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中国人群常见生化分析物的性别和年龄特异性参考区间:基于实际实验室数据的推导

Gender and age-specific reference intervals of common biochemical analytes in Chinese population: Derivation using real laboratory data.

作者信息

Wang Danchen, Ma Chaochao, Zou Yutong, Yu Songlin, Li Honglei, Cheng Xinqi, Qiu Ling, Xu Tengda

机构信息

Peking Union Medical College & Chinese Academy of Medical Science, Peking Union Medical College Hospital, Department of Clinical Laboratory, Beijing, China.

Chinese Academy of Medical Sciences, Peking Union Medical College Hospital, Department of Health Care, Dongcheng District, Beijing, China.

出版信息

J Med Biochem. 2020 Sep 2;39(3):384-391. doi: 10.2478/jomb-2019-0046.

Abstract

BACKGROUND

Indirect sampling methods are not only inexpensive but also efficient for establishing reference intervals (RIs) using clinical data. This study was conducted to select fully normal records to establish ageand gender-specific RIs for common biochemical analytes by laboratory data mining.

METHODS

In total, 280,206 records from 2014 to 2018 were obtained from Peking Union Medical College Hospital. Common biochemical analytes total protein, albumin, total bilirubin (TBil), direct bilirubin (DBil), alanine aminotransferase (ALT), glutamyltranspeptidase (GGT), alkaline phosphatase (ALP), aspartate aminotransferase (AST), lactate dehydrogenase (LDH), potassium, sodium, chlorine, calcium, urea, glucose, uric acid (UA), inorganic phosphorus, creatinine (Cr), total cholesterol, triglyceride, high-density lipoprotein cholesterol, and low-density lipoprotein cholesterol] were measured using an automatic analyzer. Sources of variation were identified by multiple regression analysis. The 2.5th and 97.5th percentiles were calculated as the lower and upper limits of the RIs, respectively.

RESULTS

Gender was the major source of variation among the 13 common biochemical analytes with an rp > 0.15. In contrast to the value listed in the WS/T 404, nearly all RIs established in this study were significantly narrower. Furthermore, age-specific RIs should be determined for DBil, LDH, and urea, whereas gender-specific RIs are suggested for GGT, LDH, and urea.

CONCLUSIONS

We recommend that gender-specific RIs should be established for ALT, AST, GGT, DBil, TBil, UA, and Cr as well as genderand age-specific RIs for urea and ALP. Through indirect sampling, ageand gender-specific RIs for common biochemical analytes were established and analyzed.

摘要

背景

间接抽样方法不仅成本低廉,而且在利用临床数据建立参考区间(RI)方面效率很高。本研究旨在通过实验室数据挖掘来选择完全正常的记录,以建立常见生化分析物的年龄和性别特异性参考区间。

方法

从北京协和医院获取了2014年至2018年的总共280206条记录。使用自动分析仪测量了常见生化分析物,包括总蛋白、白蛋白、总胆红素(TBil)、直接胆红素(DBil)、丙氨酸氨基转移酶(ALT)、γ-谷氨酰转肽酶(GGT)、碱性磷酸酶(ALP)、天冬氨酸氨基转移酶(AST)、乳酸脱氢酶(LDH)、钾、钠、氯、钙、尿素、葡萄糖、尿酸(UA)、无机磷、肌酐(Cr)、总胆固醇、甘油三酯、高密度脂蛋白胆固醇和低密度脂蛋白胆固醇。通过多元回归分析确定变异来源。分别计算第2.5百分位数和第97.5百分位数作为参考区间的下限和上限。

结果

性别是13种常见生化分析物中变异的主要来源,相关系数rp>0.15。与WS/T 404中列出的值相比,本研究中建立的几乎所有参考区间都明显更窄。此外,应确定DBil、LDH和尿素的年龄特异性参考区间,而对于GGT、LDH和尿素,建议确定性别特异性参考区间。

结论

我们建议应为ALT、AST、GGT、DBil、TBil、UA和Cr建立性别特异性参考区间,为尿素和ALP建立性别和年龄特异性参考区间。通过间接抽样,建立并分析了常见生化分析物的年龄和性别特异性参考区间。

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