Age- and Sex-Specific Pediatric Reference Intervals of Serum Electrolytes in Jilin Province of China Using the A Priori Approach

Abstract

Objectives The purpose of this study was to establish age- and sex-specific pediatric reference intervals of serum potassium (K), sodium (Na), chlorine (Cl), calcium (Ca), magnesium (Mg), and phosphorus (P) using a direct sampling technique. Methods In accordance with the a priori approach, healthy individuals (n = 6,466, aged 1 month to <18 years) were enrolled from five regions in Jilin Province, China, and all analytes were performed in the center laboratory. Reference intervals were divided according to the regression tree and Harris and Boyd’s method, and then they were calculated by the nonparametric rank method. The dynamic changes of reference intervals were evaluated by the lambda-mu-sigma (LMS) method. Results Reference intervals of serum Na and Ca were divided into three age-specific partitions. The concentrations of K, Cl, and Mg remained stable with age. However, only dramatic sex-specific changes of P were shown in those 11 to less than 13 years old and 13 to less than 15 years old, with an earlier peak time in females than in males. The correlation between Na and Cl was the strongest among all serum electrolytes (r = 0.31). Conclusions Serum electrolyte reference intervals for children and adolescents were established by regression tree, z test, and the LMS method, which provide a more accurate interpretation for diagnosis and prognosis evaluation of clinical pediatric diseases.

Reference Intervals for 26 Common Biochemical Analytes in Term Neonates in Jilin Province, China

“…The manufacturer RIs were less reliable in the evaluation of clinical applicability before use in Chinese laboratories, because they were generally based on Caucasian people and lacked data on children. The RIs of Cl, K and Na were similar to those from reagent inserts and previous ndings for children and adolescents [4]. Therefore, it seemed that the three electrolytes remained relatively stable in one's life.…”

“…Previous research has found that the differences in RIs of analytes are due to their complex patterns of biological sources of variations, such as region, race, diet, and more individual characteristic [1,2]. Data from the studies we have published con rms that establishing age-and sexappropriate local RIs is more accurate and reliable for providing clinical decision support, especially in pediatrics [3][4][5][6].…”

“…The samples were transported to the laboratory and centrifuged at 1200 ×g for 10 min within 1 h after collection. Specimens that were icteric, hemolyzed, or lipemic were removed prior to analysis, and then the activity or concentration of 26 biochemical analytes were determined on the VITROS 5600 Integrated Quali ed laboratory pro ciency and staff training were described in the research conducted in the same period [3,4]. Analytical procedures were performed according to the manufacturer's instructions and laboratory protocols, including regular maintenance, function checks, calibration, and internal quality control.…”

Establishment of age‐ and sex‐specific reference intervals for serum liver function tests in pediatric population aged 1–<18 years: A prospective study

“…In particular, all responses to these were voluntary. The exclusion criteria, described in detail in previous publications, 8 were as follows:…”

“…In particular, all responses to these were voluntary. The exclusion criteria, described in detail in previous publications, 8 were as follows: ① Presence of acute or chronic diseases which require medical intervention; ② Weight and height more than 10% of the average at the same-sex; ③ Use of medications in the past 2 weeks; ④ Surgery ⑫ White blood cell count <3.0 × 10 9 /l or >12.0 × 10 9 /l; ⑬ Hemoglobin <120 g/l (male) or <110 g/l (female).…”