scholarly journals Age- and Sex-Specific TSH Upper-Limit Reference Intervals in the General French Population: There Is a Need to Adjust Our Actual Practices

2020 ◽  
Vol 9 (3) ◽  
pp. 792 ◽  
Author(s):  
Véronique Raverot ◽  
Maxime Bonjour ◽  
Juliette Abeillon du Payrat ◽  
Pauline Perrin ◽  
Florence Roucher-Boulez ◽  
...  
Keyword(s):  
Reference Values ◽  
Adult Life ◽  
Reference Value ◽  
Daily Practice ◽  
Reference Interval ◽  
Reference Intervals ◽  
Age Group ◽  
Upper Limit ◽  
Tertiary Center ◽  
Age And Sex

It is well known that thyroid dysfunction increases with age. This study is aimed to determine reference intervals, in males and females, suitable for thyroid disease exploration during adult life using routinely collected serum thyrotropin (TSH) data in a tertiary center from 2007 to 2018. Over 11 years, 295,775 TSH levels were measured in a single lab. Among the 156,025 TSH results available for analysis, 90,538 values were from female subjects, 82,019 were from patients aged >60 years and 26,825 were from patients aged >80 years. By using an indirect approach, we determined reference values of TSH adapted to age and sex, and we then evaluated the proportion of patients who would have been reclassified with these reference values. The median TSH ranged from 1.2–1.4 mUI/L during the study period. The upper limit of reference range of TSH increased with age; in females the median to 97.5th percentile values increased continuously from the age of 30 years to the oldest age group. Using new calculated reference values in patients with TSH above the conventional upper-limit reference value (4 mUI/L), the proportion of results reclassified as within the reference interval among patients aged >60 years ranged, according to age group, from 50.5% to 65.1% of females and from 33.0% to 37.7% of males. The use of TSH age-specific and sex-specific upper-limit reference values led to the reclassification of a great number of samples, notably among women. This suggests that age-specific TSH upper-limit reference intervals in daily practice should be used in order to avoid misclassification.

scholarly journals Complex Reference Values for Endocrine and Special Chemistry Biomarkers 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. 1063-1074 ◽  
Author(s):  
Khosrow Adeli ◽  
Victoria Higgins ◽  
Michelle Nieuwesteeg ◽  
Joshua E Raizman ◽  
Yunqi Chen ◽  
...  
Keyword(s):  
Reference Values ◽  
Reference Value ◽  
Reference Intervals ◽  
Specific Reference ◽  
Blood Samples ◽  
Health Measures ◽  
Laboratory Test Results ◽  
Canadian Health ◽  
Canadian Health Measures Survey ◽  
Age And Sex

Abstract BACKGROUND Defining laboratory biomarker reference values in a healthy population and understanding the fluctuations in biomarker concentrations throughout life and between sexes are critical to clinical interpretation of laboratory test results in different disease states. The Canadian Health Measures Survey (CHMS) has collected blood samples and health information from the Canadian household population. In collaboration with the Canadian Laboratory Initiative on Pediatric Reference Intervals (CALIPER), the data have been analyzed to determine reference value distributions and reference intervals for several endocrine and special chemistry biomarkers in pediatric, adult, and geriatric age groups. METHODS CHMS collected data and blood samples from thousands of community participants aged 3 to 79 years. We used serum samples to measure 13 immunoassay-based special chemistry and endocrine markers. We assessed reference value distributions and, after excluding outliers, calculated age- and sex-specific reference intervals, along with corresponding 90% CIs, according to CLSI C28-A3 guidelines. RESULTS We observed fluctuations in biomarker reference values across the pediatric, adult, and geriatric age range, with stratification required on the basis of age for all analytes. Additional sex partitions were required for apolipoprotein AI, homocysteine, ferritin, and high sensitivity C-reactive protein. CONCLUSIONS The unique collaboration between CALIPER and CHMS has enabled, for the first time, a detailed examination of the changes in various immunochemical markers that occur in healthy individuals of different ages. The robust age- and sex-specific reference intervals established in this study provide insight into the complex biological changes that take place throughout development and aging and will contribute to improved clinical test interpretation.

scholarly journals From evidence to practice: development of web-based Dutch lipid reference values

2021 ◽  
Author(s):  
N. S. Nurmohamed ◽  
D. Collard ◽  
J. W. Balder ◽  
J. A. Kuivenhoven ◽  
E. S. G. Stroes ◽  
...  
Keyword(s):  
The Netherlands ◽  
Reference Values ◽  
Plasma Lipids ◽  
Digital Health ◽  
Reference Value ◽  
Lipid Lowering ◽  
Lipid Lowering Therapy ◽  
Lowering Therapy ◽  
Cascading Style Sheets ◽  
Age And Sex

Abstract Introduction In the Netherlands, the total number of yearly measured lipid profiles exceeds 500,000. While lipid values are strongly affected by age and sex, until recently, no up-to-date age- and sex-specific lipid reference values were available. We describe the translation of big-cohort lipid data into accessible reference values, which can be easily incorporated in daily clinical practice. Methods Lipid values (total cholesterol, LDL cholesterol, HDL cholesterol and triglycerides) from all healthy adults and children in the LifeLines cohort were used to generate age- and sex-specific percentiles. A combination of RStudio, Cascading Style Sheets and HyperText Markup Language was used to interactively display the percentiles in a responsive web layout. Results After exclusion of subjects reporting cardiovascular disease or lipid-lowering therapy at baseline, 141,611 subjects were included. On the website, input fields were created for age, sex and all main plasma lipids. Upon input of these values, corresponding percentiles are calculated, and output is displayed in a table and an interactive graph for each lipid. The website has been made available in both Dutch and English and can be accessed at www.lipidtools.com. Conclusion We constructed the first searchable, national lipid reference value tool with graphical display in the Netherlands to use in screening for dyslipidaemias and to reduce the underuse of lipid-lowering therapy in Dutch primary prevention. This study illustrates that data collected in big-cohort studies can be made easily accessible with modern digital techniques and preludes the digital health revolution yet to come.

scholarly journals Reference values of plasma homocysteine in Cuban children and adults

2020 ◽  
Vol 0 (0) ◽  
Author(s):  
Alina Concepción Alvarez ◽  
Ivette Camayd Viera ◽  
Lisy Vento Buigues ◽  
Yanet Fernández Martínez ◽  
Eraida Hernández ◽  
...  
Keyword(s):  
Reference Values ◽  
High Performance ◽  
Age Groups ◽  
Coffee Consumption ◽  
Reference Interval ◽  
Reference Intervals ◽  
Multifactorial Diseases ◽  
Weak Association ◽  
Different Populations ◽  
Cuban Population

AbstractObjectivesHomocysteine (Hcy) is a nonessential amino acid, produced by the demethylation of methionine. High Hcy levels, or hyperhomocysteinemia, have been associated with genetic and multifactorial diseases. Hcy reference values may vary between different populations, as Hcy levels are affected by factors such as sex, age, diet, smoking, and coffee consumption. The estimation reference interval (RI) allows to establish the normal values of this marker in population. At present, these levels are unknown in Cuba. The aim of this work is to estimate the Hcy reference intervals in Cuban children and adults.MethodsTotal Hcy concentration was quantified by high performance liquid chromatography (HPLC) in plasma. Hcy levels were evaluated in samples from 507 healthy individuals (260 children, 247 adults).ResultsRIs were estimated by nonparametric methods. We found significant differences between both age groups, but we did not find significant differences between sexes, within these groups. The established ranges were 2.56–14.55 µM and 3.63–17.19 µM for children and adults, respectively. Also, we observed a weak association between Hcy levels and age in both sex groups.ConclusionsThis is the first study that assesses Hcy reference values in Cuban population. Our results will allow the introduction of Hcy as a biochemical marker in laboratory testing.

Are the currently used reference intervals for creatine kinase (CK) reflecting the general population? The Tromsø Study

2012 ◽  
Vol 50 (5) ◽  
Author(s):  
Hallvard Lilleng ◽  
Stein Harald Johnsen ◽  
Tom Wilsgaard ◽  
Svein Ivar Bekkelund
Keyword(s):  
Creatine Kinase ◽  
General Population ◽  
Reference Interval ◽  
Reference Intervals ◽  
Control Analysis ◽  
Age Group ◽  
Background Population ◽  
Norwegian Population ◽  
Reference Limits ◽  
Laboratory Reference

AbstractLaboratory reference intervals are not necessarily reflecting the range in the background population. This study compared creatine kinase (CK) reference intervals calculated from a large sample from a Norwegian population with those elaborated by the Nordic Reference Interval Project (NORIP). It also assessed the pattern of CK-normalization after standardized control analyses.New upper reference limits (URL) CK values were calculated after exclusion of individuals with risk of hyperCKemia and including individuals with incidentally detected hyperCKemia after they had completed a standardized control analysis. After exclusion of 5924 individuals with possible causes of hyperCKemia, CK samples were analyzed in 6904 individuals participating in the 6th survey of The Tromsø Study. URL was defined as the 97.5 percentile.New URL in women was 207 U/L. In men <50 years it was 395 U/L and in men ≥50 years 340 U/L. In individuals with elevated CK, normalization grade after control analysis was inversely correlated to the CK level (p<0.04).URL CK values in women and in men <50 years of age were in accordance with URL CK values given by the NORIP. In men ≥50 years, a higher URL was found and the findings suggest an upward adjustment of URL in this age group.

scholarly journals Reference Intervals (RIs) of Lipid Parameters for Nepalese Population

2018 ◽  
Vol 6 (4) ◽  
pp. 366-372
Author(s):  
R.V. Mahato ◽  
R.K. Singh ◽  
A. M. Dutta ◽  
K. Ichihara ◽  
M. Lamsal
Keyword(s):  
Total Cholesterol ◽  
Reference Values ◽  
Clinical Laboratory ◽  
Local Population ◽  
Density Lipoprotein ◽  
Physical Exertion ◽  
Hdl Cholesterol ◽  
Reference Interval ◽  
Reference Intervals ◽  
Lipoprotein Cholesterol

Introduction: Reference interval (RIs) is the range of values provided by laboratory scientists in a convenient and practical form to support clinician in interpreting observed values for diagnosis, treatment and monitoring of a disease. Laboratories in Nepal uses RIs, provided in the kit inserts by the manufacturers or from the scientific literature, established for western/European population. It is well known that population across the globe differs physiologically, genetically; race, ethnically, lifestyle, food habits and diet which have great impact on the reference values. Thus, it is inappropriate to use RIs that do not represent the local population. This approach highlights for establishing reference values in Nepalese population using the IFCC-CRIDL guidelines published in (C28-A3). Objectives: The objective of this study is to analyze blood lipids concentration in apparently healthy Nepalese population to set up reference values for total cholesterol (TC), triglycerides (TG), High Density Lipoprotein-cholesterol (HDL-C) and Low Density Lipoprotein-cholesterol (LDL-C) and compare with the internationally recommended values. Methods: Reference individuals selected from healthy volunteers according to the IFCC/C-RIDL protocol in (C28 –A3). Volunteers were requested to avoid excessive physical exertion/exercise/excessive eating and drinking and fast overnight for 10-12 hour. Blood samples were collected from 120 subjects from each five centers of the country between 7:00-10:00 am, serum were separated and refrigerated at -20 in a cryo-vials. Finally, 617 samples were transported to Yamaguchi University, Graduate School of Medicine, Ube, Japan for analysis in dry Ice and 30 parameters were measured by fully automated biochemistry analyzer, Beckman Coulter (BC480) in the clinical laboratory. Results: A reference interval for each parameter was calculated from the 95% reference intervals ranging from 2.5% and 97.5% percentiles and, arithmetic mean + 2 SD were also calculated. The 95% reference range for total cholesterol (2.53-6.14), triglyceride was(0.42-3.32),for HDL Cholesterol was (0.28-1.46), for LDL was(1.05-4.00) and for VLDL was (0.054-0.92) for Nepalese population. Conclusion: Nepalese clinicians can take into consideration of reference lipid values of this study for diagnosis, treatment and monitoring of disease. Int. J. Appl. Sci. Biotechnol. Vol 6(4): 366-372

scholarly journals Reference Interval for Renal Profile parameters in North Indian Population from Rajasthan

2015 ◽  
Vol 1 (5) ◽  
pp. 233
Author(s):  
Dharmveer Yadav ◽  
Monika Gupta ◽  
Sandhya Mishra ◽  
Praveen Sharma
Keyword(s):  
Uric Acid ◽  
Reference Values ◽  
Indian Population ◽  
Reference Interval ◽  
Progressive Increase ◽  
Reference Intervals ◽  
North Indian Population ◽  
The North ◽  
Indian Origin ◽  
Objective Reference

Objective: Reference intervals are an essential part of laboratory medicine. Current study was planned to evaluate renal parameters in the healthy defined group of individuals which would serve as reference values of renal parameters for the North Indian population from Rajasthan.Design & Methods: Present study was conducted on 2021 apparently healthy individuals of North Indian origin ranging in age from 15-60 years, were selected randomly using defined criteria. Fasting samples were analyzed for Urea, Creatinine, Uric Acid, Sodium, Potassium and Chloride. Data were analyzed for middle 95 percentile (2.5th-97.5th percentile), median and 95% confidence interval using SPSS software package version 10.0.Result: RI for Urea, Creatinine and uric acid were lower in female (16-42mg/dl, 0.6-1.2mg/dl, 2.4-6.8mg/dl) as compared to male (17.00-44.35mg/dl, 0.7-1.5mg/dl, 2.8-7.2mg/dl). There was a progressive increase in urea, uric acid and Creatinine with increase in age. Though no appreciable differences could be observed in respect to most of renal parameters in rural versus urban, a wider range for uric acid was observed in urban population (2.50-7.20mg/dl). Except for Na+, K+ and Cl-, rest of parameters i.e. urea, creatinine, uric acid were higher range in obese as compared to non obese (17-45 Vs 17-44, 0.66-1.5 Vs 0.60-1.40, 2.5-7.4 Vs 2.5-7.0). Uric acid level was also found to be higher in non vegetarian population (2.6-7.5mg/dl).Conclusion: Findings of this study provide sex, age, BMI, habitat and diet specific renal function reference values to be used for North Indian population.

Reference intervals for thyreotropin and thyroid hormones for healthy adults based on the NOBIDA material and determined using a Modular E170®

2008 ◽  
Vol 46 (9) ◽  
Author(s):  
Lennart Friis-Hansen ◽  
Linda Hilsted
Keyword(s):  
Thyroid Hormones ◽  
Reference Interval ◽  
Reference Intervals ◽  
Healthy Adults ◽  
Free Triiodothyronine ◽  
Thyroglobulin Antibodies ◽  
Men And Women ◽  
Blood Samples ◽  
Upper Limit

Abstract: The aim of the present study was to establish Nordic reference intervals for thyreotropin (TSH) and the thyroid hormones in heparinized plasma.: We used 489 heparinized blood samples, collected in the morning, from the Nordic NOBIDA reference material, from healthy adults without medication. TSH, thyroxine, free thyroxine, triiodothyronine, free triiodothyronine, and thyroglobulin antibodies (Tg-ab) were measured using assays for Roche Modular E170: The measured concentrations for the thyroid hormones, but not TSH, followed a Gaussian distribution. There were more TPO-ab and Tg-ab positive women than men. After exclusion of the TPO-ab and the Tg-ab positive individuals, the reference interval TSH was 0.64 (0.61–0.72) to 4.7 (4.4–5.0) mIU/L. The exclusion of these ab-positive samples also minimized the differences in TSH concentrations between the sexes and the different Nordic countries. For the thyroid hormones, there were only minor differences between the reference intervals between the Nordic populations and between men and women. These reference intervals were unaffected by removal of the TPO-ab and TG-ab positive samples.: The upper limit of the TSH reference interval in our study is high compared to some other recent reports. This could be due to blood sampling in the morning. Furthermore, the Roche platform gives slightly higher results than other platforms. The number and distribution of the samples in the NOBIDA material makes it suitable for the determination of hormone Nordic reference intervals.Clin Chem Lab Med 2008;46:1305–12.

scholarly journals What is the Normal Value of Tpe Interval and Corrected Tpe Interval?

Acta Medica ◽  
2020 ◽  
Vol 51 (4) ◽  
pp. 10-15
Author(s):  
Hasan Koca ◽  
Mevlüt Koç
Keyword(s):  
Standard Deviation ◽  
Normal Population ◽  
Daily Practice ◽  
Reference Interval ◽  
Healthy Population ◽  
Limit Value ◽  
Upper Limit ◽  
Normal Reference ◽  
Increased Risk ◽  
End Distance

Objective: Increased T wave peak and end distance (Tpe interval) shows abnormal spread in ventricular repolarization, it is associated with increased risk of ventricular arrhythmia and poor prognosis. However, Tpe interval, corrected Tpe (Tpe-c) upper limit value, and normal reference interval have not been reported in healthy population. In our study, it was aimed to determine the normal reference range of Tpe and Tpe-c interval in healthy population. Materials and Methods: 414 healthcare professionals who had no complaints were included in the study. Tpe and Tpe-c measurements of all patients were performed on 12-lead electrocardiography taken at rest. Average and standard deviation, median, minimum, maximum, 95% confidence intervals (95% CI) values of these parameters were obtained. Results: According to the data obtained in our study; Tpe mean and standard deviation, median, minimum, and maximum values were found to be 70.3 ± 12.3 ms, 70 ms, 50 ms and 100 ms, respectively. The 95% CI value of the Tpe interval was detected as 50-90 ms. Tpe-c mean and standard deviation, median, minimum, and maximum values were found to be 76.1 ± 14.6 ms, 75 ms, 48 ms and 128 ms, respectively. The 95% CI of the Tpe-c interval was detected as 53-100 ms. It was determined that Tpe and Tpe-c intervals were not affected by demographic and clinical parameters. Conclusion: As a result of our study, it was determined that the upper limit of Tpe and Tpe-c interval values in adult, not-elderly and healthy normal population were 90 ms and 100 ms, respectively. It was thought that this information could be used for prolonged Tpe interval, which shows an increased risk of arrhythmia in daily practice. However, it was concluded that studies should be done in other communities and races on this subject as well.

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.

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