CNR Institute of Clinical Physiology and Fondazione G. Monasterio, Laboratory of Cardiovascular Biochemistry, Pisa, Italy.
Peptides. 2012 Jan;33(1):83-6. doi: 10.1016/j.peptides.2011.11.005. Epub 2011 Nov 10.
C-type natriuretic peptide (CNP) is assuming increasing importance in cardiovascular disease, and in adults its plasma levels are related to clinical and functional disease severity. Data are scarce regarding the reference values for CNP in infancy. Aim of this study was to assess the reference intervals for CNP in human healthy newborns and infants. Plasma CNP was measured in 121 healthy children divided into: 41 newborns (age 0-3 days), 24 newborns (4-30 days), 22 infants (1-12 months) and 32 children (1-12 years). A group of 32 healthy adult subjects (age 64 ± 1 years) was also studied. CNP was measured by a specific radioimmunoassay. Between- and within-assay variability resulted ≤ 30 and 20%, respectively and analytical sensitivity 0.77 ± 0.05 pg/tube. Plasma CNP resulted significantly higher in children than in adult subjects (13.6 ± 1.2 pg/ml vs. 7.4 ± 1.0 pg/ml, p=0.030). When the results were analyzed as a function of the age the reference intervals for plasma CNP resulted: 11.6 ± 2.1 pg/ml for newborns (0-3 days), 16.4 ± 3.7 pg/ml for newborns (4-30 days), 15.4 ± 2.7 pg/ml for infants (1-12 months), 13.6 ± 2.3 pg/ml for children (1-12 years) [p=0.01 newborns (4-30 days) vs. adults; p=0.03 infants (1-12 months) vs. adults]. CNP showed the highest concentrations after 12h of life with a peak between 4 and 5 days of life and with a progressive decline afterwards. According to these data at least five different reference intervals for CNP determinations should be used. These observations may be helpful for future clinical application of CNP in human children.
C 型利钠肽（CNP）在心脑血管疾病中越来越受到重视，其在成人中的血浆水平与临床和功能疾病的严重程度有关。关于婴儿 CNP 的参考值的数据很少。本研究旨在评估健康新生儿和婴儿的 CNP 参考区间。测量了 121 名健康儿童的血浆 CNP，这些儿童分为：41 名新生儿（0-3 天龄），24 名新生儿（4-30 天龄），22 名婴儿（1-12 个月龄）和 32 名儿童（1-12 岁）。还研究了 32 名健康成年受试者（年龄 64±1 岁）的 CNP。CNP 采用特异性放射免疫测定法测量。批内和批间变异性分别为≤30%和 20%，分析灵敏度为 0.77±0.05pg/管。儿童的血浆 CNP 明显高于成年受试者（13.6±1.2pg/ml 与 7.4±1.0pg/ml，p=0.030）。当结果按年龄进行分析时，血浆 CNP 的参考区间为：新生儿（0-3 天）为 11.6±2.1pg/ml，新生儿（4-30 天）为 16.4±3.7pg/ml，婴儿（1-12 个月）为 15.4±2.7pg/ml，儿童（1-12 岁）为 13.6±2.3pg/ml[新生儿（4-30 天）与成年组相比 p=0.01，婴儿（1-12 个月）与成年组相比 p=0.03]。CNP 在出生后 12 小时后达到最高浓度，峰值在出生后 4-5 天之间，随后逐渐下降。根据这些数据，至少应该使用五个不同的 CNP 测定参考区间。这些观察结果可能有助于 CNP 在人类儿童中的未来临床应用。
