Abstract
Age- and sex-specific reference intervals (RIs) for myocardial enzyme activity of children and adolescents are not available in China. Our study aimed to establish age- and gender-related RIs for AST, LDH, CK, and CKMB activity in healthy Chinese Han population aged 1∼<18 years. Healthy Han children and adolescents (n = 6322, 1∼<18 years old) were assessed from completed questionnaires and defined criteria from communities and schools in 5 administrative districts of Jilin Province from September 2017 to December 2018. Measurements of AST, LDH, CK, and CKMB activity were performed on the VITROS 5600 Integrated System. Percentiles of enzyme activity were completed by LMS. RIs were established by Medcalc according to the EP28-A3c guidelines issued by the Clinical and Laboratory Standards Institute. AST declined rapidly during 1∼<6 years and had been subsided during 11∼<18 years, though LDH decreased at a steady rate. CK activity stabilized while CKMB showed a downward trend. Sex differences started after age 12 when males presented higher results. There were significant differences comparing with domestic and other countries' experiments which applied similar methodologies. Enzymes were associated with age and sex, while age had greater impact. We established age- and sex-specific RIs of serum AST, LDH, CK, and CKMB activities for Chinese children and adolescents using the VITROS 5600 Integrated System for the first time. These data will lay the groundwork for the next horizon in pediatric RIs as well as improve test result interpretation for pediatric illness.
Highlights
Reference interval (RI) is a global research hotspot currently, referring to the range defined by 2.5 percentile and 97.5 percentile of a certain indicator among healthy population in most cases
Considering the effects of exercise intensity on myocardial enzymes [27, 28], RIs were initially divided into 1∼
Strengths. e VITROS 5600 Integrated System is mostly used in the emergency laboratory; it is rarely used for establishing RIs in a large-scale population worldwide
Summary
Reference interval (RI) is a global research hotspot currently, referring to the range defined by 2.5 percentile and 97.5 percentile of a certain indicator among healthy population in most cases. Wu et al [6] found that lower limit of the platelet interval in Chinese Han adults was slightly lower than that of the peer group in the United States [7] and Malaysia [8], and RIs of white blood cell count and neutrophil count were lower than those of the homologous US population [7] while higher than those of the Africans [9]; Oliver’s research [10] showed that RIs of certain biochemical indicators of the aged living in Asmara, Eritrea, were higher than those of Caucasians and lower than those of South Africans. The actual upper limit of total bilirubin was 2 times higher than it was recommended by the Eritrean Ministry of Health; the median of creatine kinase (CK) activity of healthy black adults was about twice higher than Caucasians in both sexes [11]. erefore, RIs establishment must be “adapted to local conditions,” or they cannot fully exert their effectiveness
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