Closing the Gaps in Pediatric Laboratory Reference Intervals: A CALIPER Database of 40 Biochemical Markers in a Healthy and Multiethnic Population of Children

Abstract

BACKGROUND:Pediatric healthcare is critically dependent on the availability of accurate and precise laboratory biomarkers of pediatric disease, and on the availability of reference intervals to allow appropriate clinical interpretation. The development and growth of children profoundly influence normal circulating concentrations of biochemical markers and thus the respective reference intervals. There are currently substantial gaps in our knowledge of the influences of age, sex, and ethnicity on reference intervals. We report a comprehensive covariate-stratified reference interval database established from a healthy, nonhospitalized, and multiethnic pediatric population.

Pediatric reference intervals for alkaline phosphatase

“…Comparison of our 2.5th and 97.5th percentile results with findings from the CALIPER study [11] demonstrates similar reference limits and age-dependent dynamics (Figure 2). In the first 6 months of life, the upper reference limits of the two studies intersect, but those provided by us are higher than those from CALIPER for a substantial period of time.…”

“…To ensure valid reference intervals when using indirect procedures, great care must be taken in the selection of samples and statistical algorithms. Previous evaluations of the applied algorithm [6,27] and comparison of our results to reference intervals from CALIPER, created using a direct method [11]. The x-axes are scaled differently on the left-and right-hand side of the figure to account for the dynamics in young infants; the x-axis on the right-hand side starts at 61 days.…”

“…Reference intervals from the Canadian CALIPER study [11] were selected for comparison to our results. These reference intervals were created using CLSI C28-A3 statistical guidelines from a representative cohort of 1213 healthy Canadian children.…”

C-reactive protein reference percentiles among pre-adolescent children in Europe based on the IDEFICS study population

“…On the contrary, two other studies reported no sex differences in children. 21,42 Both reported only CRP reference intervals (2.5th and 97.5th percentile) for broad age groups and did not investigate sex differences more closely in between. Surprisingly, in male participants of an adolescent study population even higher CRP concentrations were measured than in female participants.…”

Reference intervals for alkaline phosphatase activity in blood serum in children. Laboratory diagnosis of hypophosphatasia

“…Амери-канской ассоциацией клинической химии (aaCC) были отработаны и представлены референтные зна-чения ЩФ в зависимости от возраста и пола, начи-ная с новорожденных детей (табл. 2) (А) [13].…”