Complex Biological Pattern of Fertility Hormones in Children and Adolescents: A Study of Healthy Children from the CALIPER Cohort and Establishment of Pediatric Reference Intervals

Konforte, Danijela; Shea, Jennifer; Kyriakopoulou, Lianna; Colantonio, David; Cohen, Alma; Shaw, Julie; Bailey, Dana; Chan, Man Khun; Armbruster, David; Adeli, Khosrow

doi:10.1373/clinchem.2013.204123

Cited by 84 publications

(57 citation statements)

References 30 publications

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“…First, previous CALIPER studies have determined that, for the creation of reference intervals, certain analytes (e.g., creatinine, albumin, and ALT) show sex differences and, therefore, must be partitioned accordingly (7,16,27 ). However, due to sample size limitations, we were unable to assess the appropriateness of partitioning CV I and CV G by sex.…”

Section: Discussionmentioning

confidence: 92%

“…This is especially crucial given the many changes associated with childhood and teenage development. Previous CALIPER studies have highlighted the substantial differences between pediatric and adult reference intervals (7,15,16 ) and the effects of fasting and sampling time in a pediatric cohort (8 ). However, addressing this gap in information relevant to the pediatric population presents particular challenges, including the acquisition of samples and the necessary introduction of age partitioning to provide an accurate estimate of CV G .…”

Section: Discussionmentioning

confidence: 99%

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Pediatric Within-Day Biological Variation and Quality Specifications for 38 Biochemical Markers in the CALIPER Cohort

et al. 2014

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BACKGROUND:Studies of biological variation provide insight into the physiological changes that occur within and between study participants. Values obtained from such investigations are important for patient monitoring and for establishing quality specifications. In this study we evaluated the short-term biological variation of 38 chemistry, lipid, enzyme, and protein analytes in a pediatric population, assessed the effect of age partitions on interindividual variation, and compared the findings to adult values.

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Section: Discussionmentioning

confidence: 92%

Section: Discussionmentioning

confidence: 99%

Pediatric Within-Day Biological Variation and Quality Specifications for 38 Biochemical Markers in the CALIPER Cohort

et al. 2014

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“…However, determining population reference values is a major challenge, requiring selection and recruitment of large numbers of healthy individuals representing relevant demographic groups. The Canadian Laboratory Initiative on Pediatric Reference Intervals (CALIPER) 5 is a national program aimed at addressing the gaps in pediatric reference intervals (1)(2)(3). CALIPER has been establishing a comprehensive database of ageand sex-stratified reference intervals for pediatric disease biomarkers.…”

confidence: 99%

Biochemical Marker Reference Values across Pediatric, Adult, and Geriatric Ages: Establishment of Robust Pediatric and Adult Reference Intervals on the Basis of the Canadian Health Measures Survey

et al. 2015

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BACKGROUND Biological covariates such as age and sex can markedly influence biochemical marker reference values, but no comprehensive study has examined such changes across pediatric, adult, and geriatric ages. The Canadian Health Measures Survey (CHMS) collected comprehensive nationwide health information and blood samples from children and adults in the household population and, in collaboration with the Canadian Laboratory Initiative on Pediatric Reference Intervals (CALIPER), examined biological changes in biochemical markers from pediatric to geriatric age, establishing a comprehensive reference interval database for routine disease biomarkers. METHODS The CHMS collected health information, physical measurements, and biosamples (blood and urine) from approximately 12 000 Canadians aged 3–79 years and measured 24 biochemical markers with the Ortho Vitros 5600 FS analyzer or a manual microplate. By use of CLSI C28-A3 guidelines, we determined age- and sex-specific reference intervals, including corresponding 90% CIs, on the basis of specific exclusion criteria. RESULTS Biochemical marker reference values exhibited dynamic changes from pediatric to geriatric age. Most biochemical markers required some combination of age and/or sex partitioning. Two or more age partitions were required for all analytes except bicarbonate, which remained constant throughout life. Additional sex partitioning was required for most biomarkers, except bicarbonate, total cholesterol, total protein, urine iodine, and potassium. CONCLUSIONS Understanding the fluctuations in biochemical markers over a wide age range provides important insight into biological processes and facilitates clinical application of biochemical markers to monitor manifestation of various disease states. The CHMS-CALIPER collaboration addresses this important evidence gap and allows the establishment of robust pediatric and adult reference intervals.

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“…Great efforts have been undertaken to address these generally recognized issues (10,11 ). The Canadian Laboratory Initiative on Pediatric Reference Intervals (CALIPER) 4 provides sex-specific reference intervals from birth to adulthood for Ͼ80 biochemical analytes derived from a population of Ͼ8600 healthy children (6,(12)(13)(14)(15). The continuous dynamics for many of the examined analytes are acknowledged and carefully considered in the selection of age partitions.…”

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confidence: 99%

Age- and Sex-Specific Dynamics in 22 Hematologic and Biochemical Analytes from Birth to Adolescence

et al. 2015

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BACKGROUND Pediatric laboratory test results must be interpreted in the context of interindividual variation and age- and sex-dependent dynamics. Reference intervals as presently defined for separate age groups can only approximate the age-related dynamics encountered in pediatrics. Continuous reference intervals from birth to adulthood are not available for most laboratory analytes because of the ethical and practical constraints of defining reference intervals using a population of healthy community children. We applied an indirect method to generate continuous reference intervals for 22 hematologic and biochemical analytes by analyzing clinical laboratory data from blood samples taken during clinical care of patients. METHODS We included samples from 32 000 different inpatients and outpatients (167 000 samples per analyte) from a German pediatric tertiary care center. Measurements were performed on a Sysmex-XE 2100 and a Cobas Integra 800 during clinical care over a 6-year period. The distribution of samples considered normal was estimated with an established indirect statistical approach and used for the calculation of reference intervals. RESULTS We provide continuous reference intervals from birth to adulthood for 9 hematology analytes (hemoglobin, hematocrit, red cell indices, red cell count, red cell distribution width, white cell count, and platelet count) and 13 biochemical analytes (sodium, chloride, potassium, calcium, magnesium, phosphate, creatinine, aspartate transaminase, alanine transaminase, γ-glutamyltransferase, alkaline phosphatase, lactate dehydrogenase, and total protein). CONCLUSIONS Continuous reference intervals capture the population changes in laboratory analytes during pediatric development more accurately than age groups. After local validation, the reference intervals provided should allow a more precise consideration of these dynamics in clinical decision making.

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Complex Biological Pattern of Fertility Hormones in Children and Adolescents: A Study of Healthy Children from the CALIPER Cohort and Establishment of Pediatric Reference Intervals

Cited by 84 publications

References 30 publications

Pediatric Within-Day Biological Variation and Quality Specifications for 38 Biochemical Markers in the CALIPER Cohort

Pediatric Within-Day Biological Variation and Quality Specifications for 38 Biochemical Markers in the CALIPER Cohort

Biochemical Marker Reference Values across Pediatric, Adult, and Geriatric Ages: Establishment of Robust Pediatric and Adult Reference Intervals on the Basis of the Canadian Health Measures Survey

Age- and Sex-Specific Dynamics in 22 Hematologic and Biochemical Analytes from Birth to Adolescence

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