◽  
Using Data

Background: It is well known that blacks have higher stroke incidence rates than whites. It is commonly believed that whites have more cardioembolic (CE) and large vessel (LV) ischemic strokes (IS). However, using data from 1993-94, we showed that blacks have higher rates of every IS subtype. We sought to see if this pattern persisted in 2010 within a large, biracial population of 1.3 million representative of the US. Methods: The GCNKSS is a population-based stroke epidemiology study from five counties in the Greater Cincinnati region. During 2010, we captured all hospitalized strokes by screening ICD-9 codes 430-436. We also captured out-of-hospital strokes by sampling primary care offices and nursing homes. Study nurses abstracted all potential cases. Physicians adjudicated each possible event and then further subtyped IS based on available test results using established methods. Incidence rates per 100,000 and associated 95% confidence intervals (CI) were estimated for each subtype using first-ever IS, with weighting of out-of-hospital event sampling, then age- and sex- adjusted to the 2000 US population. Black/white risk ratios (RR) and 95% CI were also calculated. Results: In 2010 there were 2219 IS in 2116 patients, and 1693 first-ever IS. Of the 1693 incident IS, 944 (57%) were female, 346 (21%) black, with mean age 69 years. There were 285 (18%) small vessel, 465 (27%) CE, 218 (12%) LV, 107 (6%) other identified cause, and 617 (37%) undetermined. The table shows incident IS rates by subtype and the associated RR. For each subtype of IS, blacks had a higher point estimate than whites in 2010. In 2010, the RR CI’s cross 1.0 for CE and LV, thus the RR is not statistically significant. Conclusion: It is not clear if these data represent significant differences for CE and LV subtypes in 2010 or statistical variation between periods. Regardless, stroke prevention efforts for blacks should include strategies relevant to all IS subtypes, and not just those for small vessel disease.

scholarly journals Urinary N-Acetyl-Beta-D-Glucosaminidase Index Activity Normal Values in Healthy Wistar Rats

2018 ◽  
Vol 75 (1) ◽  
pp. 92
Author(s):  
Andrei Răzvan CODEA ◽  
Mircea MIRCEAN ◽  
Orsolya SARPATAKI ◽  
Bogdan SEVASTRE ◽  
Gavril GIURGIU ◽  
...  
Keyword(s):  
Reference Values ◽  
Wistar Rats ◽  
Reference Value ◽  
Mean Value ◽  
Healthy Population ◽  
Reference Ranges ◽  
Non Invasive ◽  
Invasive Method ◽  
Renal Tubular

Reference values have a major importance in describing the diversity of healthy individuals variables. These are population reference ranges (RIs) that comprise 95% of the healthy population. The determination of biological markers, like urinary NAG and creatinine, is considered a simple, rapid and non-invasive method for detecting and monitoring renal tubular function under different conditions. Calculation of the urinary NAG index provides a good estimate of the excretion of the two markers over a 24 hour period. An increase of the urinary NAG index may precede increases in standard parameters used in the diagnosis of renal disease, especially in cases of acute tubular lesions. With the purpose of detecting deviations of the urinary NAG index, this study established the reference values in Wistar rats. Urine samples were collected from 100 healthy Wistar rats, 50 males and 50 females. NAG and creatinine were determined, and subsequently the NAG index was calculated for reference value establishing. The mean value of NAG index was found to be 5.81±1.68 (U / g) for healthy females and 4.10±0.90 (U / g) for healthy males.

scholarly journals Cardiovascular magnetic resonance reference values of mitral and tricuspid annular dimensions: the UK Biobank cohort

2020 ◽  
Vol 23 (1) ◽  
Author(s):  
Fabrizio Ricci ◽  
Nay Aung ◽  
Sabina Gallina ◽  
Filip Zemrak ◽  
Kenneth Fung ◽  
...  
Keyword(s):  
Cardiovascular Magnetic Resonance ◽  
Magnetic Resonance ◽  
Reference Values ◽  
Intraclass Correlation ◽  
Specific Reference ◽  
Reference Ranges ◽  
Uk Biobank ◽  
Chamber View ◽  
The Uk ◽  
Age And Sex

Abstract Background Mitral valve (MV) and tricuspid valve (TV) apparatus geometry are essential to define mechanisms and etiologies of regurgitation and to inform surgical or transcatheter interventions. Given the increasing use of cardiovascular magnetic resonance (CMR) for the evaluation of valvular heart disease, we aimed to establish CMR-derived age- and sex-specific reference values for mitral annular (MA) and tricuspid annular (TA) dimensions and tethering indices derived from truly healthy Caucasian adults. Methods 5065 consecutive UK Biobank participants underwent CMR using cine balanced steady-state free precession imaging at 1.5 T. Participants with non-Caucasian ethnicity, prevalent cardiovascular disease and other conditions known to affect cardiac chamber size and function were excluded. Absolute and indexed reference ranges for MA and TA diameters and tethering indices were stratified by gender and age (45–54, 55–64, 65–74 years). Results Overall, 721 (14.2%) truly healthy participants aged 45–74 years (54% women) formed the reference cohort. Absolute MA and TA diameters, MV tenting length and MV tenting area, were significantly larger in men. Mean ± standard deviation (SD) end-diastolic and end-systolic MA diameters in the 3-chamber view (anteroposterior diameter) were 2.9 ± 0.4 cm (1.5 ± 0.2 cm/m2) and 3.3 ± 0.4 cm (1.7 ± 0.2 cm/m2) in men, and 2.6 ± 0.4 cm (1.6 ± 0.2 cm/m2) and 3.0 ± 0.4 cm (1.8 ± 0.2 cm/m2) in women, respectively. Mean ± SD end-diastolic and end-systolic TA diameters in the 4-chamber view were 3.2 ± 0.5 cm (1.6 ± 0.3 cm/m2) and 3.2 ± 0.5 cm (1.7 ± 0.3 cm/m2) in men, and 2.9 ± 0.4 cm (1.7 ± 0.2 cm/m2) and 2.8 ± 0.4 cm (1.7 ± 0.3 cm/m2) in women, respectively. With advancing age, end-diastolic TA diameter became larger and posterior MV leaflet angle smaller in both sexes. Reproducibility of measurements was good to excellent with an inter-rater intraclass correlation coefficient (ICC) between 0.92 and 0.98 and an intra-rater ICC between 0.90 and 0.97. Conclusions We described age- and sex-specific reference ranges of MA and TA dimensions and tethering indices in the largest validated healthy Caucasian population. Reference ranges presented in this study may help to improve the distinction between normal and pathological states, prompting the identification of subjects that may benefit from advanced cardiac imaging for annular sizing and planning of valvular interventions.

Development of a Healthy Aging Score in the Population-Based Rotterdam Study: Evaluating Age and Sex Differences

2017 ◽  
Vol 18 (3) ◽  
pp. 276.e1-276.e7 ◽  
Author(s):  
Loes Jaspers ◽  
Josje D. Schoufour ◽  
Nicole S. Erler ◽  
Sirwan K.L. Darweesh ◽  
Marileen L.P. Portegies ◽  
...  
Keyword(s):  
Sex Differences ◽  
Healthy Aging ◽  
Population Based ◽  
Rotterdam Study ◽  
Age And Sex

Individual character of variation in time-series studies of healthy people: II. Differences in values for clinical chemical analytes in serum among demographic groups, by age and sex.

1978 ◽  
Vol 24 (2) ◽  
pp. 313-320 ◽  
Author(s):  
G Z Williams ◽  
G M Widdowson ◽  
J Penton
Keyword(s):  
Reference Group ◽  
Population Based ◽  
Reference Ranges ◽  
Demographic Groups ◽  
Individual Character ◽  
Time Series Studies ◽  
The Individual ◽  
Analytical Variation ◽  
Range Of Variation ◽  
Age And Sex

Abstract Assessment of the significance of an observed set of serum chemical values for determining a person's state of health requires comparison with a set of defined reference values. We tested the assumption that a reference group of individuals, categorized by age and sex, gives a narrower range of variation than does a larger mixed population. If this were true, the demographic set would be a more sensitive reference than is the customary "normal range" for interpretation of values occurring in the individual. The ratio, R, of intra-personal to inter-personal (group) standard deviations was similar for defined age/sex classes and the overall group for 16 serum constituents. When the "raw" intra-individual variation (biological plus analytical variation) was adjusted to remove the average analytical component, the resulting R was less than 80 for all constituents except creatine kinase, which indicates that these are all particularly strong "discriminators" of individuality. These results imply the need for individual rather than population-based reference ranges, even if the latter are from persons of similar age and the same sex.

scholarly journals THE HIGH COST OF SOCIOECONOMICS ON RACIAL DISPARITIES IN HEALTHY AGING

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S591-S591
Author(s):  
Nancy Chiles Shaffer
Keyword(s):  
Racial Differences ◽  
Low Socioeconomic Status ◽  
Healthy Aging ◽  
Future Research ◽  
Mineral Density ◽  
Low Socioeconomic ◽  
Black And White ◽  
Aging Index ◽  
Health Aging ◽  
Using Data

Abstract Race-related differences in overall health across the age-span are well established; how differences manifest within a cohort selected for good functional status is unclear. Using data from Black and White older adults aged 70-79, in the Health, Aging and Body Composition (Health ABC) study, we created a healthy aging index (HAI) of mental health, fitness, lung capacity, bone mineral density, inflammation, and metabolic syndrome. We assessed if racial differences existed in HAI, the extent education, financial resources and stress attenuated any observed differences, and whether this varied by site (Memphis v. Pittsburgh). Blacks had lower HAI than whites, adjusted for age and site. Further adjustment for finances and education eliminated the effect of race in women and reduced the effect in men by 64%. A significant interaction between site and financial stress was observed. Future research should assess ways to reduce the harmful impact of low socioeconomic status on health.

Sign in / Sign up

Export Citation Format

Share Document