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.

scholarly journals A Comparison between BMI, Waist Circumference, and Waist-To-Height Ratio for Identifying Cardio-Metabolic Risk in Children and Adolescents

PLoS ONE ◽  
2016 ◽  
Vol 11 (2) ◽  
pp. e0149351 ◽  
Author(s):  
Luís B. Sardinha ◽  
Diana A. Santos ◽  
Analiza M. Silva ◽  
Anders Grøntved ◽  
Lars B. Andersen ◽  
...  
Keyword(s):  
Waist Circumference ◽  
Children And Adolescents ◽  
Metabolic Risk ◽  
Height Ratio ◽  
Waist To Height Ratio

scholarly journals Adiposity indices in the prediction of insulin resistance in prepubertal Colombian children

2012 ◽  
Vol 16 (2) ◽  
pp. 248-255 ◽  
Author(s):  
Noel T Mueller ◽  
Mark A Pereira ◽  
Adriana Buitrago-Lopez ◽  
Diana C Rodríguez ◽  
Alvaro E Duran ◽  
...  
Keyword(s):  
Insulin Resistance ◽  
Waist Circumference ◽  
Area Under The Curve ◽  
Skinfold Thickness ◽  
Model Assessment ◽  
Height Ratio ◽  
Prepubertal Children ◽  
Stepwise Selection ◽  
Waist To Height Ratio ◽  
Age And Sex

AbstractObjectiveTo compare BMI with abdominal skinfold thickness (ASF), waist circumference and waist-to-height ratio in the prediction of insulin resistance (IR) in prepubertal Colombian children.DesignWe calculated age- and sex-specific Z-scores for BMI, ASF, waist circumference, waist-to-height ratio and three other skinfold-thickness sites. Logistic regression with stepwise selection (P = 0·80 for entry and P = 0·05 for retention) was performed to identify predictors of IR and extreme IR, which were determined by age- and sex-specific Z-scores to identify the ≥ 90th and ≥ 95th percentile of homeostasis model assessment (HOMAIR), respectively. We used receiver operating characteristic curves to compare the area under the curve between models.SettingBucaramanga, Colombia.SubjectsChildren (n 1261) aged 6–10 years in Tanner stage 1 from a population-based study.ResultsA total of 127 children (seventy girls and fifty-seven boys) were classified with IR, including sixty-three children (thirty-three girls and thirty boys) classified with extreme IR. Only ASF and BMI Z-scores were retained as predictors of IR by stepwise selection. Adding ASF Z-score to BMI Z-score improved the area under the curve from 0·794 (95 % CI 0·752, 0·837) to 0·811 (95 % CI 0·770, 0·851; P for contrast = 0·01). In predicting extreme IR, the addition of ASF Z-score to BMI Z-score improved the area under the curve from 0·837 (95 % CI 0·790, 0·884) to 0·864 (95 % CI 0·823, 0·905; P for contrast = 0·01).ConclusionsASF Z-score predicted IR independent of BMI Z-score in our population of prepubertal children. ASF and BMI Z-scores together improved IR risk stratification compared with BMI Z-score alone, opening new perspectives in the prediction of cardiometabolic risk in prepubertal children.

Paediatric reference intervals for 17 Roche cobas 8000 e602 immunoassays in the CALIPER cohort of healthy children and adolescents

2019 ◽  
Vol 57 (12) ◽  
pp. 1968-1979 ◽  
Author(s):  
Mary Kathryn Bohn ◽  
Victoria Higgins ◽  
Shervin Asgari ◽  
Felix Leung ◽  
Barry Hoffman ◽  
...  
Keyword(s):  
Children And Adolescents ◽  
Reference Values ◽  
Laboratory Tests ◽  
Clinical Decision Making ◽  
Reference Intervals ◽  
Healthy Children ◽  
Serum Samples ◽  
Clinical Laboratories ◽  
Age And Sex ◽  
Roche Cobas

Abstract Background The diagnostic utility of laboratory tests in paediatric medicine relies heavily on the availability of appropriate reference intervals (RIs). The Canadian Laboratory Initiative on Paediatric Reference Intervals (CALIPER) has established a comprehensive database of covariate-stratified RIs for many paediatric laboratory tests using a large, healthy reference population. Several automated analysers in widespread use in clinical laboratories have already been studied. Here, we extend the testing to Roche immunoassays and report, for the first time, comprehensive paediatric RIs for 17 endocrine and special chemistry markers. Methods A total of 741 healthy children and adolescents (1 day to <19 years) were recruited and serum samples were analysed for 17 immunoassays on the Roche cobas 8000 e602 Immunoassay Analyzer. Age and sex-specific RIs were established and corresponding 90% confidence intervals (CIs) were calculated in accordance with Clinical and Laboratory Standards Institute guidelines. Results Reference values for all analytes measured required age partitioning, particularly during early life and throughout adolescence. Of the 17 analytes measured, eight required sex partitioning, including ferritin, thyroid stimulating hormone (TSH), total triiodothyronine (TT3) and all fertility/sex hormones, except prolactin. Conclusions This is the first study to determine accurate paediatric RIs for Roche immunoassays. RIs were generally similar to those previously published by CALIPER on other analytical platforms, highlighting the reproducibility of age- and sex-specific trends in reference values observed across the paediatric age range. The RIs established in this study will improve the accuracy of test result interpretation and clinical decision-making in clinical laboratories utilising Roche immunoassays.

Screening of central obesity among normal-weight children and adolescents in Shandong, China

2020 ◽  
pp. 1-25
Author(s):  
Ying-xiu Zhang ◽  
Jian Chen ◽  
Xiao-hui Liu
Keyword(s):  
Children And Adolescents ◽  
Health Risks ◽  
Central Obesity ◽  
Total Population ◽  
Final Analysis ◽  
Normal Weight ◽  
Overweight And Obesity ◽  
Height Ratio ◽  
Waist To Height Ratio ◽  
Age And Sex

Abstract The prevalence of central obesity in total population has been reported in numerous studies. However, information on the prevalence of central obesity within normal category of body mass index (BMI) is scant. In the present study, we examined the profiles of central obesity among normal-weight children and adolescents. A total of 29 516 (14 226 boys and 15 290 girls) normal-weight children and adolescents (excluding underweight, overweight and obesity) aged 7–18 years were included in the final analysis. Central obesity was defined by the international age- and sex-specific cut-offs of waist circumference (WC) and threshold of waist-to-height ratio (WHtR≥0.5). All subjects were classified into four groups (Q1–Q4) according to the age- and sex-specific quartiles of BMI, those in the upper fourth (Q4) were defined as ‘high-normal BMI’, and those in the lower fourth (Q1) were defined as ‘low-normal BMI’. The prevalence of central obesity as measured by WC was 9.90% (95% CI 9.41–10.39%) for boys and 8.11% (95% CI 7.68–8.54%) for girls; by WHtR was 2.97% (95% CI 2.69–3.25%) for boys and 2.44% (95% CI 2.20–2.68%) for girls. Subjects in the ‘high-normal BMI’ group had a much higher prevalence of central obesity than their counterparts in the ‘low-normal BMI’ group (P<0.01). Central obesity was also evident among normal-weight children and adolescents. Our findings suggest that the health risks of children with normal-weight central obesity may be missed when BMI is used alone as a measure, it is meaningful to include WC in the clinical practice and to include the simple message “Keep your waist to less than half your height”.

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 CALIPER Hematology Reference Standards (II)

2020 ◽  
Vol 154 (3) ◽  
pp. 342-352 ◽  
Author(s):  
Victoria Higgins ◽  
Houman Tahmasebi ◽  
Mary Kathryn Bohn ◽  
Alexandra Hall ◽  
Khosrow Adeli
Keyword(s):  
Children And Adolescents ◽  
Hemoglobin Concentration ◽  
Reference Intervals ◽  
Reference Standards ◽  
Reference Database ◽  
Specific Reference ◽  
Mean Corpuscular Hemoglobin ◽  
Healthy Children ◽  
Cell Percentage ◽  
Age And Sex

Abstract Objectives The objective of this study was to establish comprehensive age- and sex-specific reference intervals for hematologic parameters in the CALIPER cohort of healthy children and adolescents. Methods A total of 536 healthy children and adolescents (birth to 21 years) were recruited with informed consent, and whole blood samples were analyzed for 27 hematologic parameters on the Beckman Coulter DxH 520 system. Age- and sex-specific pediatric reference standards were established. Reference values obtained on the DxH 520 were also compared with data obtained on a larger laboratory-based instrument (DxH 900). Results Most hematologic parameters showed significant age- and/or sex-specific changes during growth and development. Of the 27 hematologic parameters, all except four (mean corpuscular hemoglobin concentration, basophil percentage, low hemoglobin density, immature cell percentage) required age partitioning, and eight required sex partitioning. Conclusions This study establishes a robust pediatric hematology reference database that will assist in more accurate test result interpretation. Our data clearly demonstrate significant variation in hematologic parameter concentrations in children and adolescents, necessitating the use of pediatric-specific reference standards.

Distributions of waist circumference and waist-to-height ratio for children and adolescents in Shandong, China

2012 ◽  
Vol 172 (2) ◽  
pp. 185-191 ◽  
Author(s):  
Zhang Ying-Xiu ◽  
Li Ya-Lin ◽  
Zhao Jin-Shan ◽  
Chu Zun-Hua ◽  
Zhou Jing-Yang
Keyword(s):  
Waist Circumference ◽  
Children And Adolescents ◽  
Height Ratio ◽  
Waist To Height Ratio

scholarly journals Biochemical Marker Reference Values across Pediatric, Adult, and Geriatric Ages: Establishment of Robust Pediatric and Adult Reference Intervals on the Basis of the Canadian Health Measures Survey

2015 ◽  
Vol 61 (8) ◽  
pp. 1049-1062 ◽  
Author(s):  
Khosrow Adeli ◽  
Victoria Higgins ◽  
Michelle Nieuwesteeg ◽  
Joshua E Raizman ◽  
Yunqi Chen ◽  
...  
Keyword(s):  
Health Information ◽  
Reference Values ◽  
Biochemical Markers ◽  
Biochemical Marker ◽  
Reference Intervals ◽  
Health Measures ◽  
Physical Measurements ◽  
Canadian Health ◽  
Canadian Health Measures Survey ◽  
Age And Sex

Abstract BACKGROUND Biological covariates such as age and sex can markedly influence biochemical marker reference values, but no comprehensive study has examined such changes across pediatric, adult, and geriatric ages. The Canadian Health Measures Survey (CHMS) collected comprehensive nationwide health information and blood samples from children and adults in the household population and, in collaboration with the Canadian Laboratory Initiative on Pediatric Reference Intervals (CALIPER), examined biological changes in biochemical markers from pediatric to geriatric age, establishing a comprehensive reference interval database for routine disease biomarkers. METHODS The CHMS collected health information, physical measurements, and biosamples (blood and urine) from approximately 12 000 Canadians aged 3–79 years and measured 24 biochemical markers with the Ortho Vitros 5600 FS analyzer or a manual microplate. By use of CLSI C28-A3 guidelines, we determined age- and sex-specific reference intervals, including corresponding 90% CIs, on the basis of specific exclusion criteria. RESULTS Biochemical marker reference values exhibited dynamic changes from pediatric to geriatric age. Most biochemical markers required some combination of age and/or sex partitioning. Two or more age partitions were required for all analytes except bicarbonate, which remained constant throughout life. Additional sex partitioning was required for most biomarkers, except bicarbonate, total cholesterol, total protein, urine iodine, and potassium. CONCLUSIONS Understanding the fluctuations in biochemical markers over a wide age range provides important insight into biological processes and facilitates clinical application of biochemical markers to monitor manifestation of various disease states. The CHMS-CALIPER collaboration addresses this important evidence gap and allows the establishment of robust pediatric and adult reference intervals.

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