CALIPER Program, Department of Pediatric Laboratory Medicine, Hospital for Sick Children, Toronto, ON, Canada.
Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, ON, Canada.
Clin Chem Lab Med. 2021 May 7;59(8):1421-1430. doi: 10.1515/cclm-2021-0050. Print 2021 Jul 27.
Rapid development in childhood and adolescence combined with lack of immunoassay standardization necessitates the establishment of age-, sex-, and assay-specific reference intervals for immunochemical markers. This study established reference intervals for 11 immunoassays on the new Siemens Healthineers Atellica® IM Analyzer in the healthy CALIPER cohort.
A total of 600 healthy participants (birth to 18 years) were recruited from the community, and serum samples were collected with informed consent. After sample analysis, age- and sex-specific differences were assessed, and outliers were removed. Reference intervals were established using the robust method (40-<120 participants) or nonparametric method (≥120 participants).
Of the 11 immunoassays studied, nine required age partitioning (i.e., dehydroepiandrosterone-sulfate, estradiol, ferritin, folate, follicle-stimulating hormone, luteinizing hormone, progesterone, testosterone, vitamin B12), and seven required sex partitioning. Free thyroxine and thyroid-stimulating hormone demonstrated no significant age- and/or sex-specific differences.
Overall, the age- and sex-specific trends observed closely mirrored those previously reported by CALIPER on other platforms as well as other internationally recognized studies. However, established lower and upper limits demonstrated some discrepancies between published values from healthy cohorts on alternate analytical systems, highlighting differences between manufacturers and the need for platform-specific reference intervals for informed pediatric clinical decision-making.
儿童和青少年期的快速发育,加上免疫分析标准化的缺乏,使得有必要为免疫化学标志物建立特定于年龄、性别和检测方法的参考区间。本研究在健康的 CALIPER 队列中,为新的西门子 Healthineers Atellica® IM 分析仪上的 11 种免疫检测方法建立了参考区间。
共招募了 600 名来自社区的健康参与者(从出生到 18 岁),并在知情同意的情况下采集血清样本。在分析样本后,评估了年龄和性别特异性差异,并去除离群值。使用稳健法(40-<120 名参与者)或非参数法(≥120 名参与者)建立参考区间。
在所研究的 11 种免疫检测方法中,有 9 种需要按年龄分段(即硫酸脱氢表雄酮、雌二醇、铁蛋白、叶酸、卵泡刺激素、黄体生成素、孕酮、睾酮、维生素 B12),7 种需要按性别分段。游离甲状腺素和促甲状腺激素无明显年龄和/或性别特异性差异。
总体而言,观察到的年龄和性别特异性趋势与 CALIPER 在其他平台上以及其他国际公认的研究报告的趋势非常相似。然而,已建立的上下限与其他分析系统的健康队列的文献值之间存在一些差异,这突出了制造商之间的差异以及为明智的儿科临床决策制定特定于平台的参考区间的必要性。