Ethnicity and sex-specific 99th percentile upper reference limits of high-sensitivity cardiac troponin I among adults in Xinjiang, China

Abstract

ObjectivesTo determine the 99th percentile upper reference limit (URL) of high-sensitivity cardiac troponin I (hs-cTnI) in a healthy population in Xinjiang, China, and investigate the impact of ethnicity, sex, and age on this limit. Design and MethodsFrom September 2018 to March 2022, 5,090 Han and Uyghur adults aged 20–79 years were recruited. After questionnaire screening, 2,970 participants with physical and/or laboratory normality were enrolled. Participants recruited between September 2018 and October 2021 (2,109/2,970) were evaluated by ARCHITECTi2000 to determine the 99th percentile URL of hs-cTnI. The results were then validated in 861/2,970 participants recruited from November 2021 to March 2022. A criterion of ≤ 10% of test results falling outside the original determined value was used to determine whether the newly established reference intervals were valid. ResultsThe hs-cTnI concentration was higher among Uyghurs than among Han participants (p < 0.001). The 99th percentile URLs were 17.52 ng/L for all participants, 18.96 ng/L for Uyghur, and 16.93 ng/L for Han. Hs-cTnI concentration was also correlated with sex and age. In the Han and Uyghur groups, male participants had a higher hs-cTnI concentration than female participants (p < 0.001); the 99th percentile URLs of hs-cTnI among male and female participants were 17.80 vs. 13.67 ng/L and 19.47 vs. 16.52 ng/L, respectively. Stratified by age, hs-cTnI concentrations were higher in participants aged > 60 years than in those of other age categories (p < 0.001), in both the Han and Uyghur groups. Finally, <2% of these test results exceeded the newly established reference, validating the results. ConclusionsThis study established the 99th percentile URLs of hs-cTnI in the Xinjiang. Ethnicity and sex influence the value and should be considered.