Serum reference intervals of homoarginine, ADMA, and SDMA in the Study of Health in Pomerania

2014 ◽  
Vol 52 (12) ◽  
Author(s):  
Dorothee Atzler ◽  
Edzard Schwedhelm ◽  
Matthias Nauck ◽  
Till Ittermann ◽  
Rainer H. Böger ◽  
...  
Keyword(s):  
At Risk ◽  
Risk Stratification ◽  
Serum Levels ◽  
Reference Intervals ◽  
Specific Reference ◽  
Reference Ranges ◽  
Serum Concentrations ◽  
Improve Risk Stratification ◽  
Patients At Risk ◽  
Age And Sex

AbstractLow circulating homoarginine as well as high levels of asymmetric dimethylarginine (ADMA) and symmetric dimethylarginine (SDMA) have been associated with impaired cardiovascular (CV) outcome and mortality in patients at risk and in the general population. The present study aimed to formulate reference intervals for serum homoarginine, ADMA, and SDMA to improve risk stratification between healthy individuals and individuals at risk.We determined age- and sex-specific reference intervals for homoarginine, ADMA, and SDMA in a subgroup of 1359 healthy participants (no diabetes mellitus, CV disease, increased blood pressure, elevated blood lipids, chronic kidney disease stadium III or IV, or a body mass index >30) of the Study of Health in Pomerania (SHIP) using quantile regression analyses. Homoarginine, ADMA, and SDMA serum concentrations were measured using liquid chromatography-tandem mass spectrometry.Median age of the investigated cohort was 36 (25th; 75th percentile 28; 47) years, with 62% women. Median serum concentrations of homoarginine, ADMA, and SDMA were 2.63 (2.08; 3.32) μmol/L, 0.64 (0.57; 0.73) μmol/L, and 0.43 (0.37; 0.49) μmol/L, respectively. Serum levels of homoarginine, ADMA, and SDMA showed material age- and sex-related differences (p<0.05 for all). Overall reference ranges were 1.41–5.00 and 1.20–5.53 μmol/L (2.5th; 97.5th percentile; for men and women, respectively) for homoarginine, 0.41–0.95 and 0.43–0.96 μmol/L for ADMA, and 0.30–0.67 and 0.27–0.63 μmol/L for SDMA.We formulated for the first time homoarginine, ADMA, and SDMA reference intervals in serum. These reference intervals might be useful for individual CV risk stratification.

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.

Reference intervals of plasma homoarginine from the German Gutenberg Health Study

2016 ◽  
Vol 54 (7) ◽  
Author(s):  
Dorothee Atzler ◽  
Sebastian Appelbaum ◽  
Kathrin Cordts ◽  
Francisco M. Ojeda ◽  
Philipp S. Wild ◽  
...  
Keyword(s):  
At Risk ◽  
General Population ◽  
Risk Stratification ◽  
Population Sample ◽  
Reference Intervals ◽  
Health Study ◽  
Individual Risk ◽  
Specific Reference ◽  
Nucleotide Polymorphisms ◽  
Gutenberg Health Study

AbstractLow circulating homoarginine has been associated with adverse cardiovascular (CV) outcome and mortality in patients at risk and in the general population. The present study aimed to define plasma homoarginine reference intervals from a representative population sample to improve risk stratification between healthy individuals and individuals at risk.We determined age- and sex-specific reference intervals for circulating plasma homoarginine in a subgroup of 786 healthy participants (no CV disease or risk factors) of the Gutenberg Health Study. Homoarginine concentrations were measured using a validated liquid chromatography-tandem mass spectrometry method.Median EDTA plasma homoarginine concentration was 1.88 [25th; 75th percentile, 1.47; 2.41] μmol/L, with lower concentrations in women (1.77 [1.38; 2.26] μmol/L) than in men (2.01 [1.61; 2.56] μmol/L; p<0.001). Sex-specific 2.5th and 97.5th percentiles of reference intervals were 0.84 and 3.89 μmol/L in women and 0.98 and 4.10 μmol/L in men, respectively. Homoarginine concentrations also depended on age and single nucleotide polymorphisms related to the L-arginine:glycine amidinotransferase gene.We provide plasma homoarginine reference intervals in men and women of the general population. The determination of homoarginine levels might be favorable for individual risk stratification.

scholarly journals Using Predictive Modeling and Supervised Machine Learning to Identify Patients at Risk for Venous Thromboembolism Following Posterior Lumbar Fusion

2021 ◽  
pp. 219256822110193
Author(s):  
Kevin Y. Wang ◽  
Ijezie Ikwuezunma ◽  
Varun Puvanesarajah ◽  
Jacob Babu ◽  
Adam Margalit ◽  
...  
Keyword(s):  
Machine Learning ◽  
At Risk ◽  
Venous Thromboembolism ◽  
Risk Stratification ◽  
Predictive Model ◽  
Predictive Modeling ◽  
Lumbar Fusion ◽  
Posterior Lumbar Fusion ◽  
Single Level ◽  
Patients At Risk

Study Design: Retrospective review. Objective: To use predictive modeling and machine learning to identify patients at risk for venous thromboembolism (VTE) following posterior lumbar fusion (PLF) for degenerative spinal pathology. Methods: Patients undergoing single-level PLF in the inpatient setting were identified in the National Surgical Quality Improvement Program database. Our outcome measure of VTE included all patients who experienced a pulmonary embolism and/or deep venous thrombosis within 30-days of surgery. Two different methodologies were used to identify VTE risk: 1) a novel predictive model derived from multivariable logistic regression of significant risk factors, and 2) a tree-based extreme gradient boosting (XGBoost) algorithm using preoperative variables. The methods were compared against legacy risk-stratification measures: ASA and Charlson Comorbidity Index (CCI) using area-under-the-curve (AUC) statistic. Results: 13, 500 patients who underwent single-level PLF met the study criteria. Of these, 0.95% had a VTE within 30-days of surgery. The 5 clinical variables found to be significant in the multivariable predictive model were: age > 65, obesity grade II or above, coronary artery disease, functional status, and prolonged operative time. The predictive model exhibited an AUC of 0.716, which was significantly higher than the AUCs of ASA and CCI (all, P < 0.001), and comparable to that of the XGBoost algorithm ( P > 0.05). Conclusion: Predictive analytics and machine learning can be leveraged to aid in identification of patients at risk of VTE following PLF. Surgeons and perioperative teams may find these tools useful to augment clinical decision making risk stratification tool.

scholarly journals Reference Intervals of Thyroid Hormones and Correlation of BMI with Thyroid Function in Healthy Zhuang Ethnic Pregnant Women

2018 ◽  
Vol 2018 ◽  
pp. 1-8 ◽  
Author(s):  
Yonghong Sheng ◽  
Dongping Huang ◽  
Shun Liu ◽  
Xuefeng Guo ◽  
Jiehua Chen ◽  
...  
Keyword(s):  
Thyroid Hormones ◽  
Pregnant Women ◽  
Thyroid Function ◽  
Reference Intervals ◽  
Thyroid Stimulating Hormone ◽  
Specific Reference ◽  
American Thyroid Association ◽  
Reference Ranges ◽  
Free Triiodothyronine ◽  
Cross Sectional

Ethnic differences in the level of thyroid hormones exist among individuals. The American Thyroid Association (ATA) recommends that an institution or region should establish a specific thyroid hormone reference value for each stage of pregnancy. To date, a limited number of studies have reported the level of thyroid hormones in Chinese minorities, and the exact relationship between BMI and thyroid function in pregnant women is ill. This study was performed to establish trimester-specific reference ranges of thyroid hormones in Zhuang ethnic pregnant women and explore the role of body mass index (BMI) on thyroid function. A total of 3324 Zhuang ethnic health pregnant women were recruited in this Zhuang population-based retrospective cross-sectional study. The values of thyroid stimulating hormone (TSH), free thyroxine (FT4), and free triiodothyronine (FT3) were determined by automatic chemiluminescence immunoassay analyzer. Multivariate linear regression and binary logistic regression were constructed to evaluate the influence of BMI on the thyroid function. The established reference intervals for the serum thyroid hormones in three trimesters were as follows: TSH, 0.02–3.28, 0.03–3.22, and 0.08-3.71 mIU/L; FT4, 10.57–19.76, 10.05–19.23, and 8.96–17.75 pmol/L; FT3, 3.51–5.64, 3.42–5.42, and 2.93–5.03 pmol/L. These values were markedly lower than those provided by the manufacturers for nonpregnant adults which can potentially result in 6.10% to 19.73% misclassification in Zhuang pregnant women. Moreover, BMI was positively correlated with isolated hypothyroxinemia (OR=1.081, 95% CI=1.007–1.161), while the correlation between the BMI and subclinical hypothyroidism was not statistically significant (OR=0.991, 95% CI=0.917–1.072). This is the first study focusing on the reference ranges of thyroid hormones in Guangxi Zhuang ethnic pregnant women, which will improve the care of them in the diagnosis and treatment. We also found that high BMI was positively associated with the risk of isolated hypothyroxinemia.

A multiparametric ICD algorithm for heart failure risk stratification and management: an analysis in clinical practice

EP Europace ◽  
2021 ◽  
Vol 23 (Supplement_3) ◽  
Author(s):  
L Calo" ◽  
V Bianchi ◽  
D Ferraioli ◽  
L Santini ◽  
A Dello Russo ◽  
...  
Keyword(s):  
Heart Failure ◽  
At Risk ◽  
Clinical Practice ◽  
Risk Stratification ◽  
Management Strategies ◽  
Cardiac Resynchronization ◽  
Office Visits ◽  
Increased Risk ◽  
Patients At Risk ◽  
Observation Period

Abstract Funding Acknowledgements Type of funding sources: None. Introduction The HeartLogic algorithm combines multiple implantable cardioverter defibrillator (ICD) sensors to identify patients at risk of heart failure (HF) events. Purpose We sought to evaluate the risk stratification ability of this algorithm in clinical practice. We also analyzed the alert management strategies adopted in the study group and their association with the occurrence of HF events. Methods The HeartLogic feature was activated in 366 ICD and cardiac resynchronization therapy ICD patients at 22 centers. The HeartLogic algorithm automatically calculates a daily HF index and identifies periods IN or OUT of an alert state on the basis of a configurable threshold (in this analysis set to 16). Results The HeartLogic index crossed the threshold value 273 times (0.76 alerts/patient-year) in 150 patients over a median follow-up of 11 months [25-75 percentile: 6-16]. Overall, the time IN the alert state was 11% of the total observation period. Patients experienced 36 HF hospitalizations and 8 patients died of HF (rate: 0.12 events/patient-year) during the observation period. Thirty-five events were associated with the IN alert state (0.92 events/patient-year versus 0.03 events/patient-year in the OUT of alert state). The hazard ratio in the IN/OUT of alert state comparison was (HR: 24.53, 95% CI: 8.55-70.38, p &lt; 0.001), after adjustment for baseline clinical confounders. Alerts followed by clinical actions were associated with a lower rate of HF events (HR: 0.37, 95% CI: 0.14-0.99, p = 0.047). No differences in event rates were observed between in-office and remote alert management. By contrast, verification of HF symptoms during post-alert examination was associated with a higher risk of HF events (HR: 5.23, 95% CI: 1.98-13.83, p &lt; 0.001). Conclusions This multiparametric ICD algorithm identifies patients during periods of significantly increased risk of HF events. The rate of HF events seemed lower when clinical actions were undertaken in response to alerts. Extra in-office visits did not seem to be required in order to effectively manage HeartLogic alerts, while post-alert verification of symptoms seemed useful in order to better stratify patients at risk of HF events.

scholarly journals Age- and sex-specific reference intervals for the serum cystatin C/creatinine ratio in healthy children (0–18 years old)

2019 ◽  
Vol 47 (7) ◽  
pp. 3151-3159 ◽  
Author(s):  
Changjin Liu ◽  
Jing Wen ◽  
Jialin Xiang ◽  
Xuhong Ouyang ◽  
Yan Yang ◽  
...  
Keyword(s):  
Cystatin C ◽  
Pediatric Population ◽  
Age Groups ◽  
Serum Markers ◽  
Reference Intervals ◽  
Specific Reference ◽  
Healthy Children ◽  
Serum Samples ◽  
Serum Cystatin C ◽  
Age And Sex

Objective This study aimed to investigate serum levels of the cystatin C (CysC)/creatinine (Cr) ratio and renal serum markers (CysC, Cr, urea, and uric acid [UA]) for different ages and by sex. We also aimed to establish pediatric reference intervals for the serum CysC/Cr ratio. Methods Serum samples were collected from 4765 healthy children (0–18 years old). Serum markers of renal function were measured, and the CysC/Cr ratio of each participant was calculated and statistically analyzed. Results The renal marker CysC did not substantially change after 1 year old. Cr, urea, and UA levels generally increased with age. However, the serum CysC/Cr ratio steadily decreased with age. The CysC/Cr ratio showed significant differences in age among all age groups and varied with sex, except for in the 1 to 6-year-old groups. The overall serum CysC/Cr ratio in girls was higher than that in boys. Conclusion Reference intervals of the serum CysC/Cr ratio in the pediatric population were established. These intervals need to be partitioned by age and sex.

scholarly journals Age-Specific Reference Ranges of Prostate-Specific Antigen among Saudi Men as a Representation of the Arab Population

2019 ◽  
Vol 28 (3) ◽  
pp. 242-246 ◽  
Author(s):  
Danny Munther Rabah ◽  
Karim Hamda Farhat ◽  
Mohamed Abdullah Al-Atawi ◽  
Mostafa Ahmed Arafa
Keyword(s):  
Prostate Specific Antigen ◽  
Sharp Increase ◽  
Specific Antigen ◽  
Serum Levels ◽  
Specific Reference ◽  
Reference Ranges ◽  
Arab Population ◽  
Blood Samples ◽  
Younger Men ◽  
Sugar Levels

Objective: To describe the reference ranges of serum prostate-specific antigen (PSA) in Saudi men. Materials/Subjects and Methods: Saudi males, aged 30 and above, were invited to participate in the study. Blood samples were taken from each subject to determine serum levels of PSA. Blood sugar levels, lipid profile, and anthropometric measurements were also obtained. Results: Our cohort consisted of 7,814 men; their mean PSA level was 1.24 ng/mL. The majority (90.5%) had PSA values between 0 and 2.5 ng/mL. The median PSA and the 95th percentile increased steadily with age. There was a sharp increase in the 95th percentile, from 3.8 ng/mL in men between 60 and 70 years old to 6.9 ng/mL in men over 71 years old. The 95th percentiles of PSA serum levels were lower in Saudi men than in the general population. Conclusions: PSA serum levels in Saudi men are lower than in other communities. Creating age-specific reference ranges could improve the sensitivity of the PSA tests by allowing the detection of treatable tumors in younger men if the threshold of 4.0 ng/mL is lowered. Furthermore, unnecessary biopsies among older men may be avoided if the threshold is increased.

Sign in / Sign up

Export Citation Format

Share Document